Table 1.
Dressings and antimicrobial agents used in this study: Brand name, descriptions and manufacturer recommendations
| Dressing/agent | Brand name and description |
|---|---|
| Cadexomer | Cadesorb® ointment (Smith & Nephew): Moisture dressing of cadexomer beads is designed to absorb wound exudates and modulate (reduce) protease activity by controlling local wound pH and promote healing. Cadesorb consists of water‐soluble cadexomer polymer (dextran and epichlorhydrin) cross‐linked to form a 3D matrix in the form of 0·1–0·3‐mm diameter spheres. 1 g Cadexomer can absorb 6 ml of fluid. |
| Cadexomer iodine | Iodoflex™ pad and Iodosorb® ointment (Smith & Nephew): Antimicrobial moisture dressings designed to absorb wound exudate (of ulcers, sores and infected wounds), lower wound pH and time‐release iodine from cadexomer beads at a rate to maintain iodine availability at 1 ppm to kill microbes without harming healthy tissue. Dry cadexomer beads contain 0·9% iodine. Iodosorb ointment contains 50% cadexomer iodine and 50% ointment base. |
| Calcium alginate (Ca Alginate) | Algisite®‐M (Smith & Nephew): A moisture dressing made of calcium alginate fibres and is designed to absorb wound exudates (of full‐ and partial‐thickness wounds) for up to 3 days (or changed daily for heavily exuding or infected wound). |
| Calcium alginate–nanocrystalline silver (Ca Alginate‐NanoAg) | Acticoat® Absorbent (Smith & Nephew): Antimicrobial moisture dressing made of calcium alginate fibres coated in SILCRYST™ nanocrystalline silver and is designed to absorb wound exudates (of full‐ and partial‐thickness wounds) and steadily release silver ions (70–100 ppm continuously available) for up to 7 days (with an antimicrobial effect minimum of 3 days). |
| Calcium alginate–Leptospermum honey (Ca Alginate‐L. honey) | Medihoney®‐impregnated calcium alginate pad (Derma Sciences): An absorbent wound and burn dressing with 95% active Manuka Leptospermum honey and 5% calcium alginate fibre designed for moderate to heavy exudating wounds. It is used to maintain a moist wound environment and provide high osmolarity for wound cleansing and debridement and low pH for healing of exudating full‐ and partial‐thickness wounds. |
| Cotton gauze | Medline 12 or 16 ply USP Type VII: 100% cotton woven gauze sponge. |
| Cotton gauze–polyhexamethylene biguanide (PHMB gauze) | Curity™ AMD™ (Kendall) gauze: A 100% cotton fine mesh gauze packing strip for exudating wounds, surgical wounds or wound packing, impregnated with the microbicide PHMB (0·2%) and designed to resist bacterial colonisation within the dressing and act as a prophylactic barrier to prevent penetration of external invading bacteria through the dressing. |
| Cotton gauze–silver sulphate (Ag sulphate gauze) | Tegaderm® AgMesh (3M): Antimicrobial non‐woven 100% cotton dressing that contains silver sulphate and is designed to release ionic silver on moist or moistened wounds for up to 7 days. |
| Ethanol (ETOH) | Absolute ethanol (Sigma‐Aldrich ‐E7023): 200 proof, for molecular biology. ETOH is an antimicrobial antiseptic. |
| Hydrocolloid–silver (Ag) | Contreet‐H/Biatain Ag (Coloplast Pty Ltd.): Hydrocolloid moisture dressing designed to release ionised silver (hydroactivated) in moderate to high exudating wounds for up to 7 days. |
| Leptospermum honey (L. honey) | Medihoney ointment (Derma Sciences): An absorbent wound and burn dressing with 100% active Manuka Leptospermum honey for dry to lightly exudating wounds, designed to maintain a moist wound environment and provide high osmolarity for wound cleansing and debridement and low pH for healing of exudating full‐ and partial‐thickness wounds. |
| Polyacrylate–silver chloride (polyacrylate–AgCl) | Silvasorb® Gel (Medline): An antimicrobial wound hydrogel using Microlattice® technology consisting of polyacrylate hydrophilic matrix particles suspended in glycerol and polysaccharides forming a scaffold that stabilises silver chloride salt [AgCl(n)] designed to release microbicidal silver ions at an average rate of 1·5 ppm (continuously available for at least 3 days and can potentially be left in place for up to 7 days) without harming healthy tissue in partial‐ or full‐thickness acute and chronic wounds. The unique Microlattice hydrogel was designed to allow oxygen to penetrate to the wound, minimise the moisture escaping to the surface, while simultaneously controlling the amount of exudate. |
| Polyhexamethylene biguanide (PHMB) | Prontosan™ Wound Gel (B. Braun Medical): A gel designed for moistening absorbent wound dressings and for cleansing and decontaminating partial‐ or full‐thickness acute and chronic wounds to reduce bioburden, inhibit microbial colonisation and prevent infection. It contains glycerol, hydroxyethylcellulose, 0·1% undecylenamidopropyl betaine surfactant and microbicidal 0·1% polyaminopropyl biguanide polymeric cationic antiseptic that kills microbes by disrupting electrostatic interactions without harming healthy tissue. It is designed to be applied to the wound cavity and covered with a secondary dressing and changed every 3 days (±1 day). |
| Polyethylene–nanocrystalline silver (polyethylene‐NanoAg) | Acticoat and Acticoat‐7 (Smith & Nephew): An antimicrobial barrier dressing for partial‐ and full‐thickness wounds judged to be critically colonised with bacteria or at risk from infection. Acticoat has three ultrasonically welded layers consisting of a central apertured non‐woven fabric made from rayon and polyester sandwiched between two outer layers of nanocrystalline silver‐coated polyethylene mesh. Acticoat‐7 has five ultrasonically welded layers consisting of a central nanocrystalline silver‐coated mesh of high‐density polyethylene sandwiched between two core layers of an apertured non‐woven fabric made from rayon and polyester, sandwiched between two outer layers of nanocrystalline silver‐coated polyethylene mesh. It is recommended that Acticoat and Acticoat‐7 be moistened with sterile water prior to use and that a secondary dressing be applied to maintain moisture balance. Acticoat and Acticoat‐7 may be left in place for a maximum of 3 and 7 days, respectively, although it may be necessary to replace it more frequently for heavily exuding wounds. |
| Povidone‐iodine (PVP‐I) | Triadine™ PVP‐I (USP): An antiseptic prep solution containing a 10% topical solution of PVP‐I with 1% available iodine. |
| Sodium carboxymethylcellulose–ionic silver (NaCMC‐Ag) | Aquacel®‐Ag (ConvaTec): An antimicrobial hydrofibre® moisture dressing of NaCMC containing 1·2% ionic silver was designed to absorb wound exudates and steadily release silver ions (1 ppm continuously available) for up to 7 days. |
| Sodium carboxymethylcellulose (NaCMC) | Aquacel (ConvaTec): A hydrofibre® moisture dressing of sodium carboxymethylcellulose fibres designed to absorb wound exudates for up to 7 days. |