Know Your Dressings: Calcium Alginates, CMC, and Gelling Fibers

Successful wound care involves selecting the appropriate dressing to optimize the wound healing environment. Dressing selection plays an important role in supporting autolytic debridement and promoting wound healing. 1 Wounds with heavy drainage require dressings that are absorptive, yet still maintain a moist wound environment to promote healing, such as calcium alginate or carboxymethylcellulose (CMC) gelling fiber dressings.

What is a calcium alginate dressing?
Calcium alginate dressings are made from sodium alginate extracted from brown seaweed and processed with calcium salts into nonwoven biodegradable dressings. 2 Alginate dressings can be found in sheet or rope form. The dressings uniquely gel as they come in contact with wound exudate to provide a moist wound environment that facilitates autolytic debridement. The dressings can fill wound dead space and absorb up to 20 times their weight in exudate depending on the manufacturer’s process. 3
What is a CMC gelling fiber dressing?
Carboxymethylcellulose (CMC) dressings are highly absorptive textile fiber dressings derived from natural cellulose sources and are commonly known as CMC gelling fiber dressings. 9 CMC dressings form a transparent moist gel as they bind wound exudate into the dressing. 9 The exudate cannot reenter the wound bed and inflammatory cells, especially neutrophils, are sequestered which helps to hasten wound healing. 4 CMC dressings are available in rope and sheet form and the fiber strength of these dressings makes them suitable for loosely packing sinus cavities. 4 CMC dressings do provide a moist wound environment, supporting autolytic debridement as the dressing gels and traps exudate.
Calcium alginate and CMC gelling fiber dressings:

  • Are designed for use in moderately to heavily draining wounds
  • Are non-adherent, conformable and can be cut and manipulated in the wound bed
  • May contain silver which can provide antimicrobial protection in the dressing
  • Should not be used for dry wounds since they can adhere to the dry wound bed
  • Expand in the wound due to the natural swelling of the dressing as it comes in contact with exudate, avoid overfilling the wound space
  • Can be left in place for several days depending on the condition of the wound
  • Require a secondary dressing
  • Are appropriate for use on partial and full thickness wounds, surgical incisions, pressure ulcers, infected wounds, donor sites, and in sinus tracts and tunnels. 8

What is a superabsorbent dressing?
Superabsorbent dressings also have the ability to manage exudate for moderately to heavily draining wounds. These dressings have multiple layers which include a nonadherent contact layer, a middle layer which contains fibers or gelling material to absorb exudate, as well as a water repelling outer layer. 7 Superabsorbent dressings may have an adhesive border. If an adhesive border is not present, these dressings will require a secondary bandage or adhesive to secure the product to the wound site. A superabsorbent dressing can be used on a variety of wounds including pressure ulcers, venous ulcers, diabetic foot ulcers, trauma wounds or arterial ulcers. 7
Select the correct dressing
Dressings should be selected based on the characteristics of the wound.
Calcium alginate and CMC dressings are primary dressings* designed for use on wounds with moderate to heavy drainage.
A superabsorbent dressing can be a primary or secondary dressing** which manages moderate to heavy wound exudate.
The longer wear time of these dressings minimizes the number of times the wound bed is disturbed which may improve healing outcomes. 6 Cost effectiveness should always be considered when selecting a dressing, however the least expensive dressing may not be the most cost effective. Longer wear time reduces clinician labor costs, a significant factor in overall wound care costs. 5 Dressing selection should be based on the needs of the wound to obtain the best outcomes for healing.
————————————————————————
* Primary Dressing: The dressing that is in contact with the wound and may remain on the surface of the wound over an extended period of time and in some cases until the wound is completely healed.
** Secondary Dressing: A cover dressing contains an absorbent material which will absorb wound exudate and which can be changed without disturbing the position of the primary dressing on the surface of the wound.
NEW!
AquaRite™ Extra CMC is a highly absorbent CMC fiber wound dressing that converts into a clear, soothing gel sheet when exposed to exudate or other liquids.

