Silver dressings
for antimicrobial effect

Advanced wound care with silver dressings

Silver dressings are the up-to-date wound care products intended to manage bioburden in acute and chronic wounds. The silver is used in various forms in the wound dressings.

 

Recommended use of silver dressings

Silver dressings are recommended for acute or chronic wounds with, or at risk of, a high level of bioburden or local infection. The wound infection continuum that describes the stages of impact microbes have on a wound proposes silver dressings for wounds that present localized (overt or covert), spreading or systemic infection.1)

It follows that the greater role silver dressings play is to

  • reduce bioburden in infected or colonized wounds and to
  • act as an antimicrobial barrier for wounds at high risk of infection or re-infection2) and not to directly promote the healing of the wound.

Note: The use of silver dressings should also be combined with other aspects of standard wound care protocols such as a holistic assessment of the patient as well as the wound, the management of underlying comorbidities and appropriate wound bed preparation.3)

The two-week challenge

Antimicrobial dressings were recommended initially for a period of two weeks, to be followed by an extensive assessment of the wound and the patient to adapt further wound management.3)

These two weeks may be used to ‘challenge’ the efficacy of silver dressings.2)

If after two weeks

  • the wound has improved, but there are still signs of infection, it may be clinically legitimate to continue the application of silver dressings with further regular assessment
  • the wound has improved and there aren’t any signs or symptoms of wound infection, the treatment with silver dressing should be stopped
  • no improvement in the wound has been observed, the silver-dressing treatment should be stopped and an alternative treatment with a different antimicrobial agent considered.2)

 

Choosing the dressing on the basis of patient and wound needs

Askina® Calgitrol®, and in general silver dressings, are available in different forms. The choice of dressing depends on the availability of the dressings in the clinical setting and of course on the needs of the wound and the patient, e.g. exudate level, wound depth, need for conformability, odor control, ease of removal and safety.2) 

Appication recommendations: one technology, three products

Askina® Calgitrol®: Application Recommendations

The Askina® Calgitrol® primary dressing range is available in three different forms. Its ionic silver alginate matrix provides antimicrobial barrier and helps prevent contamination from external bacteria. In the presence of wound exudate, the silver alginate matrix helps maintain a moist wound environment conducive to natural healing conditions. Each type of Askina® Calgitrol® is recommended for different wound characteristics.

  • Askina® Calgitrol® Ag, an absorbent foam layer and a layer of silver alginate matrix
  • Askina® Calgitrol® THIN, a thin layer of silver alginate matrix
  • Askina® Calgitrol® Paste, an amorphous silver alginate matrix in paste form

Askina® Calgitrol® Paste - Highly conformable, not only for small tunnels and sinuses

Askina® Calgitrol® Paste – highly conformable, not only for small tunnels and sinuses 

Close contact between silver alginate matrix and the wound bed

Askina® Calgitrol® Paste is an amorphous silver alginate matrix in paste form. It is highly conformable and provides extremely close contact to the wound bed.

Askina® Calgitrol® Paste for small tunnels and sinuses

This high conformability may prevent the formation of pools of exudate where bacteria might flourish. The small 15g tube comes with a long cannula to facilitate the application of the paste into small tunnels, sinuses and awkward wound shapes.4)

Optimal conformability adapts to all kinds of wound shapes

Askina® Calgitrol® Paste® may also be used for other wounds such as deep cavity or difficult-to-dress wounds.

Regarding flat, superficial, low exuding wounds Askina® Calgitrol® Paste® may be spread on the entire surface of the wound bed by using a sterile glove or a sterile spatula. It must be covered with an appropriate secondary dressing depending on the amount of exudate.

Askina® Calgitrol® Paste® should be reapplied after each dressing change (daily or up to three days depending on wound condition) or if wound exudate leakage occurs through the secondary dressing.5) Askina® Calgitrol® Paste® is easy to remove by simple rinsing with sterile saline (0.9%) or Prontosan® Wound Irrigation Solution.5)

Indications

Askina® Calgitrol® Paste is indicated for the management of partial to full thickness wounds, stage I - IV pressure ulcers, venous, arterial and neuropathic ulcers, second degree burns and donor sites.5)

Askina® Calgitrol® AG – for flat superficial highly exuding wounds

Askina® Calgitrol® Ag – for flat superficial highly exuding wounds

Exudate management

Askina® Calgitrol® Ag is a dressing that consists of an absorbent foam layer and the silver alginate matrix. The primary function of the polyurethane foam layer is to provide absorption for the wound exudate, so no need to cover with a secondary absorbing dressing.

