Clinicians' rationale for using a silver dressing: the French OMAg+E observational study

Abstract

To describe motivations for using a silicone, silver-releasing dressing and the type of wounds treated with this dressing, and to evaluate its short-term impact on wound characteristics. A French, prospective, observational study of adult patients prescribed a soft-silicone, silver releasing dressing (MepilexAg; Molnlycke Health Care) in the community. Each participating physician was asked to include the first two consecutive patients they treated with the silver dressing, reporting patient and wound characteristics, as well as the presence of I 0 local signs compatible with wound infection (abscesses, purulent or copious exudate, erythema, increase in local warmth, pain, oedema,lymphangitis or satellite adenitis, malodour and delayed wound healing). Clinicians were also asked to select from a list their rationale for prescribing the silver dressing for each patient, including treating a wound infection, to stimulate granulation tissue formation, to promote wound healing, to reduce wound exudate, and to decrease wound pain. Local and general treatment were also reported. Overall, 794 patients (58% females), with a mean age of 69.0 ± 15.4 years, were included by 128 general practitioners, 51 dermatologists and 63 vascular specialist. Sixty-seven per cent were venous leg ulcers (VLUs), 26% were acute wounds (post-traumatic, surgical, burn wounds and animal bites) and 6.3%were other chronic wounds (pressure ulcers, diabetic foot ulcers and oncology wounds). On average 3.7 ± 1.5 local signs of infection were present and mean pain intensity (on a visual analogue scale) was 50± 24mm.According to prescribers, infection and healing delay were the primary rationale in 82% of cases,with oral antibiotics started concurrently in 19% of these wounds. Patients were followed-up at a median of 19 days, by which time all wound parameters were documented as significantly improved. Tolerability and efficiency of the silver dressing was considered as 'good'/'very good' in more than 97% of cases. While there are some variances with the French reimbursement indication, for the clinicians surveyed in this study, the primary rationale for prescription of a silver dressing was treatment of a possible wound infection. Although this indication might not always be clinically funded, based on wound characteristics, the short-term impact of this prescription in this series was favourable.