SILVERCEL® Non-Adherent Made Easy
15/11/10 | Complex wounds, Infection | Clark R, Bradbury S
This article describes in detail the composition, mode of action, supporting evidence and practical application of the silver-containing antimicrobial dressing Silvercel® Non-Adherent.
This article describes in detail the composition, mode of action, supporting evidence and practical application of the silver-containing antimicrobial dressing SILVERCEL® Non-Adherent. This dressing has been designed to eliminate the potential problems of adherence and fibre shed that may be associated with first generation fibrous wound dressings[1,2], while maintaining the ability to manage wound infection. With an ever-increasing choice of silver-containing dressings, it is important that clinicians understand the differences between them, and know how and when to use them for successful management of infected or at risk wounds.
WHAT IS SILVERCEL NON-ADHERENT?
SILVERCEL Non-Adherent is a sterile absorbent antimicrobial wound dressing for use in moderately to heavily exuding wounds and in wounds that are infected or at an increased risk of infection. It is designed to absorb wound exudate and contains silver-coated fibres (X-STATIC®) that have a broad spectrum of antimicrobial activity. The dressing has an outer porous film layer designed to prevent adherence of the dressing to the wound and the shedding of fibres. The non-adherent property can help to reduce pain at dressing changes5 and associated patient discomfort and anxiety.
SILVERCEL Non-Adherent is a next generation product that is closely related to the silver-containing alginate dressing, SILVERCEL. The difference between the two is that Silvercel Non-Adherent has an ethylene methyl acrylate (EMA) outer film layer that uses EasyLIFT™ Precision Film technology.
WHY ARE NON-ADHERENCE AND MINIMISING FIBRE SHED IMPORTANT?
Dried out dressings and adherence of the dressing to the wound have been identified as the most important factors contributing to pain at dressing change. In a survey of 2018 patients, 40.3% found pain at dressing change to be the worst part of living with a wound.
In addition to causing pain, removal of dressings that have become adherent to tissues may cause damage to the wound bed or surrounding skin, and so have a detrimental effect on the healing process. Dressings that adhere to the wound bed may also result in additional practitioner time and use of resources.
Dressings containing fibres have long been recognised as having the potential to shed their fibres into the wound. Retained dressing fibres have been shown to act as inflammatory stimuli by inducing a foreign body reaction within wound tissue and so potentially perpetuating the inflammatory stage of wound healing[2,9,10].
HOW IS SILVERCEL NON-ADHERENT MADE?
Production of the absorbent, antimicrobial core of the dressing is based on the manufacturing process for alginate fibres. Briefly, a solution of alginate is forced under pressure through a narrow opening into a bath containing calcium ions, where fibres are formed. The calcium in the bath forms cross links between alginate polymer strands that reduce the solubility of the fibres in water. Carboxymethyl cellulose (CMC) is introduced during this process to provide additional absorbency to the alginate fibres.
The alginate and CMC fibres are spun together and then blended with silver-coated fibres in processes known as carding and needling. The carding process creates a web of fibres that form a 'felt' and the needling process gives the dressing a coherent structure. The final dressing is produced by positioning a layer of perforated EasyLIFT™ Precision Film (EMA) either side of the alginate/CMC and silver-coated fibre non-woven material. This 'sandwich' is then exposed to heat and pressure. During the 'lamination' process, the film melts onto the outer layers of the alginate/CMC and silver-coated fibres, forming an irreversible attachment that contributes to dressing integrity. Once cooled, the resulting SILVERCEL Non-Adherent dressing is cut to size for packaging. It is supplied as a sterile, non-woven dressing in either a flat form or rope (packing) presentation.