  • Highly absorbent
  • Traps debris & bacteria in the dressing
  • Maintains dressing integrity for one piece removal


Click here to learn more!
Plus, be sure to explore these other fiber / superabsorbent dressings from DermaRite:
DermaGinate
DermaGinate/Ag
HydraLock SA
References:

  1. Murphy, Patrick S., and Gregory R.D. Evans. “Advances in Wound Healing: A Review of Current Wound Healing Products.” Plastic Surgery International, vol. 2012, Sept. 2012, pp.1-8, doi:10.1155/2012/190436.
  2. Qin, Yimin. “Gel swelling properties of alginate fibers.” Journal of Applied Polymer Science, vol. 91, no. 3, 2003, pp. 1641–1645., doi:10.1002/app.13317.
  3. Morgan, Nancy. “Calcium alginate.” Wound Care Advisor, vol.1, no.2, July/Aug.2012 pp. 26-27.
  4. Merry, A., “Absorbent Hydrofiber and Calcium Alginate Foam Dressings” http://www.sooperarticles.com/health-fitness-articles/first-aid-articles/absorbent-hydrofiber-calcium-alginate-foam-dressings-731019.html Accessed 23 Sept. 2017.
  5. Making The Case For Cost-Effective Wound Management. http://www.woundsinternational.com/consensus-documents/view/international-consensus-making-the-case-for-cost-effective-wound-management
  6. “Challenging Wounds.” http://improving-outcomes-online.com/kom/challenging-wounds/ Accessed 27 Sept. 2017
  7. Wound Care Today-Product Pyramid-Superabsorbent Dressings. http://woundcare-today.com/categories-pyramid/superabsorbent-dressings Accessed 26 Sept. 2017
  8. “Evidence Summary: Wound Management: Dressings –Alginate”, Wound Practice and Research, vol. 21, no. 2, pp 90-92., http://www.woundsaustralia.com.au/journal/2102_09.pdf Accessed 23 Sept. 2017.
  9. Bahai, H S, et al. Carboxymethylcellulose wound dressings. 15 Mar. 2005. https://books.google.co.uk/patents/CA2154473C Accessed 23 Sept. 2017.

Deeper Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

  1. Qin12*, Yimin, et al. “Marine Bioactive Fibers: Alginate and Chitosan Fibers-A Critical Review.” Journal of Textile Engineering & Fashion Technology, MedCrave Online, 15 May 2017, medcraveonline.com/JTEFT/JTEFT-01-00037.php.
  2. “Alginates.” Alginate Dressings | Calcium Alginate Dressings for Wounds, www.woundsource.com/product-category/dressings/alginates.
  3. “Practical Treatment of Wound Pain and Trauma: A Patient-Centered Approach. An Overview.” Practical Treatment of Wound Pain and Trauma: A Patient-Centered Approach. An Overview | Ostomy Wound Management, www.o-wm.com/content/practical-treatment-wound-pain-and-trauma-a-patient-centered-approach-an-overview.
Posted in Clinical Insights Newsletter

Choosing The Right Dressing

A wide variety of advanced wound care products are available to treat wounds, from simple dressing materials to sophisticated products. Selecting a wound dressing requires the clinician be knowledgeable in both the process of tissue repair during wound healing and the intended use of the dressing product selected to treat the wound.1

Dressings are used to:

  • facilitate healing
  • reduce pain
  • contain wound drainage
  • provide adequate moisture for wound healing
  • maintain normothermia in the wound bed
  • minimize bioburden
  • provide a cosmetic covering for the wound

The correct dressing will improve outcomes for wound healing. Dressing selections should be based on a complete clinical assessment addressing wound characteristics, clinical efficacy, and cost of the dressing.1

Wound Characteristics
Dressing selections should be based on the type of tissue present in the wound, wound drainage, bacterial burden, condition of the periwound skin and the wound location.2

Tissue Types: More than one tissue type can be present in a wound. Select a dressing that addresses the most prevalent tissue type in the wound bed. Necrotic tissue requires dressings that support debridement while managing wound drainage. Healthy granulating wound tissue requires dressings that support adequate moisture levels.1

