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    ACTICOAT

    Antimicrobial Barrier Silver Dressing

    ACTICOAT

    About ACTICOAT

    What is ACTICOAT?

    The ACTICOAT family consists of dressings which are flexible, absorbent and conformable1,2 and that provide an efficient and effective barrier to bacterial penetration3. ACTICOAT has been shown to offer significant clinical4 and economic5 results compared to other silver dressings.


    ACTICOAT for Patients

    The ACTICOAT range is proven safe in over 10 years of clinical trials6,7,8,9. Patients benefit from a dressing that is shown to be fast10,11,12,13 and ACTICOAT for Patientseffective in-vitro against a broad spectrum of gram positive and gram negative bacteria and fungal wound pathogens14,15 including “suberbugs” such as MRSA, VRE16,17 and NDM-1 carbapenemase containing bacteria18.

    In a comparative cohort study (n=75) in mixed chronic wounds 60% of patients managed with the ACTICOAT saw resolution of infection within 2 weeks compared to only 4% and 8% of patients in the two alternative silver dressing groups4.

    A study in lower leg revascularisation surgery complications (n=248) demonstrated a 64% reduction in post-operative wound complications following a change in protocol a conventional gauze based dressing to ACTICOAT Absorbent19

    A meta-analysis of RCT data20 (n=285) from the burns area shows results comparing ACTICOAT with traditional standards of care such as decreased pain21,22, less dressing changes23,24 and reduced complication rates25 contributing to a shorter length of stay25.

    References

    1 Daubney, L; ACTICOAT Flex 7 - Evaluation of Extensibility, report reference DS.08.123.R1
    2 Smith & Nephew Data on File Report – 0403002
    3 Burrell et al, ‘Efficacy of Silver-Coated Dressings as Bacterial Barriers in a Rodent Burn Sepsis Model’, WOUNDS 1999; 11(4):64-71.
    4 Gago M, et al., A comparison of three silver-containing dressings in the treatment of infected, chronic wounds. Wounds 2008; 20 (10): 273-278
    5 Searle and Bielby (2010) dressing strategies for the management of infected wounds in community wound care: impacts and implications. Poster at Wounds UK, Harrogate, Nov 2010
    6 Haung et al., A randomised comparative trial between ACTICOAT and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007. 33(2):161-166
    7 Vlachou et al., The safety of nanocrystalline silver dressings on burns: A study of systemic absorption. Burns 2007. 33(8):979-85
    8 Moiemen et al., ACTICOAT dressings and major burns: Systemic silver absorption. Burns 2010. 37(1):27-35
    9 Sibbald et al (2001) A screening evaluation of an ionised nanocrystalline silver dressing in chronic wound care. Ostomy Wound Management 47(10): 38-4
    10 Smith & Nephew Data on file report 0810018
    11 Smith & Nephew Data on file report 0810014
    12 Smith & Nephew report reference DS/08/078/R2
    13 Smith & Nephew report reference DS/08/062/R2
    14 In-vitro study data on file: Scientific Background #0109003 and #0107010
    15 Wright JB, Lam K, Hansen D, Burrell RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-350
    16 DoF 0810016
    17 DoF: 0810017
    18 Hope R, et al., (2012) The in-vitro antibacterial activity of nanocrystalline silver dressings against bacteria withNDM-1 carbapenemase. Poster at EWMA, Austria, 2012
    19 Childress et al (2007) Impact of an absorbent silver-eluting dressing system on lower extremity revascularisation wound complications. Annals of Vascular Surgery. 21(5): 598-602
    20 Gravante et al (2009) Nanocrystalilne silver. A systematic review of randomised trials conducted on burned patients and an evidence-based assessment of potential advantages over old silver formulations. Annals of Plastic Surgery. 63(2):201-204
    21 Muangman et al. (2006) Comparison of efficacy of 1% Silver Sulphadiazine and ACTICOAT for the treatment of partial thickness burn wounds. Journal of the Medical Association of Thailand. 89(7):953-8
    22 Tredget et al, ‘A Matched-Pair, Randomized Study Evaluating the Efficacy and Safety of ACTICOAT Silver-Coated Dressing for the Treatment of Burn Wounds’, Journal of Burn Care & Rehabilitation 1998; 19(6): 531-537
    23 Cuttle L. Naidu S. Mill J. Hoskins W. Das K. and Kimble R. (2007) a retrospective cohort study of ACTICOAT versus Silvazine in a paediatric population. Burns. 33 (6): 701-7
    24 Silver et al (2007) A silver-coated antimicrobial barrier dressing used postoperatively on meshed autografts: A dressing comparison study. Journal of Burn Care and Research. 28(5):715-719
    25 Peters D, Verchere C. Healing at home: Comparing Cohorts of children with medium-sized burns treated as outpatients with in-hospital applied ACTICOAT to those children treated as inpatients with silver sulfadiazine. Journal of Burn Care & Research 2006; 27(2):198-201.
    26Westaim Report Ref. #001213 
    27Westaim Report Ref. #010322
    28Data on File: 0810012
    29Data on File: 0810013
    30Fong J, Wood F, Fowler B. A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: Comparative patient care audits. Burns 31 (2005)562-567. Burn Care Res 2006;27:198-201
    31Russell AD, Hugo WB. Antimicrobial activity and action of silver. Prog Med Chem 1994; 31: 351-71
    32Peterson and Shanholtzer (1992) Tests for Bacteriacidal effects of antimicrobial agents: technical performance and clinical relevance. Clinical Microbiology Reviews 5(4)420-432
    33Benson R Smith and Nephew Data on File 0504001v3
    34A. Keene, ACTICOAT Non-Clinical Overview (Consultation Dossier). 29th January 2002
    35Wright et al, ‘The Comparative Efficacy of Two Antimicrobial Barrier Dressings: In-VitroExamination of Two Controlled Release of Silver Dressings’, WOUNDS 1998; 10(6): 179-188
    36Lumb, H; The Antimicrobial Activity of ACTICOAT and ACTICOAT Flex 3 while Under Negative Pressure, Data on File reference 0810010
    37Bannister, N; NPWT Summary
    38Carpenter, S; Investigation into wound bed pressure under ACTICOAT using an in-vitromodel, report reference DS/09/019/R1
    39Demonstrable
    40Smith (2005) Ref: 0503008 ACTICOAT Moisture Control Dressing – Physical testing
    41International consensus. Appropriate use of silver dressings in wounds. An expert working group consensus. London: Wounds International, 2012.Available from:www.woundsinternational.com
    42Westaim report #971030
    43Data on File: Smith (2005) 0503006
    44Data on File ref: 0403003

