Made EasySuprasorb X+PHMB Made Easy - Products for Practice

Suprasorb X+PHMB Made Easy - Products for Practice

Complex wounds, Infection | Kingsley A, Kiernan M

Suprasorb X+PHMB Made Easy - Products for PracticeInfection is a significant problem for people with wounds and can result in delayed healing. For patients with an infected wound or those at high risk of a wound infection, knowledge of the available treatment options is vital when selecting an appropriate dressing. This article focuses on the use of Suprasorb X+PHMB in the management of critically colonised or infected wounds.

What is Suprasorb X+PHMB?

Suprasorb X+PHMB is a topical antimicrobial wound dressingfor use on lightly to moderately exuding infected or critically colonised wounds (Kingsley et al, 2009). It may also be used where wounds have been identified through a systematic assessmentto be at greater risk of infection (Dissemond et al, 2011). The wound dressing combines the antimicrobial properties of polyhexamethylene biguanide (polyhexanide, PHMB), with the ability to maintain a moist wound healing environment.

How does Suprasorb X+PHMB work?

Moisture management and bacterial control are two ofthe fundamental issues in wound management (Fumarolaet al, 2010). Suprasorb X+PHMB is composed of 4%cellulose and 96% water, which allows it to absorb exudate or donate moisture to manage exudate levels. The dressing also provides a carrier for PHMB (0.3%), which exerts itsantimicrobial effects both within the dressing, but also at thewound-dressing interface (Gray et al, 2010).

What is PHMB?

PHMB is a broad spectrum antimicrobial agent that has beenused commercially for over 60 years in a number of products, including contact lens solutions and swimming pool cleaners(Moore and Gray, 2007). It has been used in wound dressingsas an alternative to silver or honey.PHMB works by:Inhibiting bacterial cell metabolismBinding to the bacteria's phospholipid (outer) membrane.The positively-charged PHMB molecules attach to the outer membrane of the negatively-charged bacterial cell, causing areas of dysfunction and allowing PHMB to penetrate the inner membrane. The cell increasingly is unable to control normal transmembrane ion exchange, leading to increased fluidity, permeability, loss of integrity and cell death (Gilbert,2006; Hubner and Kramer, 2010).

Safety and efficacy of PHMB

PHMB is considered to be practically non-toxic and is welltolerated with no systemic uptake detected and no reported chronic health effects. Tests of biocompatibility for PHMB(which measures its antimicrobial activity in relation to itscytoxicity) have shown that PHMB results in less damage to healthy cells than other antimicrobial agents such aschlorhexidine and povidone iodine (Hubner and Kramer, 2010).

PHMB has demonstrated good antimicrobial efficacy andhas been found to block Pseudomonas aeruginosa-induced infection (Cazzaniga et al, 2000) and prevent its degradation of wound fluid and skin proteins in vitro (Werthen et al, 2004). It can also kill a diverse range of bacteria and fungi (Lee et al, 2004).

PHMB-containing wound dressings have been shown to beactive against biofilms (Seipp and Korber, 2008; Lenselink and Andriessen, 2011) and multi-resistant pathogens includingmethicillin-resistant Staphylococcus aureus (MRSA) (Eberleinand Wild, 2008; Wild et al 2008) and vancomycin-resistantenterococci (VRE) (Shah et al, 2009).

What is HydroBalance technology?

Suprasorb X+PHMB is made up of a unique structure composedof biosynthetic HydroBalance fibres. These fibres are theproducts of a cellulose fermentation process using Acetobacterxylinium, which produce fine cellulose fibrils, providing an exceptionally large surface area. This allows the dressing to regulate the absorption and donation of moisture at the dressing interface (Alvarez et al, 2004). Surplus exudate is taken up from the wound into the dressing, while moisture is released from the dressing into the wound. Different levels of absorption and donation can be exerted within the same wound, removingexudate from one area while releasing moisture to drier areas. PHMB is not bound to the fibres of the dressing and is free to bereleased into the wound and periwound tissues. The presence offluid in the dressing means that antimicrobial activity is possible even on dry wounds (Gray et al, 2010).