previously cited. 9,12,15 However, other indicators ofquality of life need to be considered, especially if specificquality-of-life questionnaires have not been usedwithin an evaluation or case study.Pain has a serious negative effect on quality of life.It is therefore fair to assume that lack of pain shouldbe considered a <strong>performance</strong> indicator that can havepositive effects on perceived quality outcomes.Romanelli reported that the use of Sorbion was associatedwith improved comfort and all patientspreferred it to the previously used <strong>dressing</strong> products,including Hydrofibre and foams. 15 Similarly, theabsence of wound malodour, as described by Sharp, 8skin sensitivities, trauma at <strong>dressing</strong> change asobserved by Evans, 17 and absence of malodour 8 canall be seen as positive wound-related outcomes thataffect patient satisfaction and hence quality of life.Not only does the frequency of care interventionsaffect the individual’s ability to continue normalactivities of living, but they are also a major influenceon the cost of wound management. Frequent <strong>dressing</strong>changes stop patients living a normal lifestyle andcan prevent them from returning to work. Throughoutthe case studies and evaluations mentioned here,reductions in <strong>dressing</strong> frequency were observed asexudate management was optimised, bacterial colonisationwas reduced and the toxic effect of exudateon the periwound skin was relieved.ConclusionFor the clinician faced with the dilemmas of exudatemanagement, finding a successful resolution canoften take a long time. All too often products purportedto handle fluid have proven ineffective whenused in the clinical situation, and clinicians are leftto seek further therapy options. High exudate levelsand their all too frequent sequelae of bacterial andnecrotic burden, malodour, pain, periwound macerationand proteolytic degradation can incur massivecosts and reduce quality of life. The development ofa smart technology that is easy to use, readily availableand has been proven to improve clinicaloutcomes, therefore, is long overdue.The existing evidence for Sorbion sachet S comprisespreliminary clinical data. The most robust andsupportive clinical evidence, in terms of the samplesize, is Cutting’s study, which recruited 53 patients.This non-comparative clinical evaluation providedpositive outcomes linked to multiple case studies.Without doubt, further studies are required, includingcomparative designs. However, initialnon-comparative results are very promising.From the evidence available, therefore, hydrationresponse technology in the form of Sorbion Sachet Snot only provides theoretical benefits in woundmanagement but also matches these claims withreal-life clinical outcomes.References1 Bowler, P.G., Duerden, B.I.,Armstrong, D.G. <strong>Wound</strong>microbiology and associatedapproaches to woundmanagement. Clin MicrobiolRev 2001; 14: 2, 244-269.2 Trengove, N.J., Stacey, M.C.,MacAuley, S. et al. Analysis ofthe acute and chronic woundenvironments: the role ofproteases and their inhibitors.<strong>Wound</strong> Repair Regen 1999; 7:6, 442-452.3 Saarialho-Kere, U.K. Patterns ofmatrix metalloproteinase andTIMP expression in chroniculcers. Arch Dermatol Res1998; 290: Suppl, S47-54.4 Neely, A.N., Clendening, C E.,Gardner, J., Greenhalgh, D.G.Gelatinase activities in woundsof healing-impaired mice versuswounds of non-healingimpairedmice. J Burn CareRehabil 2000; 21: 5, 395-402.5 Mulder, G.D., Vande Berg, J.S.Cellular senescence and matrixmetalloproteinase activity inchronic wounds. Relevance todebridement and newtechnologies. J Am Podiatr MedAssoc 2002; 92: 1, 34-37.6 White, R.J., Cutting, K.F.Interventions