    Economic Benefits

    ACTICOAT for Budgets

    As well as providing the patient with a comfortable and effective dressing, the ACTICOAT range also benefits the clinicians that work with it and the Health Care Systems that pay for treatment of wounds.

    ACTICOAT is easy to apply and remove making dressing changes easier for both clinicians and patients compared to traditional standards of care (silver nitrate)22. The antimicrobial barrier remains effective for up to 7 days in the case of ACTICOAT 726,27 and ACTICOAT Flex 728,29, reducing dressing change frequency.

    In a burns study ACTICOAT has been shown to shorten in-patient stay compared to patients treated with SSD30. The resulting decrease in bed time and subsequently nursing time in this study means that ACTICOAT has been demonstrated to lower overall treatment costs compared to SSD in the high cost burns arena30.

    ACTICOAT has also been shown to be more effective in a chronic setting and in a comparative study.

    ACTICOAT managed wounds

    ACTICOAT managed wounds saw a faster time to resolution of infection4 and also a decreased overall cost compared to competitors5

    TM All Trademarks Acknowledged

     

    References

    1 Daubney, L; ACTICOAT Flex 7 - Evaluation of Extensibility, report reference DS.08.123.R1
    2 Smith & Nephew Data on File Report – 0403002
    3 Burrell et al, ‘Efficacy of Silver-Coated Dressings as Bacterial Barriers in a Rodent Burn Sepsis Model’, WOUNDS 1999; 11(4):64-71.
    4 Gago M, et al., A comparison of three silver-containing dressings in the treatment of infected, chronic wounds. Wounds 2008; 20 (10): 273-278
    5 Searle and Bielby (2010) dressing strategies for the management of infected wounds in community wound care: impacts and implications. Poster at Wounds UK, Harrogate, Nov 2010
    6 Haung et al., A randomised comparative trial between ACTICOAT and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007. 33(2):161-166
    7 Vlachou et al., The safety of nanocrystalline silver dressings on burns: A study of systemic absorption. Burns 2007. 33(8):979-85
    8 Moiemen et al., ACTICOAT dressings and major burns: Systemic silver absorption. Burns 2010. 37(1):27-35
    9 Sibbald et al (2001) A screening evaluation of an ionised nanocrystalline silver dressing in chronic wound care. Ostomy Wound Management 47(10): 38-4
    10 Smith & Nephew Data on file report 0810018
    11 Smith & Nephew Data on file report 0810014
    12 Smith & Nephew report reference DS/08/078/R2
    13 Smith & Nephew report reference DS/08/062/R2
    14 In-vitro study data on file: Scientific Background #0109003 and #0107010
    15 Wright JB, Lam K, Hansen D, Burrell RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-350
    16 DoF 0810016
    17 DoF: 0810017
    18 Hope R, et al., (2012) The in-vitro antibacterial activity of nanocrystalline silver dressings against bacteria withNDM-1 carbapenemase. Poster at EWMA, Austria, 2012
    19 Childress et al (2007) Impact of an absorbent silver-eluting dressing system on lower extremity revascularisation wound complications. Annals of Vascular Surgery. 21(5): 598-602
    20 Gravante et al (2009) Nanocrystalilne silver. A systematic review of randomised trials conducted on burned patients and an evidence-based assessment of potential advantages over old silver formulations. Annals of Plastic Surgery. 63(2):201-204
    21 Muangman et al. (2006) Comparison of efficacy of 1% Silver Sulphadiazine and ACTICOAT for the treatment of partial thickness burn wounds. Journal of the Medical Association of Thailand. 89(7):953-8