Wound Drainage: Select a dressing that supports moist wound healing and manages exudate effectively. Dressings such as Hydrogels, Transparent Films and Hydrocolloids are designed to donate or retain moisture in the wound.4 Hydrogel and Transparent Film dressings work best for wounds with minimal to low wound exudate. Hydrocolloids address low to moderate exudate. Absorbent dressings such as Alginates, Foams, Gelling Fibers and Super Absorbent dressings are designed to be used for moderate to heavily draining wounds.2 Collagen dressings come in several forms and can be used for all drainage levels.

Maintain Wound Temperature: Cooling of the wound surface can impact wound healing. The cells and enzymes necessary to the wound healing process are negatively impacted by moisture loss from evaporation or inadequate moisture in the wound bed. This is due to the cooling effect moisture loss can have on the wound. Dressing removal can result in wound bed temperature variations that take over 4 hours to return to normal.7 Select wound products that minimize dressing changes and maintain wound temperature. Preparation for the dressing change can decrease the time the wound bed is exposed to room air reducing the effect of cooling on wound healing.

Bacterial Burden: Wounds exposed to bacteria can become colonized within hours of exposure to contaminents. Microbial burden in the wound can lead to delayed wound healing, infection and biofilm formation.3 Advanced wound dressings help prevent wound bed contamination. Dressings with antimicrobial additives, such as silver, help to minimize bacterial load in the dressing. Several types of antimicrobial agents are found in dressings. Silver is the most common antimicrobial additive to wound dressings and can be found in most dressing categories.6

Periwound Skin: Maintaining the health of peri-wound skin is an important part of wound dressing selection. Choose dressings that effectively manage moisture and promote skin integrity. Using a liquid skin protectant during dressing changes adds an additional layer of protection for periwound skin and can safeguard the skin from the effects of moisture and adhesive removal.

Location: Where the wound is located on the body will influence the dressing selection. Characteristics of the body such as body contour, moisture, or delicate tissue will impact the dressing choice. Some wound locations can be impacted by activity, so the adherent capabilities of the dressing should be considered.

Cost
The Agency for Healthcare Research and Quality estimates our national cost for pressure ulcer care to exceed $1.4 billion annually.5 Caregivers need to select dressings that achieve wound healing results and are cost effective. The number of dressing changes required as well as the cost of the dressing material further impact wound care costs.

References:

  1. Bennett-Madison, M., (2010). How to select a wound dressing. Clinical Pharmacist, Vol. 2. Retrieved from http://www.pharmaceutical-journal.com/files/rps-pjonline/pdf/cp201011_practice_tools-363.pdf
  2. Green, B. (2013). Wound care: Making an informed decision: how to choose the correct wound dressing. Professional Nurse Today, 17(1), 6-13.
  3. Thomas, Stephen. “A Structured Approach to the Selection of Dressings.” A Structured Approach to the Selection of Dressings. World Wide Wounds, 14 Nov. 1997. Web. 12 May 2017. Retrieved from http://www.worldwidewounds.com/1997/july/Thomas-Guide/Dress-Select.html
  4. http://www.wounds-uk.com/wound-essentials/wound-essentials-5-how-to-choose-the-appropriate-dressing-for-each-wound-type. Retrieved on June 16, 2017.
  5. Soon, S., & Chen, S. (2004). What are wound outcomes. Wounds, 16(5). Retrieved from http://www.medscape.com/viewarticle/478970_2
  6. Sood, A., Granick, M., & Tomaselli, N. (2012, April 1). Wound dressings and comparative effectiveness data – Europe PMC Article – Europe PMC. Retrieved from http://europepmc.org/articles/PMC4121107
  7. McGuiness, W., Vella, E., Harrison, D., (2004). Influence of Dressing changes on wound temperature. Journal of Wound Care, 13(9), 383-384.