to avoidmaceration of the skin andwound bed. Br J Nurs 2003;12: 20, 1186-1201.7 Gray, M., Weir, D. Preventionand treatment of moistureassociatedskin damage(maceration) in the periwoundskin. J <strong>Wound</strong> OstomyContinence Nurs 2007; 34: 2,153-157.8 Sharp, C.A. Effi cient managementof the wound environmentusing Hydration ResponseTechnology (HRT). Posterpresentation at Tissue ViabilitySociety conference 2009,Telford, UK.9 Cutting, K.F. Optimal exudatemanagement in a <strong>dressing</strong>. JCommunity Nursing 2008; 22:11, 33-34.10 Kwon Lee, Maloney S, HermansMHE. (2009) data on fi leSorbion AG, Ostbevern,Germany.11 Chadwick, P. The use of sorbionsachet S in the treatment of ahighly exuding diabetic footwound. The Diabetic FootJournal 2008; 11:4 183-186.12 Cutting, K.F. Managing woundexudate using a superabsorbentpolymer <strong>dressing</strong>: a53-patient clinical evaluation. J<strong>Wound</strong> Care 2009; 18: 5, 200,202-205.13 Vowden, K.R., Vowden, P.<strong>Wound</strong> debridement. Part 2:Sharp techniques. JWC 1999; 8:5, 237-24014 Tissue Viability NursesAssociation Conservative SharpDebridement.Procedures,Competencies and Training.TVNA, 2005. http://tinyurl.com/yzj3w4w15 Romanelli, M., Dini, V., Bertone,M. A pilot study evaluating thewound and skin care<strong>performance</strong>s of the HydrationResponse Technology <strong>dressing</strong>:a new concept of debridement.J <strong>Wound</strong> Technology 2009; 5:1-3.16 Leveen, H.H., Falk, G., Borek, B.et al. Chemical acidifi cation ofwounds: an adjuvant to healingand the unfavorable action ofalkalinity and ammonia. AnnSurg 1973; 178: 6, 745-753.17 Evans, J. Hydration ResponseTechnology and managinginfection. J Community Nursing2010; 24: 1, 15-16.18 Wilson, I.A, Henry, M., Quill, R.D., Byrne, P.J. The pH ofvaricose ulcer surfaces and itsrelationship to healing. Vasa1979; 8:4 339-342.19 Shukla, V.K., Shukla, D., Tiwary,S.K. et al. Evaluation of pHmeasurement as a method ofwound assessment. J <strong>Wound</strong>Care 2007; 16: 7, 291-294.20 Schultz, G., Mozingo, D.,Romanelli, M., Claxton, K.<strong>Wound</strong> healing and TIME: newconcepts and scientifi capplications. <strong>Wound</strong> RepairRegen 2005; 13 (Suppl 4): SI-SII.21 Cutting, K.F., Acton, C.,Dunwoody, G. et al. Clinicalevaluation of a new highabsorbency <strong>dressing</strong>. Posterpresentation at European<strong>Wound</strong> ManagementAssociation (EWMA)conference, Lisbon, 2008.1 8J O U R N A L O F W O U N D C A R E S O R B I O N S U P P L E M E N T 2 0 1 0
© 2010 MA Healthcare LtdAll rights reserved. No reproduction, transmission orcopying of this publication is allowed without writtenpermission. No part of this publication may bereproduced, stored in a retrieval system, or transmittedin any form or by any means, mechanical, electronic,photocopying, recording, or otherwise, without theprior written permission of MA Healthcare Ltd or inaccordance with the relevant copyright legislation.Although the editor and MA Healthcare Ltdhave taken great care to ensure accuracy,MA Healthcare Ltd will not be liable for any errors ofomission or inaccuracies in this publication.Opinions expressed in this publicationare those of the authors only and do notnecessarily reflect those of MA Healthcare Ltd.Printed byPensord, Blackwood, Newport, Wales, UKPublished on behalf of Sorbionby MA Healthcare Ltd,St Jude’s Church, Dulwich Road,London SE24 0PB, UKTel: +44 (0) 20 7738 5454Email: info@markallengroup.comWeb: www.markallengroup.comThis supplement has been undergonedouble-blind peer reviewJ O U R N A L O F W O U N D C A R E S O R B I O N S U P P L E M E N T 2 0 1 01 9
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