    22 Tredget et al, ‘A Matched-Pair, Randomized Study Evaluating the Efficacy and Safety of ACTICOAT Silver-Coated Dressing for the Treatment of Burn Wounds’, Journal of Burn Care & Rehabilitation 1998; 19(6): 531-537
    23 Cuttle L. Naidu S. Mill J. Hoskins W. Das K. and Kimble R. (2007) a retrospective cohort study of ACTICOAT versus Silvazine in a paediatric population. Burns. 33 (6): 701-7
    24 Silver et al (2007) A silver-coated antimicrobial barrier dressing used postoperatively on meshed autografts: A dressing comparison study. Journal of Burn Care and Research. 28(5):715-719
    25 Peters D, Verchere C. Healing at home: Comparing Cohorts of children with medium-sized burns treated as outpatients with in-hospital applied ACTICOAT to those children treated as inpatients with silver sulfadiazine. Journal of Burn Care & Research 2006; 27(2):198-201.
    26Westaim Report Ref. #001213 
    27Westaim Report Ref. #010322
    28Data on File: 0810012
    29Data on File: 0810013
    30Fong J, Wood F, Fowler B. A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: Comparative patient care audits. Burns 31 (2005)562-567. Burn Care Res 2006;27:198-201
    31Russell AD, Hugo WB. Antimicrobial activity and action of silver. Prog Med Chem 1994; 31: 351-71
    32Peterson and Shanholtzer (1992) Tests for Bacteriacidal effects of antimicrobial agents: technical performance and clinical relevance. Clinical Microbiology Reviews 5(4)420-432
    33Benson R Smith and Nephew Data on File 0504001v3
    34A. Keene, ACTICOAT Non-Clinical Overview (Consultation Dossier). 29th January 2002
    35Wright et al, ‘The Comparative Efficacy of Two Antimicrobial Barrier Dressings: In-VitroExamination of Two Controlled Release of Silver Dressings’, WOUNDS 1998; 10(6): 179-188
    36Lumb, H; The Antimicrobial Activity of ACTICOAT and ACTICOAT Flex 3 while Under Negative Pressure, Data on File reference 0810010
    37Bannister, N; NPWT Summary
    38Carpenter, S; Investigation into wound bed pressure under ACTICOAT using an in-vitromodel, report reference DS/09/019/R1
    39Demonstrable
    40Smith (2005) Ref: 0503008 ACTICOAT Moisture Control Dressing – Physical testing
    41International consensus. Appropriate use of silver dressings in wounds. An expert working group consensus. London: Wounds International, 2012.Available from:www.woundsinternational.com
    42Westaim report #971030
    43Data on File: Smith (2005) 0503006
    44Data on File ref: 0403003

    ACTICOAT Technology

    ACTICOAT Technology

    The antimicrobial properties of Silver have been exploited for centuries31; we are now in a position where there is a deeper understanding of the mechanism behind this protection and how we can optimise it to benefit patients and HCPs.

    The silver on ACTICOAT dressings is the unique nanocrystalline SILCRYST silver.

    Silcryst silver is created via a physical vapour deposition process to form a nanocrystalline structure with a large accessible surface area.

    nanocrystalline SILCRYST silver

    Magnification of nanocrystalline silver with an increased surface area to volume ratio
    Magnification of normal silver

     

     

     

    ACTICOAT with SILCRYST silver possesses the key characteristics of an antimicrobial dressing:

    ACTICOAT is effective: Dressings in the ACTICOAT range have been proven, in vitro, to be effective against a broad spectrum of over 150 wound pathogens – gram positive, gram-negative, anaerobic and resistant bacteria14, including multiple MRSA strains14 and bacteria containing NDM-1 Carbapenemases18. It has a bactericidal effect, unlike some other silvers which are simply bacteriostatic32,33.

