Prontosan. Clean. Easy Wound Healing. Wound Cleansing
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1 Prontosan Clean. Easy Wound Healing. Wound Cleansing CoE Infection Control Prontosan the unique combination of Betaine & Polihexanide reduces healing time removes and prevents biofilm prevents infections facilitates painless dressing changes is compatible with commonly used dressings
2 Prontosan Wound Irrigation Solution The solution for acute, chronic and burn wounds Indications For cleansing, rinsing and moistening of acute and chronic skin wounds, first- and second-degree burns Prevention of Infection in Acute and Chronic Wounds Every wound can develop an infection, especially if there is a high-risk predisposition e.g. due to a patient s general health condition. Therefore, the risk of an infection should be assessed carefully considering following criteria: Type of wound Wound condition (e.g. deep laceration with tissue loss) Slough and necrotic tissue (e.g. heavy contamination with greasy material like oil and / or debris and critically colonised with micro-organisms) Poor local perfusion (arterial or venous insufficiency) Wound environment General health (multimorbidity e.g. diabetes and/or cardio- vascular disease) Immune status (e.g. HIV patient or transplant patient) High age Obesity Nutritional condition (e.g. malnutritious patient) Social habits (e.g. heavy smoker, alcohol abuse) Patient s compliance If there is a predisposition to a wound infection due to the above mentioned criteria, the local application of a superior wound irrigation solution with high cleansing activity like Prontosan is strongly indicated. Prontosan Wound Irrigation Solution can be used for the prevention of an infection in acute and chronic wounds including: Traumatic wounds Postoperative wounds Chronic skin ulcers (e.g. venous, diabetic or pressure ulcers) Thermal wounds (first- and second-degree) Chemical wounds (acid- and alkali-induced) Radiation-induced wounds Ingredients: 0.1% Undecylenamidopropyl Betaine, 0.1% Polyaminopropyl Biguanide (Polihexanide), Purified Water
3 Prontosan Wound Irrigation Solution Properties Ready-to-use colourless solution for irrigation and wound bed preparation to remove coatings before further treatment is carried out Based on betaine surfactant and Polihexanide (Polyaminopropyl biguanide): high tissue tolerance and biocompatibility of the product Sterile solution Can be used on colonised, critically colonised and locally infected wounds Absorbs wound odours Can be used up to 8 weeks after first opening Advantages Ready to use Easy and simple to use Direct application from the practical squeeze bottle Well-known substances with low allergenic potential Can be warmed up to body temperature Can be used on sensitive or irritated skin No risk of further contamination of wounds Can be used in combination with standard and advanced wound dressings
4 Prontosan cost-effective wound bed preparation Wound Bed Preparation The term «Wound bed preparation» was first described by Falanga et al (2000) and can be defined as the global wound management plan to accelerate endogenous healing and to enhance the effectiveness of advanced wound care products. The ultimate aim is to ensure formation of healthy granulation tissue resulting in complete wound closure. The TIME framework (T= Tissue, non-viable or deficient / I= Infection or Inflammation / M= Moisture imbalance / E= Edge of wound, nonadvancing) was developed by Schultz et al in 2003 to provide a systematic approach to the management of chronic wounds. TIME means identifying essential elements for optimal wound bed preparation and correcting abnormalities contributing to impaired wound healing. Therefore, proper wound bed preparation in chronic wounds means: Reduction of bacterial bioburden in the wound bed Removal of necrotic tissue and slough Control of exudate Management of cellular dysfunction and biochemical imbalance One of the basic principles of proper wound bed preparation is certainly appropriate wound cleansing to create a wound environment optimal for healing. Therefore, thorough wound cleansing with an advanced wound irrigation solution like Prontosan should be the aim of every clinician as a prerequisite for normal wound healing and as an efficient contribution to wound bed preparation by the removal of biofilm, slough and necrotic tissue. Cleansing the wound with Prontosan Wound Irrigation Solution increases the healing rate, shortens the duration of treatment, lowers the frequency of complications and thus contributes to lower material and care costs. No. of Patients Comparative healing times of patients with venous leg ulcers, Prontosan vs. traditional therapy Prontosan Wound Irrigation Solution Traditional irrigation solution up to 1 mo up to 2 mo up to 3 mo up to 4 mo up to 5 mo up to 6 mo no healing Assessment of a wound cleansing solution in the treatment of problem wounds. Andriessen AE, Eberlein TE. Wounds 2008;20(6):
5 removes biofilms Removal of Biofilm Chronic wounds are generally difficult to treat. They are usually sloughy and may grow biofilm. It is well known that a «dirty» wound (contaminated with detritus, foreign body) can cause a delay in wound healing and give rise to complications, particularly if the wound bed is coated with biofilm. A biofilm is an assemblage of microbial cells that is firmly adhered to the wound surface and enclosed in a three-dimensional matrix of primarily polysaccharide material. In dermal wounds, especially in chronic wounds, formation of biofilm increases the risk of an infection and may lead to delayed wound healing due to impaired migration and proliferation of keratinocytes, decreased susceptibility to host immunological defence system and impaired penetration of antibiotics into the biofilm matrix. Prontosan contains Undecylenamidopropyl Betaine and Polihexanide. Undecylenamidopropyl betaine reduces the surface tension of Prontosan Wound Irrigation Solution up to a level of 31 mn / m (comparable to a dish-washing detergent) which results in a maceration of the biofilm solutionand finally allows a better penetration into it. Subsequently the biofilm can be «washed away». The mechanism of action can basically be compared with a dishwashing detergent. Comparison of the efficacy of different irrigation solutions against biofilm (Pseudomonas aeruginosa) after 24 hours exposure time. Biofilm equivalents (EU/ml) Baseline Isotonic Ringer s Prontosan load NaCl solution Efficacy of various wound irrigation solutions against biofilms. Seipp HM, Hofmann S, Hack A, Skowronsky A, Hauri A. ZfW 2005;4(5):
6 Prontosan simple and reliable to use Application possibilities for every wound status: Direct application from the practical syringe bottle (40ml/350ml). Gently rubbing the wound with saturated swabs or compresses. Case report diabetic foot Initial situation: greasy wound coating. Visible granulation of the wound, no more signs of inflammation present, all coatings removed. Moistening a compress and keeping it on the wound for minutes to soften wound coatings. This effect can also be achieved in combination with the saturated wound dressing. Removal of the wound dressing. Result: after 11 weeks no macerations visible, good rehydration.
7 painless change of wound dressings Pleasant body temperature for sensitive wounds: Patients with chronic wounds are often sensitive to temperature. Cleansing and removal of wound coatings is also much improved at body temperature. For this reason it is advisable to warm the irrigation solution to about 37.5 C e.g. in a baby-bottle heating device. The dressing change procedure and wound treatment will be more pleasant for the patient. Painless change of dressings with Prontosan Dressings are often encrusted and stick to the wound surfaces. If an attempt is made to remove these dressings from the wound surface when dry, new injuries around the wound area often arise with the additional risk of infection, which in turn delay the healing process. In cases where bandaging is difficult to release, intensive moistening of the wound dressings with Prontosan Wound Irrigation Solution is advisable until they can be gently released without traumatising the surfaces of the wound. If stubborn large encrustations are present, the whole section of the body including the dressing should be thoroughly saturated with Prontosan Wound Irrigation Solution until the dressings can be easily released.
8 B. Braun Medical AG CoE Infection Control Seesatz 17 CH-6204 Sempach Phone Fax AV4058_ (DH476)
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