Deeper Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

  1. https://blog.wcei.net/2009/05/temperature-effects-on-wound-healing. Retrieved on June 16,2017.
  2. https://www.wound-doc.co.uk/therapies/essentials-of-wound-healing. Retrieved on June 16, 2017.
  3. Expert Working Group, (2012). International concensus: Optimising wellbeing in people living with a wound. Retrieved from http://www.woundsinternational.com/consensus-documents/view/international-consensus-optimising-wellbeing-in-people-living-with-a-wound
  4. Sussman G. Technology update: Understanding film dressings.Wounds International 2010; 1(4). Retrieved
    from: http://www.woundsinternational.com/ product-reviews/technologyupdate-understanding-filmdressings
Posted in Articles, Clinical Insights Newsletter

DermaRite Industries Appoints Barbara Osborne as Chief Commercial Officer

North Bergen, New Jersey – June 2017 – DermaRite Industries, LLC (“DermaRite”) announced it has named Barbara J. Osborne as Chief Commercial Officer of the company. In her role, Ms. Osborne will be responsible for driving the company’s sales and commercialization efforts.

Ms. Osborne is an experienced healthcare industry executive. Most recently, she served as the U.S. Division President and CEO of LEO Pharma. Previously, Ms. Osborne served as the President of Mölnlycke Health Care’s U.S. Wound Care business.

Ms. Osborne has a broad background encompassing sales, marketing, finance, accounting, business development and R&D. During her tenure in the healthcare industry, she also held senior leadership positions at C.R. Bard, Microtek Medical, and Covidien.

“Ms. Osborne is joining the company at a key stage in our development,” says Naftali Minzer, Chief Executive Officer of DermaRite. “Her extensive experience in the wound care industry and her proven success leading and growing similar size organizations will be a strong addition to our business as we position the company for future growth.”

“I am honored to be joining DermaRite, and I am looking forward to building on the company’s strong foundation,” commented Ms. Osborne. “It is an exciting time to impact the next growth phase of the company.”

Ms. Osborne holds a Master of Science in Accounting from New York University’s Stern School of Business and received her undergraduate degree from Colgate University.

About DermaRite Industries:
DermaRite Industries has been providing high-quality, clinically effective and cost-effective skin and wound care products to nursing homes, home health agencies, hospice and wound clinics for over 20 years. Based in North Bergen, New Jersey, the company’s Healing In D.E.P.T.H. program provides caregivers with the tools and services needed to assure optimal care.

For more information about DermaRite, visit Dermarite.com.

Please direct all inquiries to Yalitza Hernandez, yalitzah@dermarite.com, 973-569-9000 x113.

Posted in Press Release

Senior Digestive Health

Fruit Salad

Many systems of the body change with age, including the digestive system. It’s estimated that 40% of seniors experience digestive changes. 1 Many factors impact bowel health and result in constipation including age, medical conditions, poor diet, medications, lack of fiber, inadequate exercise and frequent laxative use. Constipation or diarrhea, a common complaint for seniors, is a symptom the body sends indicating that something is not right.3

What is Constipation?  Simply stated, constipation is infrequent stool elimination. After eating, food is passed through the intestines by a rhythmic, wavelike movement called peristalsis. Intestinal contraction and rest allows food and liquid to be mixed together and propels fecal matter through the digestive tract for elimination. 4 Humans are creatures of habit, and bowel habits will vary. Bowel movements from 3 times per day to once every other day can be considered “normal”. Infrequent stools become hard, difficult to pass, and can cause damage to the nerves and muscles in the rectal area.4

Why are seniors more likely to suffer from constipation?  Aging can weaken muscles in the bowel and abdomen. Muscle contractions are necessary to move food and waste products through the digestive tract. When this process slows, more water is absorbed from the food waste resulting in hard, difficult to pass stool. 1 Nerves may function less effectively and bowel tissue can lose the ability to stretch also making stool more difficult to pass. 5 Seniors dealing with mobility issues or conditions requiring bedrest face changes in bowel habits resulting from inactivity. Disease processes such as Parkinson’s, endocrine disorders, diabetes mellitus, or stroke are also associated with constipation.7