    ACTICOAT is rapid: Dressings in the ACTICOAT range are proven, in vitro, to begin working within 30 minutes10,13,34,35. This rapid action gives the bacteria very little time to multiply and allows control to be exerted faster.  

    ACTICOAT is sustained: The ACTICOAT range provides an antimicrobial barrier for the wear time for the dressing; chose between 3 or 7 days to suit your patient. Please refer to the instructions for use for product specific wear time.

    ACTICOAT is easy to use: the ACTICOAT range of dressings are available in a variety of forms including ACTICOAT Flex; a conformable wound contact layer that is suitable for use under Negative Pressure Wound Therapy36,37,38 ACTICOAT Site specifically designed for percutaneous device sites, ACTICOAT Moisture Control; a foam based dressing and ACTICOAT Absorbent; a calcium alginate dressing. This wide range of dressing types ensures that the appropriate form can be selected.

     

    References

    1 Daubney, L; ACTICOAT Flex 7 - Evaluation of Extensibility, report reference DS.08.123.R1
    2 Smith & Nephew Data on File Report – 0403002
    3 Burrell et al, ‘Efficacy of Silver-Coated Dressings as Bacterial Barriers in a Rodent Burn Sepsis Model’, WOUNDS 1999; 11(4):64-71.
    4 Gago M, et al., A comparison of three silver-containing dressings in the treatment of infected, chronic wounds. Wounds 2008; 20 (10): 273-278
    5 Searle and Bielby (2010) dressing strategies for the management of infected wounds in community wound care: impacts and implications. Poster at Wounds UK, Harrogate, Nov 2010
    6 Haung et al., A randomised comparative trial between ACTICOAT and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007. 33(2):161-166
    7 Vlachou et al., The safety of nanocrystalline silver dressings on burns: A study of systemic absorption. Burns 2007. 33(8):979-85
    8 Moiemen et al., ACTICOAT dressings and major burns: Systemic silver absorption. Burns 2010. 37(1):27-35
    9 Sibbald et al (2001) A screening evaluation of an ionised nanocrystalline silver dressing in chronic wound care. Ostomy Wound Management 47(10): 38-4
    10 Smith & Nephew Data on file report 0810018
    11 Smith & Nephew Data on file report 0810014
    12 Smith & Nephew report reference DS/08/078/R2
    13 Smith & Nephew report reference DS/08/062/R2
    14 In-vitro study data on file: Scientific Background #0109003 and #0107010
    15 Wright JB, Lam K, Hansen D, Burrell RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-350
    16 DoF 0810016
    17 DoF: 0810017
    18 Hope R, et al., (2012) The in-vitro antibacterial activity of nanocrystalline silver dressings against bacteria withNDM-1 carbapenemase. Poster at EWMA, Austria, 2012
    19 Childress et al (2007) Impact of an absorbent silver-eluting dressing system on lower extremity revascularisation wound complications. Annals of Vascular Surgery. 21(5): 598-602
    20 Gravante et al (2009) Nanocrystalilne silver. A systematic review of randomised trials conducted on burned patients and an evidence-based assessment of potential advantages over old silver formulations. Annals of Plastic Surgery. 63(2):201-204
    21 Muangman et al. (2006) Comparison of efficacy of 1% Silver Sulphadiazine and ACTICOAT for the treatment of partial thickness burn wounds. Journal of the Medical Association of Thailand. 89(7):953-8
    22 Tredget et al, ‘A Matched-Pair, Randomized Study Evaluating the Efficacy and Safety of ACTICOAT Silver-Coated Dressing for the Treatment of Burn Wounds’, Journal of Burn Care & Rehabilitation 1998; 19(6): 531-537
    23 Cuttle L. Naidu S. Mill J. Hoskins W. Das K. and Kimble R. (2007) a retrospective cohort study of ACTICOAT versus Silvazine in a paediatric population. Burns. 33 (6): 701-7
    24 Silver et al (2007) A silver-coated antimicrobial barrier dressing used postoperatively on meshed autografts: A dressing comparison study. Journal of Burn Care and Research. 28(5):715-719
    25 Peters D, Verchere C. Healing at home: Comparing Cohorts of children with medium-sized burns treated as outpatients with in-hospital applied ACTICOAT to those children treated as inpatients with silver sulfadiazine. Journal of Burn Care & Research 2006; 27(2):198-201.
    26Westaim Report Ref. #001213 
    27Westaim Report Ref. #010322
    28Data on File: 0810012
    29Data on File: 0810013
    30Fong J, Wood F, Fowler B. A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: Comparative patient care audits. Burns 31 (2005)562-567. Burn Care Res 2006;27:198-201
    31Russell AD, Hugo WB. Antimicrobial activity and action of silver. Prog Med Chem 1994; 31: 351-71
    32Peterson and Shanholtzer (1992) Tests for Bacteriacidal effects of antimicrobial agents: technical performance and clinical relevance. Clinical Microbiology Reviews 5(4)420-432
    33Benson R Smith and Nephew Data on File 0504001v3
    34A. Keene, ACTICOAT Non-Clinical Overview (Consultation Dossier). 29th January 2002
    35Wright et al, ‘The Comparative Efficacy of Two Antimicrobial Barrier Dressings: In-VitroExamination of Two Controlled Release of Silver Dressings’, WOUNDS 1998; 10(6): 179-188
    36Lumb, H; The Antimicrobial Activity of ACTICOAT and ACTICOAT Flex 3 while Under Negative Pressure, Data on File reference 0810010
    37Bannister, N; NPWT Summary
    38Carpenter, S; Investigation into wound bed pressure under ACTICOAT using an in-vitromodel, report reference DS/09/019/R1
    39Demonstrable
    40Smith (2005) Ref: 0503008 ACTICOAT Moisture Control Dressing – Physical testing
    41International consensus. Appropriate use of silver dressings in wounds. An expert working group consensus. London: Wounds International, 2012.Available from:www.woundsinternational.com
    42Westaim report #971030
    43Data on File: Smith (2005) 0503006
    44Data on File ref: 0403003

