Here - EWMA 2013

POSTER PRESENTATIONS
P 266
When pain is an issue – Experiences of wound patients with
different treatment options
Poster: Dressings
Karin Bronstering 1 , Alexander Maassen 1
1 Sorbion GmbH & Co. KG (Münster, Germany).
Aim: To investigate the advantages of a self-adhesive dressing based on Hydration
Response Technology (HRT). The objective of this subgroup analysis was to compare
patients’ pain levels (a) at dressing change and (b) between dressing changes upon
treatment alteration to HRT.
Method: A questionnaire with wound experts from across Germany was conducted. The
first assessment referred to the experts’ experiences with previously used dressings.
The up to four subsequent assessments referred to their experiences with HRT. Pain at
dressing change was scale-recorded with 0-1 indicating hardly any, 2-5 medium, and 6-9
high levels of pain. Pain between dressing changes was dichotomised into regular
versus occasionally.
Results: To begin with, the majority of the 66 patients (57%) reported hardly any pain at
dressing change. However, 24% indicated medium and 19% high levels of pain. With
on-going HRT application, the level of pain decreased. At the last dressing change, of
the initial ‘medium group’ 64% reported hardy any pain, and of the initial ‘high group’
82% reported a reduction to medium levels. Furthermore, regular occurrences of pain
between dressing changes were reported by 19% of all patients at onset, which
decreased to 3% after four HRT applications.
Conclusion: Overall, the study has shown that for a subgroup of wound patients, pain
seems to be a critical issue. The results suggest that HRT might add to a reduction in
pain in wound patients, which, as a conseqeunce, might well improve their quality of life.
POSTER: DRESSINGS
P 267
Poster: Dressings
COMPARING SILVER ALGINATE EFFICACY AGAINST THREE WOUND
ENVIRONMENTALPRESSURES: PH, ORGANISM PHENOTYPE AND SPECIES
COMBINATIONS
John G. Thomas 1
1 West Virginia University (Morgantown, United States).
Aim: Using an international reservoir of 100 wound isolates, we evaluated the efficacy of
silver alginate against environmental pressures. Here we focused on ten wound
organisms emphasizing MDRO, C. difficile and Acinetobacter baumannii, ranking the
efficacy of silver alginate influenced by three variables.
Methods: 4 Gram positives including C difficle and C.albicans and 5 MDR Gram
negatives including A. baumanni were selected with established C-ZOI. Efficacy of 1 cm 2
silver alginate gauze was measured by C-ZOI at 24/48 hrs. on 30% poloxomer (biofilm)
vs. Muller Hinton (planktonic) at pH 5.5, 6.8 and 8.5. 18hr cultures of single and multiple
organism combinations up to 3, were assayed in triplicate and validity defined by t-test.
Results: Mean C-ZOIs (mm) for pH 6.8, planktonic species were established for Gram
Positives (7.3) vs. Gram Negatives (8.2), and allowed for impact of change including 1)
individual species (Range 1.9 -12) and 2)pH, 5.5 (Range 3.1-15.2) vs. 8.5 (Range 3.1-
7.5). Single species to combinations (Range 1.9-4.8) and Planktonic to Biofilm (Range
1.9-4.2 were also measured. Most influential variables were three species Gram
positives with C difficile combined with Biofilm phenotype at pH 5.5 (Range 1.9-14.2).
MDR organisms including A. baumannii did not rank high.
Conclusions: Mimicking 3 wound environmental pressures unmasked their
unpredictable impact, but confirmed universal efficacy of silver alginate influenced most
by pH.
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