Suprasorb Moist Wound Management The right dressing for each wound.

Transcription

1 Suprasorb Moist Wound Management The right dressing for each wound.

2 2

3 Contents The complete range of moist wound management 15 Wound healing a three-phase process 16-7 Suprasorb professional care for each wound 18-9 PHMB antimicrobially active and well tolerated Pain management enhancing patients quality of life Professional wound care a scientifically established principle Suprasorb a powerful combination Suprasorb always the right choice Suprasorb Liquacel Hydroactive Fibre Dressing Suprasorb A Calcium Alginate Wound Dressing Suprasorb A + Ag Antimicrobial Calcium Alginate Wound Dressing Suprasorb X HydroBalance Wound Dressing Suprasorb X + PHMB Antimicrobial HydroBalance Wound Dressing Suprasorb C Collagen Wound Dressing Suprasorb P PU Foam Dressing Suprasorb P silicone Silicone Foam Dressing Suprasorb H Hydrocolloid Dressing Suprasorb F Film Wound Dressing Suprasorb G Gel Dressing References 144 The right dressing for each wound Synopsis

4 L&R a good partner. Other products and services provided by Lohmann & Rauscher other wound care products compression Suprasorb CNP mobilization immobilization Ratioline general hygiene, healthcare supplies and incontinence products OR drape system OR clothing Kitpack /Setpack 4

5 The complete range for moist wound management As an international company with a comprehensive product range, L&R produces innovative medical devices and hygiene products ranging from traditional dressing materials to the latest state-of-the-art therapy and patient care systems. The company s in-house Research and Development activities are the foundation of its continued success over several decades. The main focus is on the benefit and well-being of the patient, for whom the healing process shall be made as comfortable and effective as possible. Phase-oriented wound management throughout all phases of healing The management of acute or chronic wounds requires a sensitive approach which is carefully adjusted to the individual phases of wound healing, including the use of appropriate wound dressings. After all, the purpose is to prevent an infection of the wound and to promote wound healing in a manner which is efficient and sustainable, yet gentle on the patient. With its Suprasorb products, L&R provides a comprehensive range of moist wound management modalities to be used by physicians and nurses in clinical and practice settings: for all phases of wound healing, for any level of exudate, for infected as well as non- infected wounds a complete and well-rounded package solution that ensures optimum care for the patient in accordance with the principles of moist wound management, throughout the entire process of healing. Moist wound dressings create an optimum environment for the multitude of individual activities which determine the healing process. L&R engages in extensive research in the field of wound care, and is thus capable of providing products that are always state of the art. The benefit to the user: a complete one-stop solution for optimum patient care. 5

6 Wound healing a three-phase process Physiological wound healing is a complex and dynamic process which always runs the same course, regardless of the type of wound involved. This process typically includes three mutually dependent phases, with smooth, continuous transitions in between. 1. Exudation phase The exudation or cleansing phase begins immediately after the injury. The clinical picture shows a local inflammation, which is followed by high amounts of exudate. This phase involves blood coagulation, wound cleansing, and the body s natural defence against infection. Pathogens and destroyed tissues are removed through the process of phagocytosis. In the exudation phase, moist wound management promotes and enhances the natural wound cleansing process in the best way possible, thus creating a clean wound environment. If the wound has coatings or necrotic tissues, they are softened and removed. Exudate, cell debris and pathogens are absorbed by the dressing. A perfect wound dressing keeps the wound moist and protects it against infection the ideal basis for quick and efficient healing. Dressing change intervals are determined by the condition of the wound and the amount of exudate. Thus, dressings may have to be changed several times a day. If necessary, necrotic tissues and coatings will also be removed in the process. 1 EXUDATION Days

7 2. Granulation phase In the granulation or proliferation phase, new cells are formed. The wound space is gradually filled in with fresh granulation tissue. There is an increased migration of fibroblasts into the wound, and collagen synthesis sets in. Capillaries grow towards the centre of the wound, while exudation decreases. The clinical picture now shows a reddish tissue with good blood perfusion. In the granulation phase, a moist wound dressing keeps the wound from drying out, while efficiently absorbing any excess exudate. It provides safety from infection and mechanical damage and protects the fresh tissue. In this phase as well, it is the best possible wound management modality in terms of an ideal moist wound environment. The individual condition of the wound determines how often the dressing has to be changed. As a general rule, dressing change intervals tend to increase over the course of wound treatment. A distinct advantage is the fact that a moist wound dressing facilitates an atraumatic change of dressings, which means less pain for the patient and better healing. 3. Epithelization phase The epithelization or regeneration phase is characterized by a progression in tissue differentiation and epithelization. The wound edges move in towards each other; the wound is gradually covered by epithelial tissue growing inwards from the edge. Wound contraction and scar formation completes the process of wound healing. In this phase, moist wound management promotes the final stage of healing and the formation of fresh epithelial tissue. The dressing maintains an optimum level of moisture and provides protection from outside influences to keep the wound undisturbed. The individual condition of the wound determines how often the moist wound dressing needs to be changed. As exudation keeps decreasing, the dressing may remain in place for up to 7 days, which is a benefit to users as well as patients. 2 GRANULATION 3 EPITHELIZATION

8 Suprasorb professional care for each wound Wound with necrotic tissue Wound with fibrinous coatings Epithelizing wound Granulating wound In an effort to facilitate the phase-oriented use of individual wound dressings, wounds are classified into four stages on the basis of their visual appearance, as follows: wounds with necrotic tissue / wounds with fibrinous coatings / granulating wounds / epithelizing wounds. For practical purposes, these four stages are commonly identified by colour codes black, yellow, red, and pink, respectively. The amount of exudate in a wound (light, moderate, or high) serves as another criterion for choosing the appropriate wound dressing. Furthermore, the possibility of an infection must always be taken into account. A clinical infection is characterized by the classic signs of inflammation (swelling, redness, heat, pain, and possibly impaired function), plus such signs of infection, as wound odour and suppuration. These must be distinguished from colonization and contamination of the skin or the wound. Colonization occurs when pathogens invade the skin or wound, while contamination refers to a colonization of the wound with pathogens which does not result in a host reaction. 8

9 Suprasorb Liquacel Hydroactive Fibre Dressing Suprasorb A Calcium Alginate Dressing Suprasorb A + Ag Calcium Alginate Dressing for infected Wounds Suprasorb X HydroBalance Wound Dressing Suprasorb X + PHMB HydroBalance Wound Dressing for infected Wounds Suprasorb C CollagenWound Dressing Suprasorb P PU Foam Dressing Suprasorb P silicone Silicone Foam Dressing Suprasorb H Hydrocolloid Dressing standard border sacrum thin Suprasorb F Film Wound Dressing Suprasorb G Gel Dressing Amorphous Gel Dressing 9

10 PHMB antimicrobially active and well tolerated Polyhexamethylene biguanide (or PHMB for short) is an active substance with a broad antimicrobial spectrum, a favourable toxicological profile, and a low allergenic potential. PHMB has long been used in a wide variety of everyday products, for instance as a preservative in cosmetics and solutions for contact lenses, or in the manufacture of surface disinfectants. Its positive effects on wound healing make PHMB the agent of choice in the treatment of poorly healing chronic wounds. 1-3 PHMB a tiny agent with a big effect. Consequently, L&R uses PHMB in combination with the biosynthetic Suprasorb X HydroBalance wound dressing for treatment of infected wounds or wounds at risk of infection, in various phases of wound healing, for lightly to moderately exuding wounds. Even with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycinresitant Enterococcus (VRE), the antimicrobial effects of PHMB have been proven in studies