    ACTICOAT Products

    Product Selection

    ACTICOAT is available in a range of different substrate types, all containing the unique SILCRYST silver technology.

    Whether the wounds you deal with on a daily basis are chronic, acute or burn wounds ACTICOAT provides an effective antimicrobial barrier3 with proven efficacy in vitro against highly antibiotic resistant superbugs such as MRSA and VRE16,17.

    Choose from:

    ACTICOAT
    ACTICOAT 

    An antimicrobial barrier dressing3 with an absorbent inner core and a 3 day wear time.

    ACTICOAT 7
    ACTICOAT 7

    A 5 layer antimicrobial barrier dressing3 with an absorbent inner core and a longer, 7 day wear time.

    ACTICOAT Flex
    ACTICOAT Flex

    A conformable and flexible39 mesh antimicrobial barrier dressing available in both a 3 day and 7 day variant. ACTICOAT Flex is suitable for use under NPWT for up to 3 days36,37,38 and is ideal for packing, filling and conforming to difficult anatomical areas39

    ACTICOAT Absorbent
    ACTICOAT Absorbent

    All of the benefits of ACTICOAT in a conformable3, absorbent  type 1 alginate dressing suitable for moderately exuding wounds, this dressing has a 7 day wear time and is suitable for use in cavity wounds.

    ACTICOAT Moisture Control
    ACTICOAT Moisture Control

    All of the benefits of ACTICOAT in a flexible, absorbent foam40 for use on moderate to highly exuding wounds, this dressing has a 7 day wear time and is suitable for use under compression.

    ACTICOAT Surgical
    ACTICOAT Surgical

    Designed for use on surgical incision sites; this adhesive foam post-operative dressing has slits cut into the pad for added conformability.

    ACTICOAT Site
    ACTICOAT Site

    ACTICOAT site is an absorbent foam dressing designed to fit in intimate contact with vascular and non-vascular percutaneous device sites.

     

