Made EasySuprasorb X+PHMB Made Easy - Products for Practice

Suprasorb X+PHMB Made Easy - Products for Practice

Complex wounds, Infection | Kingsley A, Kiernan M

Role in pain management

Pain is a common experience for patients with infected wounds(Mudge and Orsted, 2010). The moist wound environment afforded by the HydroBalance technology creates a cooling effect at the wound surface, which has been shown to reduce pain significantly (Alvarez et al, 2004). Mosti et al (2008) and Galitz et al (2009) also found that the use of Suprasorb X+PHMB saw a decrease in patient-reported pain at dressing changes, with significant reductions (p<0.05) in visual analogue scores after the first day. PHMB has also been found in laboratory studies to inhibit formation of reactive oxygen species (Gilliver, 2009). This suggests additional anti-inflammatory properties, which may play a role in pain management.

When is Suprasorb X+PHMB indicated?

Suprasorb X+PHMB is indicated for use on lightly or moderatelyexuding, superficial and deep, critically colonised and infected wounds (Kingsley et al, 2009). These may include chronic ulcers such as diabetic foot, venous leg and pressure ulcers, partial thickness wounds, surgical wounds and skin donor/recipient sitewounds. It has also been used as a safe antimicrobial alternativein the management of children with epidermolysis bullosa(Denyer, 2009) and in paediatric lacerations (Elzinga et al, 2011).Topical antimicrobials play a significant role in the prevention and management of infection. It is important that clinicians recognise and differentiate the signs and symptoms of localised, spreading and systemic infection in different wound types (EWMA, 2005).Early recognition of wounds at risk (W.A.R.) of infection is essential to avoid delayed healing and to prevent serious infections from occurring (Dissemond et al, 2010). Host susceptibility, highnumbers of bacteria in the wound and presence of devitalised or sloughy tissue can increase the risk of infection (EWMA, 2004).A checklist in the form of a score for at risk wounds has been created based on a clinically-orientated risk assessment using specific patient circumstances. A W.A.R. score of 3 or more points indicates that the wound has a greater risk of infection and local antimicrobial treatment with a topical antimicrobial such as PHMB is justified (Dissemond et al, 2011).



How to apply Suprasorb X+PHMB?

  1. Prepare the woundThoroughly cleanse the wound according to local protocols.Ensure the surrounding skin is clean and dry.
  2. Apply the dressingSelect an appropriately sized dressing. Remove the protectivefilm from both sides and apply either side down. If required,the dressing and the rope may be cut to size with sterilescissors, or folded to conform to the shape of the wound.The dressing should overlap the wound by 2-3cm. Apply a suitable secondary dressing as indicated by the level ofexudate. Film dressings are recommended as a first choice,particularly when there are low levels of exudate.

Tip: When using the rope, gently place it into the wound,layering by folding it onto itself. In cavities, ensurethat 2-3cm of the rope dressing is secured outside ofthe wound for easy removal. Do not pack the materialtoo tightly within the wound. Cover the rope with anappropriate secondary dressing

Tip: When using the sheet dressing, gently smooth thedressing in place and allow it to conform to theshape of the wound

How frequently should the dressings be changed?

All wounds should be checked at regular intervals to monitor for improvement or deterioration. More frequentreview is advised for infected wounds and daily dressing changes performed as appropriate. For wounds that are at risk of invasive infection (i.e. critically colonised), the frequency of changing Suprasorb X+PHMB sheet or rope dressing is dependent on the status of the wound bed and can range between 2-7 days.

Tip: When removing Suprasorb X+PHMB sheet dressing lift one edge and gently peel the dressing from the wound.Should the dressing dry out, rehydrate the dressing withsaline 30 minutes before removal.

When should Suprasorb X+PHMB be discontinued?
As with all topical antimicrobial treatments, therapy should be reviewed after two weeks with the decision to continue treatment based on individual patient assessment. When there is a deep infection suspected, systemic antibiotic therapy must be considered (Best Practice Statement, 2011).
When is Suprasorb X+PHMB contraindicated?
Suprasorb X+PHMB is not indicated for full thickness burns, cartilage injuries or for intraocular applications. It should not be used in patients with a known sensitivity to PHMB.

What is the evidence for use?
The clinical effectiveness of Suprasorb X+PHMB has been reported through a number of clinical  trials (Table 1) and numerous case studies (Glover and Wicks, 2009 ; Gray et al, 2011).

Availability on Drug Tariff
Suprasorb X+PHMB is available on prescription in a range of sizes (5cmx5cm; 9cmx9cm; 14cmx20cm), including a rope dressing (2cmx21cm) for cavity wounds.