11 It fights bacterial cells but protects human cells A common complication associated with chronic wounds is colonization with Staphylococcus aureus, one of the dreaded causes of infections acquired in a clinical environment. Due to the specific propensity of Staphylococcus aureus in resistance to antibiotics, and in particular to methicillin (MRSA), an additional treatment by use of antimicrobial wound dressings is of essential importance for a successful outcome of therapy. The use of Suprasorb X + PHMB has a significant antibacterial effect on infected cells, while skin cells are protected against the pathogen. 7 No development of resistances with repeated inoculation Quick release for good success A successful and sustainable treatment is not only contingent upon the efficacy of PHMB as such. The release of PHMB from the wound dressing is also an essential factor with regard to therapy success. The Suprasorb X + PHMB HydroBalance wound dressing has produced good results in this regard. Within a short period of time, PHMB is released from the wound dressing. 6 Thus, even substantial bioburdens in a wound can be fought efficiently. Likewise, the effectiveness of PHMB over a period of 7 days has been demonstrated. 4 Even with frequently repeated use of PHMB, no resistances have been observed. Specific tests with Staphylococcus aureus have shown that no resistances were developed even after 100 days of repeated incubation with PHMB. 8 Particularly effective when used in combination In the treatment of infected wounds or wounds at risk of infection, Suprasorb X + PHMB is an outstanding therapy option. PHMB has been proven to be antimicrobially effective against the pathogens involved in colonization and infection, without any harmful effects on healthy tissue. The HydroBalance effect automatically controls the level of moisture in the wound. Suprasorb X + PHMB is safe and easy to use to the benefit of the patient. 11

12 Pain management enhancing patients quality of life Wound pain is a complex, multi-level phenomenon. As a general rule, there are two different types of pain nociceptive pain and neuropathic pain. Nociceptive pain can be triggered, for example, by injuries. Nociceptive pain is usually temporary. Neuropathic pain, by contrast, is the result of a malfunction of the nervous system, which may be due to an injury or infection. Neuropathic pain is the most common cause of chronic pain conditions. In patients with chronic pain, even the slightest touch, or a change in temperature, can trigger severe pain. Especially when pain is persistent, the patients morale will also suffer. They will often feel left out from everyday activities because their pain deprives them of the energy they need to live a normal life like a healthy person. As a general rule, each individual patient perceives his or her pain in a different way. Listening to the patient An optimum approach to pain management must give consideration to all individual aspects of a patient s perception of pain. Therefore the attending physician must be capable of accurately assessing the pain. Patients should be encouraged to describe their pain to the medical professionals to help them obtain a clearer picture of its nature and severity. Furthermore, various instruments are available for the assessment of pain. For instance, patients may use a pain scale to describe their pain, or a pain diary in which they note all relevant aspects of wound pain over time. 12

13 Rediscover your smile. To physicians or nurses, such records can provide valuable guidance in their pain reduction efforts, for even the choice of an appropriate wound dressing as such can reduce wound pain considerably. With its Suprasorb product range for moist wound management, L&R provides a wide variety of appropriate wound dressings, which not only facilitate a virtually pain-free changing of dressings, but also show specific pain-reducing effects in the treatment of chronic wounds. For this is the ultimate purpose to achieve the best possible, quick and largely pain-free wound healing, and let the patients rediscover their quality of life. What is a chronic wound? Experts estimate that about three or four million people in Germany (approx. 4 % of the population) are suffering from chronic wounds. In most of the professional literature there is a common consensus that wounds should be referred to as chronic if no tendency towards healing is apparent within a period of four to twelve weeks from their origin (the individual nature of the wound as well as other factors are essential aspects in this context). 9 The most common types of chronic wounds include pressure ulcers, leg ulcers, and Diabetic Foot ulcers. 13

14 Professional wound care a scientifically established principle Scientific expertise the basis of professional wound management To L&R, providing conclusive scientific evidence for all their products is a matter of course in their professional work. In clinical studies, Suprasorb products are compared to established wound care products and they prove that they provide a combination of therapeutic efficacy and excellent tolerability. In surveillance studies, the moist wound management products are tested under real-life conditions, and laboratory tests are performed to determine their specific mechanisms of action. For doctors and nursing staff in a clinical or practice setting, this means reliability and wound management and the best possible safety of use. The particular therapeutic benefits of the Suprasorb products are investigated and proven in studies designed specifically for this purpose. Active pain management established in randomized controlled trials With Suprasorb X and Suprasorb X + PHMB, L&R provides wound management which also includes pain management. This fact, as well as the good tolerability of Suprasorb wound dressings, has been established in several randomized, controlled trials. Thus, for instance, the HydroBalance-System has been shown to afford a high potential for pain relief without any analgesic additives. With excellent tolerability, Suprasorb X and Suprasorb X + PHMB were highly effective at fighting wound pain, as compared to traditional wound dressings, moist wound management products, or a foam dressing with an analgesic component

15 Antimicrobial action of PHMB* PHMB has been shown to be effective in the eradication of MRSA and in the treatment of locally infected wounds or wounds at risk of infection. This has also been proven in clinical trials Accelerated wound healing with Suprasorb C* In various case series and laboratory tests, it has been established that the native collagen in Suprasorb C binds factors that inhibit wound healing, while protecting growth factors. The migration and activity of tissue-forming cells is enhanced, and blood perfusion at the microcirculation level in the wound is improved wound healing is actively encouraged, and thus accelerated * Further material on studies can be found on 15

16 Suprasorb a powerful combination A comprehensive one-stop solution. The complete Suprasorb product range is designed in such a manner that the individual dressings can be combined with each other. Thus, L&R provides a wide variety of treatment modalities which allows the right combination of primary and secondary dressings in any phase of wound healing. The following synopsis shows how all types of wounds, throughout all stages of healing, can be treated with this comprehensive one-stop solution. In addition, L&R also provides products for the treatment of concomitant conditions e.g., in the case of venous leg ulcers, specific compression products for the therapy of chronic venous insufficiency. In compression therapy, the Suprasorb products are used as primary wound dressings underneath specific compression devices (e.g. Rosidal sys) to promote healing. Furthermore, products from the Suprasorb range are also available for further treatment of large and deep wounds. The benefit to physicians and nurses: the individual dressings are excellently compatible with each other to make their use particularly safe and easy. Thus, the potential of each individual product becomes even more noticeable. 16