    References

    1 Daubney, L; ACTICOAT Flex 7 - Evaluation of Extensibility, report reference DS.08.123.R1
    2 Smith & Nephew Data on File Report – 0403002
    3 Burrell et al, ‘Efficacy of Silver-Coated Dressings as Bacterial Barriers in a Rodent Burn Sepsis Model’, WOUNDS 1999; 11(4):64-71.
    4 Gago M, et al., A comparison of three silver-containing dressings in the treatment of infected, chronic wounds. Wounds 2008; 20 (10): 273-278
    5 Searle and Bielby (2010) dressing strategies for the management of infected wounds in community wound care: impacts and implications. Poster at Wounds UK, Harrogate, Nov 2010
    6 Haung et al., A randomised comparative trial between ACTICOAT and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007. 33(2):161-166
    7 Vlachou et al., The safety of nanocrystalline silver dressings on burns: A study of systemic absorption. Burns 2007. 33(8):979-85
    8 Moiemen et al., ACTICOAT dressings and major burns: Systemic silver absorption. Burns 2010. 37(1):27-35
    9 Sibbald et al (2001) A screening evaluation of an ionised nanocrystalline silver dressing in chronic wound care. Ostomy Wound Management 47(10): 38-4
    10 Smith & Nephew Data on file report 0810018
    11 Smith & Nephew Data on file report 0810014
    12 Smith & Nephew report reference DS/08/078/R2
    13 Smith & Nephew report reference DS/08/062/R2
    14 In-vitro study data on file: Scientific Background #0109003 and #0107010
    15 Wright JB, Lam K, Hansen D, Burrell RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-350
    16 DoF 0810016
    17 DoF: 0810017
    18 Hope R, et al., (2012) The in-vitro antibacterial activity of nanocrystalline silver dressings against bacteria withNDM-1 carbapenemase. Poster at EWMA, Austria, 2012
    19 Childress et al (2007) Impact of an absorbent silver-eluting dressing system on lower extremity revascularisation wound complications. Annals of Vascular Surgery. 21(5): 598-602
    20 Gravante et al (2009) Nanocrystalilne silver. A systematic review of randomised trials conducted on burned patients and an evidence-based assessment of potential advantages over old silver formulations. Annals of Plastic Surgery. 63(2):201-204
    21 Muangman et al. (2006) Comparison of efficacy of 1% Silver Sulphadiazine and ACTICOAT for the treatment of partial thickness burn wounds. Journal of the Medical Association of Thailand. 89(7):953-8
    22 Tredget et al, ‘A Matched-Pair, Randomized Study Evaluating the Efficacy and Safety of ACTICOAT Silver-Coated Dressing for the Treatment of Burn Wounds’, Journal of Burn Care & Rehabilitation 1998; 19(6): 531-537
    23 Cuttle L. Naidu S. Mill J. Hoskins W. Das K. and Kimble R. (2007) a retrospective cohort study of ACTICOAT versus Silvazine in a paediatric population. Burns. 33 (6): 701-7
    24 Silver et al (2007) A silver-coated antimicrobial barrier dressing used postoperatively on meshed autografts: A dressing comparison study. Journal of Burn Care and Research. 28(5):715-719
    25 Peters D, Verchere C. Healing at home: Comparing Cohorts of children with medium-sized burns treated as outpatients with in-hospital applied ACTICOAT to those children treated as inpatients with silver sulfadiazine. Journal of Burn Care & Research 2006; 27(2):198-201.
    26Westaim Report Ref. #001213 
    27Westaim Report Ref. #010322
    28Data on File: 0810012
    29Data on File: 0810013
    30Fong J, Wood F, Fowler B. A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: Comparative patient care audits. Burns 31 (2005)562-567. Burn Care Res 2006;27:198-201
    31Russell AD, Hugo WB. Antimicrobial activity and action of silver. Prog Med Chem 1994; 31: 351-71
    32Peterson and Shanholtzer (1992) Tests for Bacteriacidal effects of antimicrobial agents: technical performance and clinical relevance. Clinical Microbiology Reviews 5(4)420-432
    33Benson R Smith and Nephew Data on File 0504001v3
    34A. Keene, ACTICOAT Non-Clinical Overview (Consultation Dossier). 29th January 2002
    35Wright et al, ‘The Comparative Efficacy of Two Antimicrobial Barrier Dressings: In-VitroExamination of Two Controlled Release of Silver Dressings’, WOUNDS 1998; 10(6): 179-188
    36Lumb, H; The Antimicrobial Activity of ACTICOAT and ACTICOAT Flex 3 while Under Negative Pressure, Data on File reference 0810010
    37Bannister, N; NPWT Summary
    38Carpenter, S; Investigation into wound bed pressure under ACTICOAT using an in-vitromodel, report reference DS/09/019/R1
    39Demonstrable
    40Smith (2005) Ref: 0503008 ACTICOAT Moisture Control Dressing – Physical testing
    41International consensus. Appropriate use of silver dressings in wounds. An expert working group consensus. London: Wounds International, 2012.Available from:www.woundsinternational.com
    42Westaim report #971030
    43Data on File: Smith (2005) 0503006
    44Data on File ref: 0403003

    FAQs

    Frequently Asked Questions about ACTICOAT 

    ACTICOAT and ACTICOAT 7 have a blue side and a silver side, which side should be in contact with the wound bed?

    Either side can be placed in contact with the wound bed, there is no difference in efficacy.

    Why should ACTICOAT be moistened with water and not saline?

    The chloride and ions in saline have the potential to neutralise Ag+ ions so to prevent this, water is the best wetting agent.

    What is the minimum age a patient should be for ACTICOAT application?

    ACTICOAT should only be used in premature infants (<37 weeks gestation) when clinical benefits outweigh any potential patient risks. No clinical data is available in this age group and only limited data is available for use in neonates.

    Can ACTICOAT be used alongside other topical therapy such as collagenase?