Does diet play a role?  Poor diet or lack of adequate hydration and fiber can play a significant role in the development of constipation. Fiber is found in fruits, vegetables and whole grains. Adding fiber to your diet softens and adds weight to food waste, resulting in bulky, easy to pass stool. Consuming “fast” food or heavily processed food can lead to constipation since these foods are usually lacking in fiber, which is vital for bowel health.3 Healthy diets should contain about 25-30 grams of fiber daily. Adequate fluid intake keeps stool soft and easy to pass. Consuming 8 glasses of water per day can decrease the likelihood of constipation. 6 Adequate fiber and fluid intake may be difficult to achieve in the senior population without assistance from caregivers to promote a healthy diet.2

Do medications play a role?  Opioid pain medications, antacids with calcium, antidepressants, iron supplements, anti-parkinsonian drugs, diuretics and antispasmodics are some of the medications that can result in constipation. Many of these medications are necessary for the health of seniors and their use cannot be avoided.6

Won’t laxatives fix the problem? Laxatives may be used to relieve occasional constipation. Overuse of laxatives to treat constipation may result in poor tone in the intestinal muscles. These muscles become “lazy” and unable to function independently. 2 Americans spend nearly $22 million on laxatives each year. Overall cost to treat constipation is estimated to be $1 billion dollars annually.2

What is your normal?  Bowel movements give significant insight to overall health status. The Bristol Stool chart is an easy to use guide to determine how “normal” you are. Types 3, 4 or 5 are considered normal. Sudden changes in bowel habits not associated with factors known to cause constipation can be indicators of serious health concerns.4

DermaRite FiberHeal™ Liquid Fiber Supplement assists in maintaining good bowel health. It combines the stool-softening effects of fiber with all-natural sorbitol, which aids in gentle elimination without diarrhea. FiberHeal has the added benefit of FOS (fructooligosaccharides) to promote the growth of beneficial intestinal bacteria. As part of a healthy diet, FiberHeal helps maintain regularity, reducing dependence on harsh laxatives, and helps maintain lower cholesterol levels and supports blood sugar control. FiberHeal provides 15 grams of fiber in a great tasting one ounce dose. The sugar-, lactose- and gluten-free formula is compatible with most diets.

References

  1. Aging and Digestive Health. Retrieved January 18, 2017, from http://www.webmd.com/digestive-disorders/features/digestive-health-aging#1
  2. Evaluating and Managing Constipation in the Elderly, David A. Ginsberg, MD; Sidney F. Phillips, MD; Joyce Wallace, MSN, CRNP, APRN-BC; Karen L. Josephson, MD Urol Nurs. 2007;27(3):191-200, 212.
  3. Did everything come out okay? Senior bowel issues. Retrieved January 18, 2017, from http://www.eldercarelink.com/Other-Resources/Health/understanding-senior-bowel-issues.htm
  4. http://articles.mercola.com/sites/articles/archive/2014/03/10/bowel-movements-segmentation.aspx
  5. http://www.aboutincontinence.org/incontinence-and-aging.html
  6. Cashin-Garbutt, A. (2013, March 20). Drugs that Cause Constipation. Retrieved January 18, 2017, from http://www.news-medical.net/health/Drugs-that-Cause-Constipation.aspx
  7. Constipation in the Elderly. Retrieved January 18, 2017, from http://www.thedoctorwillseeyounow.com/content/aging/art2080.html

Deeper Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

  1. Gainer, C. Bowel Habits and Aging. Retrieved January 30, 2017, from http://www.muschealth.org/healthy-aging/august-2014/index.html
  2. Strategies for Establishing Bowel Control. Retrieved January 30, 2017, from http://www.aboutconstipation.org/bowel-retraining.html
  3. Constipation And Laxatives – Are You Aware of the Dangers? Retrieved January 30, 2017, from http://www.poopdoc.com/articles/constipation-and-laxatives-dangers.htm
  4. Bostock,N., Kelly, A., (2011) Help for people who care for someone with bladder or bowel problems. Retrieved January 20, 2017 Department of Health and Aging website: http://www.bladderbowel.gov.au/assets/doc/ContinenceCarers.html
Posted in Articles, Clinical Insights Newsletter

The Results Are In – Healing Never Tasted This Good!