17 When used in combination with each other, Suprasorb dressings are even more effective. With the right combination of primary and secondary dressings, L&R provides a complete system for wound treatment throughout all phases of healing. Product * Options for product combinations * Liquacel A A X X C P P H F G + + Ag PHMB silicone Suprasorb Liquacel Suprasorb A Gel Suprasorb A + Ag Suprasorb X Vliwasorb Vliwazell Vliwaktiv Vliwasorb Vliwazell Vliwaktiv Vliwasorb Vliwazell Lomatuell H Solvaline N Suprasorb X + PHMB Lomatuell H Solvaline N Suprasorb C Gel Vliwasorb Vliwazell Suprasorb P Suprasorb P silicone Suprasorb H Gel Suprasorb F Dressing Suprasorb G In malodorous wounds, Vliwaktiv Ag efficiently fights wound odour as well as bacteria. It can be used as an antimicrobial absorbent dressing, or in its rope version for deep wounds, in combination with an appropriate secondary dressing. * Some products may not be available in all countries. 17

18 Suprasorb always the right choice Non-infected wounds and wounds at risk of infection With non-infected wounds, the main objective consists of promoting granulation and epithelization. In order to ensure a successful outcome, appropriate therapies for any underlying conditions, as well as adequate wound bed preparation (removal of necrotic tissues, coatings etc.) must be incorporated in the wound management concept. The choice of a therapeutically appropriate wound dressing is contingent upon the individual condition of the wound and the amount of exudate. Wounds at risk of infection Critical colonization may occur on a wound which is at risk of infection, which may quickly develop into a local infection involving all the complications commonly associated with this situation. What kinds of wounds are at risk of infection?* Whether a wound is at risk of infection or not depends on a variety of factors. Patients suffering from concomitant conditions, such as diabetes or an immunodeficiency, have an increased risk of infection compared to healthy individuals. In general, hygienic conditions and the specific site of the wound are also relevant aspects with regard to its susceptibility to infection. Thus, for instance, a pet owner will have a higher risk of infection. Similarly, gunshot wounds, bite wounds, and contaminated wounds sustained in an outdoor environment also involve a general risk of infection. In an effort to prevent such infections, antimicrobial wound dressings such as Suprasorb X + PHMB and Suprasorb A + Ag should be used. In addition to promoting wound healing, the objective is to prevent critical colonization and subsequent infection. Recommended treatment for non-infected wounds**: Wounds with low amounts of exudate The moisture-controlling Suprasorb X HydroBalance wound dressing and the hydroactive Suprasorb Liquacel fibre dressing keep the surface of the wound moist and absorb exudate. Use in combination with the Suprasorb F film dressing as a secondary dressing. Wounds with moderate amounts of exudate The moisture-controlling Suprasorb X HydroBalance wound dressing and the hydroactive Suprasorb Liquacel fibre dressing keep the surface of the wound moist and absorb exudate. Use in combination with the fine-pore PU foam dressing Suprasorb P. Suprasorb Liquacel with Suprasorb P silicone is a further possible combination.*** Wounds with high amounts of exudate The absorbent Suprasorb A Calcium Alginate dressing or the hydroactive Suprasorb Liquacel fibre dressing absorb exudate. Use in combination with the Suprasorb P foam dressings, Vliwazell, the highly absorbent all-purpose dressing, or Vliwasorb, the superabsorbent wound dressing. When there is a stagnation in the process of wound healing, the Suprasorb C active collagen wound dressing is used to promote healing. The use of antimicrobial wound dressings such as Suprasorb X + PHMB and Suprasorb A + Ag is particularly appropriate for preventing local infection, and any complications associated with it, in high-risk wounds. Suprasorb P silicone can be applied on wounds with low to moderate exudate levels. * Further information on the subject of evaluating the risk of infection can be found on ** Some products may not be available in all countries. 18

19 Recommended treatment The moisture-controlling Suprasorb X HydroBalance wound dressing and the hydroactive Suprasorb Liquacel fibre dressing keep the surface of the wound moist and absorb exudate. Use in combination with the Suprasorb F film dressing as a secondary dressing. Secondary dressing: Suprasorb F Film Wound Dressing Suprasorb X Suprasorb Liquacel non-infected wound Secondary dressing: PU Foam Dressings Suprasorb P or Suprasorb P silicone*** Suprasorb X + PHMB wound at risk of infection Wounds with moderate exudate levels Suprasorb X + PHMB Suprasorb Liquacel***** wound at risk of infection Recommended treatment The moisture-controlling Suprasorb X HydroBalance wound dressing and the hydroactive Suprasorb Liquacel fibre dressing keep the surface of the wound moist and absorb exudate. Use in combination with the fine-pore PU foam dressing Suprasorb P. Suprasorb Liquacel with Suprasorb P silicone is a further possible combination.*** In case of problem wounds, the active wound dressing Suprasorb C can be used in any phase of wound healing, and for any amount of exudate, to stimulate the healing process. Suprasorb P silicone can be used on wounds with low to moderate levels of exudate. Wounds with low exudate levels Suprasorb X Suprasorb Liquacel non-infected wound Secondary dressing: Vliwazell Highly Absorbent All-Purpose Dressing, Vliwasorb Superabsorbent Wound Dressing or Suprasorb P PU Foam Dressing Wounds with high exudate levels Suprasorb A + Ag Suprasorb Liquacel***** wound at risk of infection Suprasorb A Suprasorb Liquacel non-infected wound Recommended treatment The absorbent Suprasorb A Calcium Alginate Dressing or the hydroactive Suprasorb Liquacel fibre dressing absorb exudate. Use in combination with the Suprasorb P foam dressings, Vliwazell, the highly absorbent all-purpose dressing, or Vliwasorb, the superabsorbent wound dressing. In high-risk wounds, the use of antimicrobial wound dressings such as Suprasorb X + PHMB and Suprasorb A + Ag is particularly appropriate for preventing local infection and any complications associated with it, using the WAR Score for assistance.**** *** Combining Suprasorb X/Suprasorb X + PHMB with Suprasorb P silicone is not recommended. **** Further information on the WAR Score can be found on ***** Another option that the healthcare professionals responsible for therapy may decide on is to combine and/or use an established antimicrobial wound rinsing solution as part of daily dressing changes. 19

20 Suprasorb always the right choice Infected wounds With infected wounds, in addition to promoting wound healing, the main objective is to reduce the bioburden of microorganisms. Polyhexamethylene biguanide (PHMB) and silver have antimicrobial effects and can actively fight micro organisms in the wound area. PHMB is appropriate for long-term use, as it has special cell-preserving properties. The choice of a therapeutically appropriate wound dressing is contingent upon the individual condition of the wound and the amount of exudate. What is an infected wound?* A wound which is at risk of infection may quickly develop a critical colonization, which then advances to infection. Infections with Staphylococcus aureus or Enterococcus are particularly critical in this context, as these specific pathogens have a tendency to develop resistances (MRSA and VRE, respectively). These two are the most common causes of nosocomial infections (i.e. infections acquired in a hospital setting). In any case, the treatment of infected wounds requires antimicrobial wound management. For this specific purpose, the antimicrobial wound dressings Suprasorb A + Ag and Suprasorb X + PHMB are particularly appropriate, and for malodorous wounds also Vliwaktiv Ag. Recommended treatment for infected wounds**: Wounds with low amounts of exudate The moisture-controlling Suprasorb X + PHMB HydroBalance wound dressing with antimicrobially active PHMB reduces microbial counts and keeps the surface of the wound moist. Use in combination with Solvaline N. Wounds with moderate amounts of exudate The moisture-controlling Suprasorb X + PHMB HydroBalance wound dressing with antimicrobially active PHMB reduces microbial counts, keeps the surface of the wound moist, and absorbs exudate. Use in combination with an absorbent secondary dressing, such as Solvaline N. Wounds with high amounts of exudate The highly absorbent Suprasorb A + Ag Calcium Alginate dressing with antimicrobial silver reduces microbial counts and absorbs exudate. Use in combination with Vliwazell, the highly absorbent all-purpose dressing, or Vliwasorb, the superabsorbent wound dressing. In malodorous wounds, Vliwaktiv Ag efficiently fights wound odour as well as bacteria. It can be used as an antimicrobial absorbent dressing, or in its rope version for deep wounds, in combination with an appropriate secondary dressing. * Further information on the subject of evaluating the risk of infection can be found on ** Some products may not be available in all countries. 20

