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Cutimed® Sorbact®

Introduction

Infection and bacterial bio-burden represents a major challenge in accelerating the rate of healing for both chronic and acute wounds. The appropriate use of wound filler, in part, determines the effectiveness of negative pressure wound therapy (NPWT). In order to prevent colonization of bacteria and widespread infection, antimicrobial dressings in combination with negative pressure, when negative pressure is indicated, is recommended to decrease and control bacterial load. Cutimed Sorbact represents a safe and effective solution and has several advantages over foam-based negative pressure systems.

About Cutimed Sorbact

Sorbact® pathogen attraction magnified
Sorbact® pathogen attraction magnified
Cutimed Sorbact is a woven acetate mesh that is coated with a fatty acid ester called DACC (dialkylcarbamoylchloride). DACC is a synthetically produced derivative of a naturally occurring hydrophobic fatty acid. Cutimed Sorbact is effective in binding microbes in contaminated to highly colonized wounds. Cutimed Sorbact relies on a physical rather than a chemical property to decrease the bio-burden.

Mechanism Of Action

Most pathogens are hydrophobic and will naturally aggregate or clump together while immersed in an aqueous environment. The hydrophobic interaction inherent to Cutimed Sorbact attracts, binds and inactivates pathogens. Once sequestered, the pathogenic microbes are permanently bound to Cutimed Sorbact and become inert, where they lose their ability to reproduce or release harmful and malodorous toxins into the wound bed. The microorganisms are then removed from the wound with each dressing change, aiding in reducing the bacterial load and leaving the non-hydrophobic microorganisms in the wound bed to stimulate healing.

Sorbact® pathogen attraction magnified

Bacteria and fungus bind to surfaces via hydrophobic interaction

Frequently Asked Questions

What can it inactivate?

Effective against MRSA, VRE, and C. diff., as well as:

  • Staph. aureus
  • E. coli
  • Enterobacter
  • H. influenzae
  • Serratia
  • Vibrio
  • Group A Streptococci
  • Pseudomonas aeruginosa
  • Klebsiella
  • Fungi:
    • Candida albicans
    • Aspergillus brasiliensis

What are the benefits of Cutimed Sorbact versus foam when used with NPWT?

Cutimed Sorbact in conjunction with PhaseOne has many beneficial affects as compared to foam-based sytems. Cutimed Sorbact is safe, effective and results in rapid wound healing without the complications of foam and antibiotics. These benefits include a broad microbial spectrum, no resistance or allergies, no cytotoxicity, rapid action, granulation tissue formation, reduction in pain, ease of application, reduced frequency of dressing changes and improved quality of life.

Broad Microbial Spectrum

Cutimed Sorbact is effective against wound pathogens, binding and inactivating a wide range of fungi and bacteria including Staphylococcus aureus and methicillin-resistant Pseudomonas aeruginosa. There is a strong correlation between the virulence of the bacterium and the degree of hydrophobicity. The more virulent the bacterium the greater the hydrophobicity, which in turn, increases the attraction and binding properties of Cutimed Sorbact.

Contrast: Foam can contribute to an increase in the wound bed’s bacterial load.1

No Resistance or Allergic Response

Cutimed Sorbact binds and inactivates pathogens, decreasing the likelihood of cross-contamination without the use of chemical interactions, such as antibiotics, to which pathogens quickly develop resistance. Bacteria and fungi cannot become resistant to this sequestration process. Pathogenic resistance becomes especially prevalent in the presence of biofilm. Unlike topical antibiotics, Cutimed Sorbact does not donate a chemically active substance to the wound bed, so there is no risk of sensitization, skin staining or systemic absorption. There is no known risk of developing an allergy to DACC. Where indicated, Cutimed Sorbact can be used in preference to topical or systemic antibiotics.

Contrast: Foam does not have antimicrobial properties.

No Cytotoxicity

Cutimed Sorbact binds pathogens rendering them inert and inactive with no disruption to the cell wall and no systemic absorption. When the dressing is changed, there is no cellular debris left behind. Antibiotics and antiseptics kill microbes by breaking down the extracellular walls and membranes. Microbial cytoplasm and endotoxins are released into the wound bed, causing inflammation and triggering an immune response that interferes with wound healing.