An independent taste test conducted on November 8, 2016 revealed that over 70% of participants preferred the taste of ProHeal™ Liquid Protein Supplement when compared to the leading brand.

The blind taste test comparison occurred on 11/8/16 in a dining room of a post-acute care setting using a sample of convenience that included 20 residents and 5 staff members. The residents were from assisted living, long-term care and rehabilitation. All participants were informed of the taste trial for the 2 cherry flavored products (ProHeal™ and ProStat SF®). No food allergies were reported. The facility’s staff conducted the trial and no manufacturer representative was present during the taste test. The samples were unlabeled and the identities of the products were known only to the testers. The subjects reported their preference based on taste after sampling both products.

Results:  

Staff reported preference (n=5):  Prostat=1 (20%); ProHeal=4 (80%).

Residents reported preference (n=20):  Prostat=5 (25%); ProHeal=14 (70%); no preference=1 (5%). Statistical analysis using one sample t-test between the percents shows a statistically significant (p=.031) difference in test preference in favor of ProHeal.

Cumulative staff & residents (n=25):  Prostat=6 (24%); ProHeal=18 (72%); no preference=1 (4%). Statistical analysis using one sample t-test between the percents shows a statistically significant (p=.010) difference in test preference in favor of ProHeal.

This product has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Click here for more information

Posted in Press Release

Palliative Wound Care

Palliative Wound CarePalliative care is defined by the World Health Organization (WHO) as an “approach that improves quality of life in patients and their families facing the problems associated with life-threatening illnesses”. 1 Palliative care focuses on prevention and relief from suffering, providing pain control, spiritual support and symptom control, done with respect for cultural differences and individual needs. Care decisions should be made through a process that involves open dialogue between patient, family and caregivers. 1

What do we know about wounds that occur at end of life?     

The skin is the largest organ of the body and is vulnerable to wound development when the organs begin to fail. End of life wounds include pressure injury, ischemic wounds and Kennedy ulcers. 3 In 2009, Skin Changes at Life’s End (SCALE) was a concept introduced to describe end of life wounds. 4 These ulcers are considered unavoidable especially in immobile patients at the end of life. Management of wounds should focus on patient comfort and minimizing the impact of the wound on quality of life, not necessarily healing wounds. 2 However, palliative care does not imply less care or lack of care, but may change the focus to more emphasis on patient comfort and prevention of new ulceration formation. 2

Where does wound care begin?   

As for any patient, good skin and wound care begins with a comprehensive assessment including a risk assessment, and wound assessment. 2 These individuals will also require a comprehensive pain assessment and discussion of quality of life and personal choices. Care should be coordinated between the patient, family and caregivers with the patient’s comfort taking precedence.

How to manage pain and exudate?

Wound pain is often experienced during dressing changes.   The wound surface is fragile, and adherent dressings or crusted, dry exudate can be traumatic to the wound during dressing removal and result in significant pain for the patient. 3 Gauze dressings have been found to be more painful due to granulation tissue growing through the porous gauze material evoking pain and trauma with

dressing changes. 3 Careful selection of dressings and utilization of dressing material such as silicone, foam, alginate or hydrocolloid dressings will help to manage exudate and control pain.

Are there other concerns?

Odor from wounds can have a significant impact on the quality of life for the patient.  Odors can increase patient stress and embarrassment, resulting in depression and a decreased quality of life. 1 Odors are often a result of increased bacteria in the wound or wound dressing. When odor persists, antibiotic therapy or dressings designed to reduce microbial contamination may be needed. Dressings with silver have been found to be effective in reducing odor producing microbes in the wound environment. 3

How can DermaRite help?