21 Recommended treatment The moisture-controlling Suprasorb X + PHMB HydroBalance wound dressing with antimicrobially active PHMB reduces microbial counts and keeps the surface of the wound moist. Use in combination with Solvaline N. Secondary dressing: Solvaline N Dressing Suprasorb X + PHMB Wounds with low exudate levels Secondary dressing: Solvaline N Dressing Recommended treatment The moisture-controlling Suprasorb X + PHMB HydroBalance wound dressing with antimicrobially active PHMB reduces microbial counts, keeps the surface of the wound moist, and absorbs exudate. Use in combination with an absorbent secondary dressing, such as Solvaline N. Wounds with moderate exudate levels Suprasorb X + PHMB Secondary dressing: Vliwazell Highly Absorbent All-Purpose Dressing Wounds with high exudate levels Suprasorb A + Ag or Vliwasorb Superabsorbent Wound Dressing Recommended treatment The highly absorbent Suprasorb A + Ag Calcium Alginate dressing with antimicrobial silver reduces microbial counts and absorbs exudate. Use in combination with Vliwazell, the highly absorbent all-purpose dressing, or Vliwasorb, the superabsorbent wound dressing. Register dieser Teil wird abgeschnitten! In malodorous wounds, Vliwaktiv Ag efficiently fights wound odour as well as bacteria. It can be used as an antimicrobial absorbent dressing, or in its rope version for deep wounds, in combination with an appropriate secondary dressing. 21

22 Suprasorb Liquacel Hydroactive Fibre Dressing Register dieser Teil wird abgeschnitten! Suprasorb Liquacel forms a cohesive gel upon contact with wound exudate and this gel traps exudate, debris and bacteria and transfers them to a secondary dressing, e.g. Suprasorb P. Thereby exudate is kept away from the wound edge, the risk of maceration is reduced and wound healing is assisted. Suprasorb Liquacel stands out by its uncomplicated application even when moist: the dressing can be removed fast and easily in one piece. This atraumatic dressing change promotes wound healing. The primary dressing can be cut to size and folded and may also be used as a wound packing. It coats the wound bed completely and is low-adherent. Applications Protection and safety for the wound and wound environment. Suprasorb Liquacel is suitable for exuding, superficial to deep wounds. For example for ulcers of various aetiology, acute wounds (e.g. lacerations, cuts and abrasions, 2 nd degree burns), postoperative wounds (e.g. skin donor sites), and traumatic wounds. Dressing change intervals To be determined by the attending physician in accordance with individual wound condition, amount of exudate and secondary dressing used, but no longer than 7 days reduced risk of maceration through vertical absorption and transfer of exudate to a secondary dressing forms a cohesive gel upon contact with wound exudate traps exudate, debris and bacteria in the gel 22

23 P P silicone H F Vliwasorb Vliwazell Liquacel Suprasorb Liquacel* Hydroactive Fibre Dressing** primary dressing for exuding wounds effectively manages exudate by forming a gel and transfer to a secondary dressing protects the wound edge can be removed fast and easily in one piece Register dieser Teil wird abgeschnitten! * Further material on studies can be found on ** The stated properties are based on in vitro data available at this stage. 23

24 Register dieser Teil wird abgeschnitten! Excess exudate from the wound is absorbed into the dressing Gel formation by ion exchange 24

25 P P silicone H F G Amorphous Gel Vliwaktiv Vliwasorb Vliwazell Suprasorb A Calcium Alginate Dressing Alginate A Suprasorb A ensures a clean wound environment in wounds with high amounts of exudate. This is due to the high absorption capacity of calcium alginate from natural brown algae. Suprasorb A is particularly soft and supple, with excellent packing behaviour it conforms excellently to any wound base. Cleanses the wound naturally. Suprasorb A stands out by absorbing large volumes of exudate and by gel formation: the gel is formed through an exchange of calcium ions from the wound dressing with sodium ions in the wound exudate. The exudate is bound, and bacteria as well as cell debris are locked up inside the dressing. When dressings are changed, the exudate, bacteria, and cell debris are removed with the alginate fibre material. Suprasorb A Calcium Alginate Dressing ability to absorb high volumes of exudate promotes wound healing high comfort due to a particularly soft structure and easy wound packing good conformability to any wound bed (gel formation through ion exchange) binding of bacteria and cell debris in the gel Applications Suprasorb A is used with heavily exuding, superficial or deep wounds in the exudation and granulation phase e.g. ulcers of various aetiology (venous, arterial), second-degree burns, skin donor sites, or post-operative wounds. Dressing change intervals To be determined by the attending physician in accordance with individual wound condition, amount of exudate, and secondary dressing used, but no longer than 5-7 days. Register dieser Teil wird abgeschnitten! 25

26 Suprasorb A + Ag Antimicrobial Calcium Alginate Dressing Register dieser Teil wird abgeschnitten! Suprasorb A + Ag provides a clean wound environ ment and reduction of microbial counts due to a combination of natural calcium alginate and antimicrobial silver. Suprasorb A + Ag is the dressing for wounds with high amounts of exudate, as well as wounds which are infected or at risk of infection. Through the gel formation process of the alginate, the silver ions released by contact with the wound exudate can exert their effect immediately on the surface of the wound. Suprasorb A + Ag covers a broad antimicrobial spectrum and can also be used in cases of manifest clinical infection. Dead bacteria and pathogens are trapped inside the gel and removed together with the dressing when it is changed. The dressing is effective against MRSA and VRE. With regard to its material structure, Suprasorb A + Ag is similar to the Suprasorb A Calcium Alginate dressing. Cleanses the wound and reduces bioburden. Applications Suprasorb A + Ag is appropriate for heavily exuding, superficial or deep wounds, as well as wounds which are infected or at risk of infection, in the exudation and granulation phase. Indications include ulcers of various aetiology, second-degree burns and skin donor sites, but also fungal lesions. Bacterium 2 3 Bacterium Bacterium Dressing change intervals 1 To be determined by the attending physician in accordance with individual wound condition, infection status, amount of exudate and secondary dressing used*, but no longer than 5-7 days** Excess exudate from the wound is absorbed into the dressing Gel formation by ion exchange Bacteria are killed by silver ions released from the dressing * In case of infection, please note: occlusive secondary dressings should be used only at the attending physician s discretion, depending on the overall situation. ** In case of infection, please note: dressings should be changed on a daily basis. 26