Contrast: Black foam does not inactive pathogens allowing them to continue reproducing and multiplying. When the foam is removed during dressing changes, microbial debris and pathogens are released back into the wound bed. There is ample evidence that frequent dressing changes, while using foam, introduces foreign bacteria in addition to those that were present in the colonized wound bed.

Rapid Action

The tissue in a wound with a bacterial count of 105 per gram of tissue is considered to be infected. One square centimeter of Cutimed Sorbact can bind and inactivate 105 bacteria within 30 seconds. Within 2 hours the Cutimed Sorbact binding property increases of up to 105 pathogens per square centimeter. Rapid reduction of bacterial burden, enhanced by PhaseOne eliminates one of the primary barriers to wound healing. Repeated contact with Cutimed Sorbact and PhaseOne at the bed of the wound helps to prevent the reformation of biofilm.

Contrast: Black foam does not have pathogen binding capabilities and relies on negative pressure to pull exudate and pathogens through the pores to decrease the bio-burden.

Granulation Tissue Formation

Granulation tissue is the combination of small vessels and connective tissue that forms in the wound bed. It provides a matrix that allows epidermal cells to migrate over the bed of the wound. The amount and the quality of the granulation tissue varies depending on the wound filler being used. Foam encourages the growth of thick, but fragile granulation, while gauze creates thin but dense granulation. Cutimed Sorbact, when used in negative pressure, has properties between foam and gauze making it an attractive filler for all types of wounds.

Contrast: Foam generates thick granulation tissue that may lead to complications such as fibrosis, scarring and contractures. During dressing changes, the removal of foam often also causes painful loss of newly formed granulation tissue.

Reduction in Pain and Complications Associated with High Negative Pressures

Cutimed Sorbact allows for effective withdrawal of exudate while using low negative pressure. When the wound has heavy exudate, it is appropriate to use -125mmHg for rapid removal of fluids. Studies have shown that at -80mmHg several optimal biological effects occur. These include wound contraction, increased regional blood flow and the formation of granulation tissue. When treating poorly perfused wounds, high negative pressures may inhibit micro-vascular blood flow to the already compromised tissues.

Contrast: There are a number of complications associated with tissue ingrowth into foam. With high negative pressure and the use of foam as a non-hydrophobic barrier, patients often experience pain during dressing changes and require pre-medication with strong analgesics. When treating poorly perfused tissue, ischemia may develop in the wound tissue and patients may experience pain during treatment. The wound bed can also be disrupted during dressing changes. It is possible that pieces of foam may be left behind during dressing changes. This debris will act as a foreign body that may impede wound healing.

Ease of Application

Cutimed Sorbact requires no contouring and fitting to the margins of the wound and the wound bed surface. Negative pressure predominantly works only when the filler is in direct contact with the wound bed. Cutimed Sorbact is easy to apply and due to its moldability can easily reach deeper structures and irregularities. A simple “fluff and fill” method is used. No cutting or shaping required.

Contrast: Foam is a difficult and time-consuming process to contour into the shape and depth of the wound bed. Particulates are often left behind that require detailed removal before the following dressing change can take place.

Reduced Frequency of Dressing Changes

The frequency of dressing changes depends on the level of wound exudate, wound status, bio-burden and likelihood for tissue ingrowth. When used on infected wounds, Cutimed Sorbact should be changed as needed to allow for visual inspection of the wound and to apply PhaseOne to disrupt and eradicate the biofilm. For wounds at less risk of infection, the dressing may be changed every 4 days. Less frequent dressing changes saves time and money, consumes fewer nursing resources, decreases the likelihood of cross-contamination and does less damage to new granulation tissue formation. Patient satisfaction also improves with fewer dressing changes.

Contrast: Foam dressings are generally changed 3 times per week, especially in heavily exudating wounds. Contouring and applying foam is a time consuming process and exposes the wound to foreign materials and re-entry of bacteria as well as foam debris.

Improve Patient Quality of Life

Cutimed Sorbact has been shown to reduce pain, virtually eliminate wound odor, decrease exudate and accelerate wound healing when used in combination with negative pressure.

References

  1. Ljungh Ã… et al. Journal of Wound Care 2006; 15 (4): 175—180.
  2. Martinez-Rossi N. M, et al. Mycopathologia 2008; 166 (5-6): 369-383.
  3. Johansson A et al. J Wound Care 2009; 18 (11): 470- 473.
  4. Data on file, Abigo Medical AB