DermaRite’s skin and wound care products help caregivers meet the needs of even the most challenging wound conditions. DermaGinate, our calcium alginate dressing line, is designed for moderate to highly exuding wounds.  DermaGinate conforms easily to the wound bed and acquires a soothing gel-like consistency when in contact with moisture and exudate, yet maintains its integrity for ease in dressing removal. DermaGinate AG contains silver to protect against microbial contamination of the dressing, minimizing odor. Both DermaGinate and DermaGinate AG are available in pad and rope forms.

Learn More About Calcium Alginate Dressings >

  1. Burt T. Palliative care of pressure ulcers in long-term care. Annals of Long-Term Care: Clinical Care and Aging. 2013; 21(3):20-28.
  2. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers:  Clinical Practice Guideline.  Emily Haesler (Ed.) Cambridge Media: Perth, Australia 2014
  3. Palliative wound care management strategies for palliative patients and their circles of care. Clinical Management, 283, 130-141.
  4. Krasner, D. (2015, 04). SCALE wounds: unavoidable pressure injury. medscape.com. Retrieved 10, 2016, from http://www.medscape.com/viewarticle/844514

Deep Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

Posted in Articles, Clinical Insights Newsletter

FDA Bans Antimicrobial Soaps – What Does It Mean For You?

The U.S. Food & Drug Administration (FDA) published a final ruling last week regarding Consumer Antiseptic (antimicrobial)Washes. As a manufacturer of antiseptic hand and body washes, DermaRite would like to address this ruling and assure you that you can continue to use any of our hand and body washes as usual.

Women washing hands in white sink good suds

THE RULING

The FDA presented a Proposed Rule on Consumer Antiseptic (Antimicrobial) Washes in December of 2013. Following several years of research and consultation with manufacturers and industry leaders, the FDA has concluded that “there isn’t enough science to show that over-the-counter (OTC) antibacterial soaps are better at preventing illness than washing with plain soap and water. To date, the benefits of using antibacterial hand soap haven’t been proven. In addition, the wide use of these products over a long time has raised the question of potential negative effects on your health.”[1]

As a result, the FDA is banning the use of 19 active ingredients commonly used as antibacterial agents in consumer hand and body washes that are used with water. Manufacturers have one year to remove these ingredients from their products.

WHAT YOU NEED TO KNOW

  • This final ruleapplies to consumer antiseptic wash products containing one or more of 19 specific active ingredients, including the most commonly used ingredients – triclosan and triclocarban. These products are intended for use with water, and are rinsed off after use.
  • This rule does not affectconsumer hand sanitizers or wipes intended to be used without water.
  • This rule does not affect antibacterial products used inhealth care settings.[2]
  • DermaRite hand and body washes do not contain the active ingredients banned by the FDA.

Hygiene. Cleaning Hands. Washing hands.
WHAT YOU SHOULD DO

  • If you are a DermaRite customer, you can continue to use any of our hand and body washes as usual as they do not contain the active ingredients banned by the FDA.
  • Furthermore, if you are using handwashes in a healthcare setting, continue to follow accepted guidelines for hand hygiene, as the FDA’s ruling only applies to consumer hand and body washes.
  • Hand sanitizers are also not included in the FDA’s final ruling and can be used as usual for the time being.
  • In consumer settings, the FDA currently recommends practicing good hygiene by using plain soap and water.

Hand hygiene is one of the most important and most effective ways to reduce the spread of infectious diseases. It is important that healthcare facility staff maintain the highest standards for hand hygiene in order  to protect the health and safety of those under their care.

DermaRite offers a full line of hand hygiene products, including alcohol-based and non-alcohol hand sanitizers, and a wide range of hand and body washes. These products are FDA approved. This wide variety of products ensures that your facility can find the products that fit your individual needs.

For the latest guidelines and information regarding proper hand hygiene, you can visit the Center for Disease Control’s website at www.cdc.gov/handhygiene.