27 P * P silicone Vliwaktiv Vliwasorb Vliwazell Alginate + Ag A Suprasorb A + Ag Antimicrobial Calcium Alginate Dressing ability to absorb high volumes of exudate promotes wound healing quick and broad antimicrobial efficacy, even against MRSA and VRE good conformability to any wound base (gel formation through ion exchange)) microorganisms on the wound bed are killed and locked up in the gel Register dieser Teil wird abgeschnitten! 27

28 Register dieser Teil wird abgeschnitten! Excess exudate from the wound is absorbed into the dressing Moisture is released from the dressing to the lightly exuding part of the wound 28

29 C P F Lomatuell H Solvaline N Suprasorb X HydroBalance Wound Dressing Controls the level of moisture in the wound. Suprasorb X for lightly to moderately exuding, non-infected wounds, controls wound moisture by means of the structure of its biosynthetic HydroBalance fibres. Its speciality: Suprasorb X is capable of absorbing moisture from the wound as well as releasing moisture depending on individual wound condition and the amount of exudate involved. Thus, the dressing will either absorb excess exudate, or release moisture into the wound, or do both at the same time. Suprasorb X is particularly soft and supple, and fights pain. As both sides of the dressing can be applied in the same manner, it provides a high degree of user safety. In terms of moist wound management, an appropriate secondary dressing (e.g. Suprasorb F or Suprasorb P) should be used to ensure that an adequate level of moisture is maintained in Suprasorb X on the wound. HydroBalance X Suprasorb X HydroBalance Wound Dressing very good wound healing due to the unique HydroBalance effect (moisture control) pain reduction without any pharmacological additives high comfort due to a particularly soft and supple material structure particularly economical in use due to longer dressing change intervals 24 Applications Suprasorb X is suitable for a wide range of applications: the wound dressing is used for lightly to moderately exuding, superficial or deep, non-infected wounds in all phases of wound healing. This includes ulcers of various aetiology (venous, arterial), second-degree burns, skin donor and graft sites, and postoperative wounds, as well as abrasions and lacerations. Dressing change intervals To be determined by the attending physician in accordance with individual wound condition, amount of exudate and secondary dressing used, but no longer than 5-7 days. Register dieser Teil wird abgeschnitten! 29

30 Suprasorb X + PHMB Antimicrobial HydroBalance Wound Dressing Register dieser Teil wird abgeschnitten! Suprasorb X + PHMB is the moisture-controlling, antimicrobial wound dressing for lightly to moderately exuding wounds which are either infected or at risk of infection. In addition to the special properties and benefits of Suprasorb X with its biosynthetic HydroBalance fibres, Suprasorb X + PHMB contains 0.3% polyhexamethylene biguanide (PHMB), a highly efficient antimicrobial agent. PHMB realizes its potential with a broad antimicrobial spectrum both inside the dressing and on the surface of the wound, efficiently destroying microorganisms such as bacteria, fungi and yeasts. Even in cases of clinically manifest infection, Suprasorb X + PHMB provides a high degree of safety to the user and good tolerability to the patient. The dressing is reliably effective against MRSA and VRE as well. In terms of moist wound management, an appropriate secondary dressing (e.g. Solvaline N) should be used to ensure that an adequate level of moisture is maintained in Suprasorb X + PHMB on the wound. Controls the level of moisture in the wound and reduces bioburden. Applications Suprasorb X + PHMB is used with lightly to moderately exuding, superficial or deep, infected wounds as well as wounds at risk of infection; in all phases of wound healing. This includes ulcers of various aetiology (venous, arterial), second-degree burns, skin donor and graft sites and postoperative wounds, as well as abrasions and lacerations. 1 Bacterium 3 2 Dressing change intervals To be determined by the attending physician in accordance with individual wound condition, infection status, amount of exudate and secondary dressing used*, but no longer than 5-7 days** Excess exudate from the wound is absorbed into the dressing Moisture is released from the dressing to the lightly exuding part of the wound Microorganisms are killed by polyhexamethylene biguanide (PHMB) released from the dressing * In case of infection, please note: occlusive secondary dressings should be used only at the attending physician s discretion, depending on the overall situation. ** In case of infection, please note: dressings should be changed on a daily basis. 30

31 P * F * Lomatuell H Solvaline N + PHMB HydroBalance X Suprasorb X + PHMB Antimicrobial HydroBalance Wound Dressing very good wound healing due to the unique HydroBalance effect (moisture control) pain reduction without any pharmacological additives quick and broad antimicrobial efficacy, even against MRSA and VRE high comfort due to a particularly soft and supple material structure Register dieser Teil wird abgeschnitten! 31

32 Register dieser Teil wird abgeschnitten! Quick absorption of exudate and gel formation; factors which inhibit wound healing are bound inside the dressing Collagen is supplied to activate wound healing and protect growth factors 32

33 X P P silicone H F G Vliwasorb Vliwazell Suprasorb C Collagen Wound Dressing Actively accelerates wound healing. Suprasorb C is a native, absorbable collagen sponge which actively accelerates the healing process. Its naturally powerful effect is due to its open-pored, pure collagen structure when it makes contact with wound exudate, Suprasorb C forms a gel, and factors that inhibit wound healing, for example, are also absorbed quickly and efficiently together with the exudate. Furthermore, Suprasorb C promotes physical haemostasis in the wound. In any phase of the wound healing process, Suprasorb C restores the natural balance of the wound: factors which inhibit wound healing, such as proteases, radicals and cytokines, are bound and safely locked up, while growth factors which promote wound healing are protected. The mi gration of fibroblasts for fresh growth of granulation tissue is stimulated, and the formation of new epidermal cells is promoted. Collagen C Suprasorb C Collagen Wound Dressing actively accelerates wound healing quick absorption of exudate binds factors which inhibit wound healing protects growth factors stimulates the migration of cells, and thus the formation of fresh tissue The three-phase effect of Suprasorb C affords a high degree of treatment safety by cleansing the wound and changing the wound environment in the exudation phase, by stimulating the granulation tissue in the granulation phase, and by accelerating the process of re-epithelization in the epithelization phase. Applications Suprasorb C can be used for any amount of exudate for superficial or deep, non-infected and chronic wounds, in all phases of wound healing. This includes ulcers of various aetiology, seconddegree burns, and postoperative wounds. Dressing change intervals Register dieser Teil wird abgeschnitten! * In case of lightly exuding wounds, Suprasorb C should be moistened with physiological saline or Ringer s solution. Suprasorb C is resorbable and can be left in the wound. The secondary dressing is changed as determined by the attending physician in accordance with wound condition and level of exudate, but no longer than 5-7 days.* 33