    No - silver is a heavy metal and can inactivate the enzymes.

    How long can ACTICOAT be used for?

    International consensus documents state that a topical antimicrobial should have a positive effect within 2 weeks41. Progress should be assessed every 2 weeks to help dictate forward strategies in terms of therapeutic options.

    In certain "at risk" wound types (including surgical incisions) ACTICOAT use can be part of a preventative strategy even though the signs and symptoms of infection are absent. Use over extended time periods should be based on a clinical and microbiological justification.

    Is silver toxic?

    A study of silver levels in patients dressed with ACTICOAT for skin grafts, and residual burn sites showed that the levels of serum silver for ACTICOAT were less than the maximal level reported in the literature for patients treated with SSD cream7.

    The authors concluded that the use of ACTICOAT was not associated with clinical, biochemical or haematological signs of toxicity7. Another study found no significant difference between ACTICOAT and SSD with routine blood tests, liver and renal function tests6.

    Additionally, no side effects were found relating to the use of ACTICOAT6. In relation to chronic wounds, blood testing of a cohort of venous leg ulcer patients showed no clinically relevant changes in serum silver concentrations, haematology or biochemistry results following ACTICOAT usage9.

    A clinical study in chronic wounds demonstrated a faster rate of wound healing in patients treated with ACTICOAT compared to other silver dressings4

    Isn't silver expensive?

    The unit cost for an ACTICOAT dressing may be greater than a non-antimicrobial but the benefits to both the patient and the overall care budget outweigh this difference.

    ACTICOAT has been shown to decrease the length of inpatient stay30 and has been demonstrated to lower overall treatment costs compared to SSD in the high cost burns arena30.

    ACTICOAT has also been shown to be more effective in a chronic setting compared to competitors4. In a comparative study ACTICOAT was shown to not only result in faster time to resolution of infection4 but also a decreased overall cost compared to competitors5.

    In terms of the total cost of wound care it is the complications such as infection that drive up costs. For example infection may cause an increase in bed days, increased antibiotic use and increased clinician time. So an interventional, fast acting product with improved outcomes can easily justify a higher price.

    How long does it take ACTICOAT to have an effect?

    ACTICOAT has been shown (in-vitro) to kill bacteria in as little as 30 minutes‡10,11,34,35. International consensus documents state that a topical antimicrobial should have a positive effect within 2 weeks41.

    In a comparative clinical study in chronic wounds 60% of the patients treated with ACTICOAT saw a resolution of wound infection within 2 weeks compared to only 8% and 10% in competitor dressing cohorts4.

    What microbes is ACTICOAT effective against?

    ACTICOAT is effective (in-vitro) against a broad spectrum of over 150 gram positive and gram negative bacteria and fungal wound pathogens14,15. It is also effective (in-vitro) against Antibiotic-resistant bacteria such as Pseudomonas, Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-Resistant Enterococcus (VRE)15,16,17 and bacteria containing NDM-1 Carbapenemases18.

    How long does ACTICOAT remain active for?

    ACTICOAT and ACTICOAT Flex 3 both have been shown to maintain antimicrobial barrier efficacy for 3 days (in-vitro)42, Other variants including ACTICOAT 726,27, ACTICOAT Flex 728,29, ACTICOAT Moisture Control43 and ACTICOAT Absorbent44 maintain antimicrobial barrier efficacy for up to 7 days.

    When should ACTICOAT dressings be changed?

    ACTICOAT dressings have recommended wear times of between 3 and 7 days depending on the variant (please refer to dressing specific insert leaflet), appropriate clinical protocols and judgement should always be used when deciding on dressing change timings.

    Can I use ACTICOAT under NPWT?

    ACTICOAT and ACTICOAT Flex are both indicated for use under negative pressure devices. ACTICOAT requires fenestration before application whilst the mesh structure of ACTICOAT Flex gives fluid transfer properties for use as an antimicrobial layer under NPWT28,29,30 and can be used for up to 3 days36,37,38.