For more information regarding DermaRite products, please visit DermaRite.com or email us at info@dermarite.com

To learn more about the FDA’s ruling you can select one of the links below:

[1] Antibacterial Soap? You Can Skip It — Use Plain Soap and Water  http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm378393.htm

[2] FDA issues final rule on safety and effectiveness of antibacterial soaps http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm517478.htm

Posted in Press Release

Managing Pain with Dressing Changes

F-Tag 309 is a government regulation that deals with pain stating: “Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care”.  (1)

How does this relate to wound pain?  Pain related to wounds can be a result of day-to-day activities or dressing changes and wound procedures such as debridement.  The presence of a wound may stimulate pain pathways and increase transmission of pain impulses, resulting in wound pain. (3)    For some people, dressing changes can be times of extreme pain;   a 2004 French study noted that pain was experienced by 87% of patients during the dressing removal process.  (4)   Techniques to reduce, prevent and manage pain are necessary to maintain the highest physical, mental and psychosocial well- being of the patient.  Strategies for pain management begin with:

  • recognizing and predicting the instances of pain and when it is likely to occur
  • proper evaluation of existing pain
  • implementing treatments and techniques to manage and prevent pain (2)

Managing wound pain includes an assessment rating the intensity, quality, and location of pain.  In addition, non-verbal cues such as facial grimacing, guarding the area, restricted movement, noting if the pain radiates to other areas and factors that may aggravate or relieve pain are critical to a complete pain assessment.  The nonverbal resident presents additional challenges in pain assessment, so include input from primary caregivers related to previous wound pain when needed.   Residents that have experienced wound pain previously with dressing changes may anticipate pain and become tense and anxious, resulting in more pain at dressing change.  (3)  Treatment interventions to minimize dressing change pain include:

  • Explaining prior to the dressing change, what can be expected, and the interventions that will be used to minimize pain.
  • Using music, deep breathing techniques and relaxation exercises to reduce anxiety prior to dressing changes.
  • Utilizing products such as skin prep before applying adhesive dressings and practicing gentle techniques to avoid trauma when removing adhesive dressings and tape.
  • Avoid using plain gauze dressings, which are known to cause pain due to adherence of the dressing to the wound bed.
  • Administering prescribed medications for pain control then allowing adequate time for the medications to be effective before beginning dressing changes.
  • Selecting a dressing that suits the drainage level of the wound: hydrogels, alginates, or silicone dressings can  promote moisture balance,  minimize adherence and adhesive related skin stripping, which can decrease the occurrence of pain during dressing changes. (3)

DermaRite’s ComfortFoam self-adherent silicone foam wound dressings minimize the wound trauma and pain associated with dressing changes.  ComfortFoam Border and ComfortFoam Border Lite dressings include an adhesive border for superior adhesion and gentle removal.  ComfiTel is a silicone contact layer wound dressing that permits wound exudate to pass through to a secondary absorptive dressing, protecting the wound bed from trauma while providing comfort.  The ComfortFoam line of silicone products support moist wound healing and provide protection to fragile periwound tissue.  The foam dressings absorb exudate and insulate the wound bed.  ComfortFoam dressings and ComfiTel are not made with natural rubber latex.  ComfortFoam and ComfiTel should be part of your solution to reduce painful dressing changes for your residents.

References

  1. “Pain F-Tag (309).” Pain F-Tag (309). 07 July 2016. http://www.geriatricpain.org/Content/Resources/Regulations/Pages/PainF-Tag(309).aspx
  2. Swezey, L. “How to Decrease Pain Associated with Dressing Changes.” Http://www.woundsource.com/blog/how-decrease-pain-associated-wound-dressing-changes. Woundsource.com, 06 June 2013. Web. 7 July 2016.
  3. Browning, A. “Strategies to Reduce or Eliminate Wound Pain.” NursingTimes 110.15 (2014): 12-
  4. Nursingtimes.net. Web. 7 July 2016.
  5. Romanelli, M., and V. Dini. “Chapter 5 Assessment of Wound Pain at Dressing Change.” Web. 7 July 2016.

Deep Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

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