34 Suprasorb P PU Foam Dressing Suprasorb P absorbs wound exudate quickly and efficiently, as the fine-pored PU foam material provides a very good capillary effect right at the base of the wound. The material conforms to any wound base. The special surface structure of the Suprasorb P wound contact layer the all-rounder in wound management is gentle on easily injured surfaces like healing wounds. The semipermeable PU base layer provides an adequately moist wound environment. The dressing reliably maintains its shape even after fluids have been absorbed. It is impermeable to bacteria and water*; the patient can wear the dressing even while taking a shower. Suprasorb P is easy to apply and pleasantly soft and comfortable to wear. Suprasorb P is available in three versions: non-adhesive, self-adhesive, and sacrum. The self-adhesive version has an additional skin-friendly adhesive edge. Reliably absorbs exudate. Register dieser Teil wird abgeschnitten! Applications Suprasorb P has been used effectively on moderately exuding, superficial, non-infected wounds in all phases of wound healing. This includes ulcers of various aetiology (venous, arterial), seconddegree burns, skin donor and graft sites as well as postoperative wounds. Dressing change intervals To be determined by the attending physician in accordance with individual wound condition and amount of exudate but no longer than 5-7 days. In the event of discoloration on the outer surface of the wound dressing, the dressing has to be changed. Suprasorb P can be used as a secondary dressing with wounds at risk of infection within the scope of a regular antimicrobial therapy regimen H 2 O 4 Water vapour Even distribution of wound exudate Perforated wound contact layer Impermeable to bacteria and water* Permeable to water vapour 1 3 Bacterium 2 34

35 A A + Ag X X + PHMB Suprasorb Liquacel C PU Foam P Suprasorb P PU Foam Dressing assists wound healing through reliable exudate management high wearing comfort due to a soft, supple material structure easy assessment of wound exudate PU membrane is impermeable to bacteria and water* * Suprasorb P non-adhesive Register dieser Teil wird abgeschnitten! 35

36 Suprasorb P silicone Silicone Foam Dressing Suprasorb P silicone is a three-layered wound dressing with a wound-facing soft silicone layer, a polyurethane foam and a polyurethane foam carrier layer. Suprasorb P silicone maintains a moist wound healing environment and thereby assists the natural healing process. Exudate and factors which inhibit wound healing are absorbed fast and evenly into the dressing The open-pored foam structure and the generously dimensioned perforation of the adhesive silicone layer result in the good exudate management of Suprasorb P silicone. The wound dressing is easy to apply and can be removed causing virtually no pain Suprasorb P silicone is particularly gentle on the wound bed and the sensitive skin surrounding the wound. 25 Removal is virtually painless. Suprasorb P silicone adheres to parts of the body that are difficult to treat. 25 The silicone foam dressing is available in two versions: border and non-bordered. Applications Register dieser Teil wird abgeschnitten! Suprasorb P silicone is used for wounds with low to moderate levels of exudate and for superfical to deep wounds, in combination with a suitable wound filler. For example on ulcers of various origin, decubital and diabetic ulcers, 1 st and 2 nd degree burns. It may also be used to prevent skin injuries or lacerations. Also, the product is suitable as a secondary dressing in combination with a wound filler, e.g. Suprasorb A calcium alginate. Dressing change intervals To be determined by the attending physician in accordance with individual wound condition, level of exudate, and secondary dressing used, but no longer than 7 days H 2 O 4 Water vapour Even distribution of wound exudate Gentle silicone adhesive layer with generously dimensioned perforation Impermeable to bacteria and water Permeable to water vapour 1 3 Bacterium 2 36

37 A A + Ag C Suprasorb Liquacel Suprasorb P silicone Silicone Foam Dressing application is easy and removal virtually painless 25 gentle on the wound bed and sensitive 25, 28 surrounding skin reliably manages exudate and promotes a moist wound healing environment 25 Silicone Foam P 37

38 2 2 H 2 O 3 Water vapour Bacterium When exudate is absorbed, the hydrocolloid swells up, forming a gel in which exudate and cell debris are bound Repels bacteria and fluids Excess water vapour evaporates 38

39 A C G Suprasorb Liquacel Suprasorb H Hydrocolloid Dressing Suprasorb H creates a moist wound environment in lightly to moderately exuding wounds, thus reliably promoting the wound healing process. Thin and flexible, for a moist wound healing environment. An absorbent hydrocolloid layer applied on top of a polyurethane film swells up when it makes contact with the wound, forming a gel in which exudate and cell debris are bound. Through the process of gel formation, the dressing conforms to the structure of the wound. All versions of Suprasorb H are particularly thin and flexible. Due to its good adhesion, the dressing is easy and safe to use. As the dressing repels bacteria and fluids, the patient can wear it even while washing or taking a shower. A 5 x 5 cm sized version of Suprasorb H thin is available specifically for treating the diabetic foot. Applications Suprasorb H Hydrocolloid Dressing very good wound healing due to good exudate management high comfort due to easy application particularly thin and flexible repels bacteria and fluids can be worn in the shower Suprasorb H is available in various versions: Suprasorb H thin for lightly exuding wounds, and Suprasorb H standard, border or sacrum for moderately exuding wounds. The dressing can be used for superficial, non-infected wounds in all phases of wound healing, including ulcers of various aetiology (venous, arterial), seconddegree burns, skin donor sites, and postoperative wounds. Dressing change intervals To be determined by the attending physician in accordance with individual wound condition, amount of exudate and any primary dressing used, but no longer than 5-7 days. In the event of pronounced swelling of the dressing beyond the surface of the wound, the dressing has to be changed. Hydrocolloid H 39

40 Suprasorb F Film Wound Dressing Suprasorb F provides transparent protection. The polyurethane film is breathable and flexible, enabling a moist wound environment that promotes wound healing through gas and heat exchange. Suprasorb F is waterproof and protects the wound against influcences such as pathogens (impermeable to bacteria and water). Through its transparency, the wound dressing offers easier wound monitoring. Suprasorb F is flexible, stretchable, and very easy to use. Suprasorb F can be wiped, also with disinfectants containing alcohol, iodine, and octenidine. The wound dressing provides effective protection from outside influences and can be worn even while the patient is washing or taking a shower. Suprasorb F is available as a sterile film wound dressing and as a non-sterile film dressing off the roll. Protects the wound and retains the dressing. Applications Suprasorb F is used for lightly exuding, superficial, non-infected wounds in the epithelization phase. This includes ulcers of various aetiology (venous, arterial), second-degree burns, skin donor sites and postoperative wounds, as well as abrasions. Suprasorb F can also be used as a secondary dressing for wounds at risk of infection within the scope of a regular antimicrobial therapy regimen H 2 O 3 Bacterium Water vapour Dressing change intervals To be determined by the attending physician in accordance with individual wound condition, amount of exudate and any primary dressing used, but no longer than 5-7 days Transparent polyurethane film Impermeable to bacteria and water Excess water vapour evaporates 40

41 A X X + PHMB C G Suprasorb Liquacel Suprasorb F Film Wound Dressing promotes wound healing through high breathability easy application safe, yet flexible fit affords high wearing comfort very good wound monitoring Film F 41

42 2 2 H 2 O Bacterium 1 Hydrogel layer 1 2 Dry necrotic tissue is gently dissolved by the hydrogel layer Polyurethane film repels bacteria and fluids (gel dressing) 42