In contact with wound exudate, the ionic silver alginate matrix gels to form a moist wound environment conducive to natural healing conditions.

How to use Askina® Calgitrol® Ag

  • Select the appropriate dressing size to completely cover the wound surface, ensuring 2 to 3 cm excess beyond the edges of the wound. Askina® Calgitrol® Ag can be cut to size, if needed.
  • Place the dressing with the silver matrix (dark surface) facing the wound. If necessary, several dressings can be overlapped to cover very large wound areas. 
  • To secure Askina® Calgitrol® Ag cover it with an appropriate secondary dressing or secure with surgical tape or bandage.5) 

Fewer dressing changes

Askina® Calgitrol® Ag may be left in place for up to seven days or until the dressing is saturated with wound exudate.

Indications

Askina® Calgitrol® Ag is indicated for the management of exuding partial to full thickness wounds, stage I to IV pressure sores, venous ulcers, second degree burns and donor sites.

Askina® Calgitrol® THIN – also suitable for cavity wounds

Askina® Calgitrol® THIN – also suitable for cavity wounds 

Great adaptability

Askina® Calgitrol® THIN is a slim layer of silver alginate matrix.

In contact with wound exudate, the ionic silver alginate matrix forms a soft gel maintaining a moist wound environment conducive to natural healing conditions.

Askina® Calgitrol® THIN is recommended not only for shallow wounds but also suitable for deep cavity wounds.5) In addition, the thinness of the dressing allows to conform the dressing to irregularly shaped wounds or to wounds in awkward anatomical sites.4)

Shallow wounds

  • Select the appropriate Askina® Calgitrol® THIN size that will completely cover the wound surface, ensuring 2 to 3 cm excess beyond the edges of the wound.
  • Askina® Calgitrol® THIN can be cut to size, if needed, before removing the protective films.
  • If necessary, several dressings can be overlapped to cover very large wound areas.
  • As Askina® Calgitrol® THIN does not absorb wound exudate; it should be covered with an appropriate secondary dressing depending of the amount of exudate.

Deep cavity wounds

Pack Askina® Calgitrol® THIN into deep wounds and cover the wound with appropriate secondary dressing depending of the amount of exudate.

Fewer dressing changes

Askina® Calgitrol® THIN may be left in place for several days until the secondary dressing requires changing.

Indications

Askina® Calgitrol® THIN is indicated for the management of partial to full thickness wounds, stage 1 to IV pressure ulcers, venous ulcers, second degree burns and donor sites.

Case studies, Consensus document and explanation videos

Related documents:

Askina® Calgitrol® Made Easy Consensus Document

AMR increases patient morbidity, extends hospital stay, and increases treatment costs and mortality rates (Fletcher et al, 2020). In wound care, infection should be managed using topical antimicrobials containing agents that do not contribute to AMR, such as silver (Kramer et al, 2018; Edwards-Jones and Spruce, 2019). The Askina® Calgitrol® range has been designed to manage infection by delivering a controlled and sustained release of silver ions to the wound bed, and is suitable for use in a range of wounds, including common wound types such as venous leg ulcers (VLUs), pressure ulcers (PUs), diabetic foot ulcers (DFUs) and burns.

Askina® Calgitrol® Case Studies

Since the launch of our Askina® Calgitrol® range, we have received reports of treatment successes on different ulcers (diabetic foot, leg and pressure), burns and acute wounds. We would like to share these with you in the form of a short photo storyboard.  

Videos to discover Askina® Calgitrol®

  • How does Askina® Calgitrol® work

    In contact with wound exudate, the silver alginate matrix of Askina® Calgitrol® forms a soft gel. This helps both maintain a moist wound environment conducive to natural healing conditions as well as prevent contamination from external bacteria.

  • How to use Askina® Calgitrol®

    The Askina® Calgitrol® range is available in three different forms. The three dressings are easy to apply.

References:

1) International Wound Infection Institute (IWII) Wound infection in clinical practice. Wounds International 2016

2) International consensus. Appropriate use of silver dressings in wounds. An expert working group consensus. London: Wounds International, 2012. Available to download from: www.woundsinternational.com

3) Sibbald RG, Goodman L, Krasner DL, et al. Special considerations in Wound Bed Preparation 2011: An Update. Adv Skin Wound Care 2011; 415-36.

4) Opasanon S, Magnette A, Meuleneire F, Harding K. Askina® Calgitrol® Made Easy. Wounds International 2012; 3(1). Available from http://www.woundsinternational.com2012

5) Instruction for use: Askina@ Calgitrol@ Ag, Askina@ Calgitrol@ THIN, Askina@ Calgitrol@ Paste