     

    ‡ACTICOAT, ACTICOAT 7, ACTICOAT Flex 3, ACTICOAT Flex 7

    ACTICOAT Flex

    References

    1 Daubney, L; ACTICOAT Flex 7 - Evaluation of Extensibility, report reference DS.08.123.R1
    2 Smith & Nephew Data on File Report – 0403002
    3 Burrell et al, ‘Efficacy of Silver-Coated Dressings as Bacterial Barriers in a Rodent Burn Sepsis Model’, WOUNDS 1999; 11(4):64-71.
    4 Gago M, et al., A comparison of three silver-containing dressings in the treatment of infected, chronic wounds. Wounds 2008; 20 (10): 273-278
    5 Searle and Bielby (2010) dressing strategies for the management of infected wounds in community wound care: impacts and implications. Poster at Wounds UK, Harrogate, Nov 2010
    6 Haung et al., A randomised comparative trial between ACTICOAT and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007. 33(2):161-166
    7 Vlachou et al., The safety of nanocrystalline silver dressings on burns: A study of systemic absorption. Burns 2007. 33(8):979-85
    8 Moiemen et al., ACTICOAT dressings and major burns: Systemic silver absorption. Burns 2010. 37(1):27-35
    9 Sibbald et al (2001) A screening evaluation of an ionised nanocrystalline silver dressing in chronic wound care. Ostomy Wound Management 47(10): 38-4
    10 Smith & Nephew Data on file report 0810018
    11 Smith & Nephew Data on file report 0810014
    12 Smith & Nephew report reference DS/08/078/R2
    13 Smith & Nephew report reference DS/08/062/R2
    14 In-vitro study data on file: Scientific Background #0109003 and #0107010
    15 Wright JB, Lam K, Hansen D, Burrell RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-350
    16 DoF 0810016
    17 DoF: 0810017
    18 Hope R, et al., (2012) The in-vitro antibacterial activity of nanocrystalline silver dressings against bacteria withNDM-1 carbapenemase. Poster at EWMA, Austria, 2012
    19 Childress et al (2007) Impact of an absorbent silver-eluting dressing system on lower extremity revascularisation wound complications. Annals of Vascular Surgery. 21(5): 598-602
    20 Gravante et al (2009) Nanocrystalilne silver. A systematic review of randomised trials conducted on burned patients and an evidence-based assessment of potential advantages over old silver formulations. Annals of Plastic Surgery. 63(2):201-204
    21 Muangman et al. (2006) Comparison of efficacy of 1% Silver Sulphadiazine and ACTICOAT for the treatment of partial thickness burn wounds. Journal of the Medical Association of Thailand. 89(7):953-8
    22 Tredget et al, ‘A Matched-Pair, Randomized Study Evaluating the Efficacy and Safety of ACTICOAT Silver-Coated Dressing for the Treatment of Burn Wounds’, Journal of Burn Care & Rehabilitation 1998; 19(6): 531-537
    23 Cuttle L. Naidu S. Mill J. Hoskins W. Das K. and Kimble R. (2007) a retrospective cohort study of ACTICOAT versus Silvazine in a paediatric population. Burns. 33 (6): 701-7
    24 Silver et al (2007) A silver-coated antimicrobial barrier dressing used postoperatively on meshed autografts: A dressing comparison study. Journal of Burn Care and Research. 28(5):715-719
    25 Peters D, Verchere C. Healing at home: Comparing Cohorts of children with medium-sized burns treated as outpatients with in-hospital applied ACTICOAT to those children treated as inpatients with silver sulfadiazine. Journal of Burn Care & Research 2006; 27(2):198-201.
    26Westaim Report Ref. #001213 
    27Westaim Report Ref. #010322
    28Data on File: 0810012
    29Data on File: 0810013
    30Fong J, Wood F, Fowler B. A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: Comparative patient care audits. Burns 31 (2005)562-567. Burn Care Res 2006;27:198-201
    31Russell AD, Hugo WB. Antimicrobial activity and action of silver. Prog Med Chem 1994; 31: 351-71
    32Peterson and Shanholtzer (1992) Tests for Bacteriacidal effects of antimicrobial agents: technical performance and clinical relevance. Clinical Microbiology Reviews 5(4)420-432
    33Benson R Smith and Nephew Data on File 0504001v3
    34A. Keene, ACTICOAT Non-Clinical Overview (Consultation Dossier). 29th January 2002
    35Wright et al, ‘The Comparative Efficacy of Two Antimicrobial Barrier Dressings: In-VitroExamination of Two Controlled Release of Silver Dressings’, WOUNDS 1998; 10(6): 179-188
    36Lumb, H; The Antimicrobial Activity of ACTICOAT and ACTICOAT Flex 3 while Under Negative Pressure, Data on File reference 0810010
    37Bannister, N; NPWT Summary
    38Carpenter, S; Investigation into wound bed pressure under ACTICOAT using an in-vitromodel, report reference DS/09/019/R1
    39Demonstrable
    40Smith (2005) Ref: 0503008 ACTICOAT Moisture Control Dressing – Physical testing
    41International consensus. Appropriate use of silver dressings in wounds. An expert working group consensus. London: Wounds International, 2012.Available from:www.woundsinternational.com
    42Westaim report #971030
    43Data on File: Smith (2005) 0503006
    44Data on File ref: 0403003