43 A C H F Suprasorb G Gel Dressing Suprasorb G, by virtue of the gentle power of a hydrogel, loosens coatings and necrotic tissue from the wound base in lightly exuding and dry wounds. Supplies moisture and enhances autolysis. Necrotic tissues and cell debris are gently dis solved and absorbed by the gel. Thus, Suprasorb G enhances the autolytic process. In moist wound management, Suprasorb G is used as a gel dressing for superficial wounds and as an amorphous gel for deep wounds. Both versions have several things in common: They supply moisture and alleviate pain. Their special, user-friendly consistency and the applicator syringe make them particularly easy to use for physicians and nurses. Applications Suprasorb G Gel Dressing loosens necrotic tissue; gentle on healthy tissue provides moisture convenient to use with applicator syringe (amorphous gel) very good wound monitoring through transparent film material (gel dressing) Suprasorb G is the wound dressing for necrotic, non-infected, superficial (dressing) or deep (amorphous gel) wounds with low exudate levels. The dressing can be used in all phases of wound healing, e.g. for ulcers of various aetiology, seconddegree burns, and postoperative wounds. Dressing change intervals The Suprasorb G dressing should be changed when it appears slightly cloudy due to exhaustion of its absorption capacity, but no later than after a maximum of 5-7 days. Suprasorb G amorphous gel is to be changed in accordance with the secondary dressing, at the latest after 5-7 days. The Suprasorb G gel dressing must not be applied beyond the edges of the wound. It can be cut to size and trimmed as needed to fit the size and shape of the wound. Due to the transparent film material of the gel dressing and the secondary dressing Suprasorb F, the wound can be inspected through the closed dressing when it is in place. 43 Gel G

44 References 1 Kramer, A., Daeschlein, G., Kammerlander, G., Andriessen, A., Aspöck, C., Bergemann, R., Eberlein, T., Gerngross, H., Görtz, G., Heeg, P., Jünger, M., Koch, S., König, B., Laun, R., Peter, R. U., Roth, B., Ruef, C., Sellmer, W., Wewalka, G., Eisenbeiß, W. Konsensusempfehlung zur Auswahl von Wirkstoffen für die Wundantiseptik. J Wound Heal (ZfW) (2004) 3: [Consensus recommendation for selecting agents in wound antisepsis.] 2 Kramer, A., Roth, B. Polihexanid. In: Kramer, A., Assadian, O. (Hrsg) Wallhäußer s Praxis der Sterilisation, Desinfektion, Antiseptik und Konservierung. Thieme, Stuttgart (2008) [Wallhäußer s practice of sterilisation, disinfection, antisepsis, and preservation.] 3 Dissemond, J., Gerber, V., Kramer, A., Riepe, G., Strohal, R., Vasel- Biergans, A., Eberlein, T. Practice-oriented expert recommendation for the treatment of critical colonised and local infected wounds using polihexanide. J Wound Heal (ZfW) (2009) 1: und WundManagement (2009) 3 (2): XCell Cellulose Wound Dressing, Antimicrobial Technical Dossier 5 Eberlein, T., Wild, T., Andriessen, A. Successful sanitation of MRSAcontaminated chronic skin wounds by using a PHMB-containing HydroBalanced biocellulose based wound dressing. Poster. European Wound Management Association (EWMA) Helsinki/FIN, May Wilhelms, T., Schulze, D., Alupei, I.-C., Wiegand, C., Hipler, U. C., Rohrer, C., Abel, M., Release of Polyhexamethylene biguanidene hydrochloride (PHMB) from a Hydrobalanced cellulose wound dressing with PHMB. Poster. European Wound Management Association (EWMA) Glasgow/UK, 2-4 May EWMA Journal (2007) 7 (Suppl.): Wiegand, C., Abel, M., Ruth, P., Hipler, U.-C. HaCaT keratinocytes in co-culture with Staphylococcus aureus can be protected from bacterial damage by polihexanide. Wound Rep Reg (2009) 17: Wiegand, C., Abel, M., Ruth, P., Hipler, U.-C. In-vitro-Evaluierung von Polihexanid: biokompatibel und effektiv. GMS Krankenhaushygiene Interdisziplinär (2009) 4 (2): Doc15 ( ) [In vitro evaluation of polihexanide: biocompatible and effective.] 9 Aus Expertenstandard: Pflege von Menschen mit chronischen Wunden von Deutsches Netzwerk für Qualitätsentwicklung in der Pflege, DNQP FH Osnabrück, 2007 [Expert recommendation: Caring of people with chronic wounds.] 10 Alvarez, O.M., Patel, M., Booker, J., Markowitz, L.: Effectiveness of a biocellulose wound dressing for the treatment of chronic venous leg ulcer: Results of a single center randomized study involving 24 patients. Wounds (2004) 16 (7): Coerper, S., Beckert, S., Gängler, G., Deutschle, G., Küper, M., Königsrainer, A.: A Retrospective Evaluation of Hydrocellulose Dressings in the Management of Chronic Wounds. Ostomy Wound Management (2008) 54 (8): E1-E6 12 Romanelli, M., Dini, V., Barbanera,S., Berton, M.S., Brilli, C., De Lorenzo, A.: Improvement of treatment in patients with venous leg ulcer by a new pain-reducing wound dressing with HydroBalance. Poster. European Wound Management Association (EWMA) Lisbon/P, May EWMA Journal Supplement (2008) 8 (2): Bruckner, M., Wild, T., Schwarz, C., Payrich, M., Eberlein, T.: Autolytic wound cleansing potential of different cellulose-based dressings. Poster. European Wound Management Association (EWMA) Helsinki/ FIN, May EWMA Journal Supplement (2009) 9 (2): Mosti, G., Mattaliano, V., Mantero, M., Abel, M.: Prospective, controlled, randomized comparison study of two various wound dressing systems under compression. L&R Conference brochure: Treatment strategies for therapy of chronic wounds (part I) and Antimicrobial local therapy for chronic wounds (part II). European Wound Management Association (EWMA), Helsiniki/FIN, May Nygaard, R, Jorgensen, S.F.: New HydroBalance concept tested in the primary healthcare sector. EWMA Journal (2009) 9 (2): Wild, T., Bruckner, M., Payrich, M., Schwarz, C., Eberlein, T.: Prospective randomized study for eradication of MRSA with polihexanide containing biocellulose dressing compared with polihexanide containing wound solution. Poster. European Wound Management Association (EWMA) Helsinki/FIN, May EWMA Journal Supplement (2009) 9 (2): Galitz, C., Hämmerle, G., Signer, M., Traber, J., Eberlein, T., Abel, M., Strohal, R., Gruber-Mösenbacher, U.: Polihexanide versus silver wound dressings - first interim results of a controlled, randomized, prospective, multicentric study. Poster. European Wound Management Association (EWMA) Helsinki/FIN, May EWMA Journal Supplement (2009) 9 (2): Wiegand, C., Schoenfelder, U., Abel, M., Ruth, P., Kaatz, M., Hipler, U.-C. Protease and pro-inflammatory cytokine concentrations are elevated in chronic compared to acute wounds and can be modulated by collagen type I in vitro. Arch Dermatol Res Aug; 302 (6): Schoenfelder, U., Abel, M., Ruth, P., Elsner, P., Hipler, U.-C. The influence of PDGF-BB released from a bovine collagen wound dressing on normal human dermal fibroblasts in vitro. Poster. European Wound Management Association (EWMA) Prag/CZ, May Andriessen, A., Polignano, R., Abel, M. Monitoring the microcirculation to evaluate dressing performance in patients with venous leg ulcers. Journal of Wound Care (2009) 18 (4): Beckert, S., Deutschle, G., Halm-Nill, C., Königsrainer, A., Coerper, S. Increase of angiogenesis in chronic wounds after application of native collagen. Poster. European Wound Management Association (EWMA) Prag/CZ, May Piatkowski, A., Ulrich, D., Abel, M., Pallua, N. The influence of Suprasorb P and Suprasorb C on angiogenesis and matrixmetalloproteinases in pressure sores. Poster. 16th Annual Meeting of the European Tissue Repair Society (ETRS), Pisa/I, Sept Wound Rep Reg (2007) 15 A Boom, M., Vijverberg, A., Vijverberg, L. The successful use of Suprasorb C, a collagen wound dressing, on ten patients with mainly severe surgical wounds. Poster. 2nd World Union of Wound Healing Societies Meeting, Paris, 8-13 July Schmitz M., Eberlein T.: Cost-effectiveness in Modern Wound Management. Observation study with a HydroBalance biocellulose based wound dressing in Germany. Lecture. European Wound Management Association (EWMA) Lisbon/P, May EWMA Journal Supplement (2008) 8 (2): R. Brambilla, B. Lange-Asschenfeldt, S. Wolber, E. Lahnsteiner, V. Dini, D. Schomburg, G. Stern, U. Wagner, C. Zell, M. Abel: Evaluation of ergonomic aspects in the daily routine of a new foam dressing with silicone adhesive layer IWWT 2014, Paris (Poster) 26 World Union of WoundHealing Societies (WUWHS). Principles of best practice: Wound exudate and the role of dressings. A consensus document. London: MEP Ltd, Phil Davies, Marc Rippon: Comparison of foam and hydrocolloid dressings in the management of wounds: a review of the published literature, World wide wounds (2010) 28 G. Springmann, S. Bielfeldt, KP. Wilhelm, M. Abel: Tolerability of wound dressings with silicone or polyacrylate glues (border or wound pad) demonstrated by a clinical experimental skin stripping test IWWT 2014, Paris (Poster) 44

45 The right dressing for each wound Suprasorb Liquacel Hydroactive Fibre Dressing Suprasorb A Calcium Alginate Dressing Suprasorb +Ag A Antimicrobial Calcium Alginate Dressing Suprasorb X HydroBalance Wound Dressing Suprasorb +PHMB X Antimicrobial HydroBalance- Wound Dressing Suprasorb C Collagen Wound Dressing Suprasorb P Suprasorb silicone PU Foam Dressing Silicone Foam Dressing P Suprasorb H Hydrocolloid Dressing Suprasorb F Film Wound Dressing Suprasorb G Gel Dressings Rope Rope Dressing Dressing Rope Dressing Rope Dressing Rope Dressing individual non adhesive non- border thin individual Amorphous Dressing sterile adhesive bordered sterile Gel standard border sacrum rolled nonsterile P P silicone H * F ** Vliwasorb Vliwazell P P silicone H F G Amorphous Gel Vliwaktiv Vliwasorb Vliwazell P P silicone Vliwaktiv Vliwasorb Vliwazell C P F Lomatuell H Solvaline N Lomatuell H Solvaline N P F X P P silicone H F G Amorphous Gel Vliwasorb Vliwazell Suprasorb Liquacel A A +Ag X X +PHMB C A X C Suprasorb Liquacel A A +Ag C A C Suprasorb Liquacel A C G Amorphous Gel Suprasorb Liquacel A X X +PHMB C G Dressing A C H thin F Wound stage wound with necrotic tissue coated wound granulating wound epithelizing wound Depth of wound deep superficial Recommended as a primary dressing in case of wound infection Recommended for amount of exudate: low moderate high Secondary dressing required Recommended combinations F * Secondary dressing for lightly to moderately exudating wounds ** Secondary dressing for lightly exudating wounds Please note the instructions for preparing the wound bed: Use Debrisoft for superficial wounds. With deeper wounds, rinse the wound and then perform mechanical or surgical debridement if required. Treat the underlying condition as follows: Apply compression with Rosidal or use pressure relief and metabolic regulation. In case of infection, please note: occlusive secondary dressings should be used only at the attending physician s discretion, depending on the overall situation. 45

46 Suprasorb a complete and professional solution Suprasorb Liquacel Hydroactive Fibre Dressing sterile, individually sealed Dressing Rope Suprasorb A Calcium Alginate Dressing sterile, individually sealed Dressing Rope Size (cm) REF Shipping units (pcs.) 5 x / x / x / cm, 2 g / 50 Suprasorb A + Ag Antimicrobial Calcium Alginate Dressing sterile, individually sealed Dressing Rope Size (cm) REF Shipping units (pcs.) 5 x / x / x / cm, 2 g / 20 Suprasorb X HydroBalance Wound Dressing sterile, individually sealed Dressing Rope Size (cm) REF Shipping units (pcs.) 5 x / 90 9 x / x / 65 2 x / 130 Suprasorb X + PHMB Antimicrobial HydroBalance Wound Dressing sterile, individually sealed Dressing Rope Size (cm) REF Shipping units (pcs.) 5 x / x / x / 50 2 x / 50 Size (cm) REF Shipping units (pcs.) 5 x / 90 9 x / x / 65 2 x / 130 Suprasorb C Collagen Wound Dressing sterile, individually sealed Size (cm) REF Shipping units (pcs.) 4 x 6 x / x 8 x / x 12 x / 90 Suprasorb P PU Foam Dressing sterile, individually sealed Size (cm) REF Shipping units (pcs.) self-adhesive 7.5 x / x / x / x / 50 non-adhesive 5 x / x / x / x / x / 50 sacrum, self-adhesive 18 x / 50 Suprasorb P silicone Silicone Foam Dressing sterile, individually sealed Size (cm) REF Shipping units (pcs.) border (with adhesive edge) 7.5 x / x / x / x / 50 non-bordered (without adhesive edge) 5 x / x / x / x / x / 50 Suprasorb H Hydrokolloid Dressing sterile, individually sealed standard thin sacrum border Size (cm) REF Shipping units (pcs.) 10 x / x / x / 50 5 x / x / x / x / x / x / x / x / 200 Suprasorb F Film Wound Dressing sterile, individually sealed Size (cm) REF Shipping units (pcs.) 5 x / x / x / x / x / x / x / 180 Suprasorb F Film Dressing rolled, non-sterile Size (cm x m) REF Shipping units (pcs.) 10 x / x / x / 10 Suprasorb G Amorphous Gel in application syringe sterile Size (g) REF Shipping units (pcs.) / / 240 Suprasorb G Gel Dressing sterile, individually sealed Size (cm) REF Shipping units (pcs.) 5 x / x / x / 15

47

48 Lohmann & Rauscher GmbH & Co. KG Westerwaldstrasse 4 D Rengsdorf, Germany Lohmann & Rauscher GmbH Johann-Schorsch-Gasse 4 A-1141 Vienna, Austria Lohmann & Rauscher AG Oberstrasse 222 CH-9014 St. Gallen, Switzerland e