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Wounds can vary widely in how they present, from straight forward through to complex, challenging us at every turn. Wounds may be superficial, gaping full thickness or punctures that go deeper than we can see, but no matter the depth of the wound, if it is not clean it cannot heal.
Wound cleaning is vitally important to ensure we give the tissue the best chance at repairing with no infection. Acute and chronic wounds are at risk of becoming infected which can compromise the normal healing pathway, leading to a greater problem in the underlining tissue. 50% of chronic wounds are estimated to be infected.1
The presence of biofilm is reported in over 90% of non-healing wounds. 2 While the role that biofilm plays in the chronicity of wounds is still not fully investigated, it is becoming widely accepted that hard-to-heal wounds contain biofilm - and somehow its presence delays or prevents healing.
What is Biofilm?
Biofilm forms when bacteria adhere to surfaces by excreting a thick, glue-like substance known as the Extracellular Polymeric Substance (EPS). This substance forms a protective layer, where the bacteria are no longer free to move (planktonic) but adhere to the wound bed. New bacteria are produced, and the colony grows under the protection of the EPS. Biofilms are often difficult to detect visually, but they delay wound healing due to the protection they provide to the bacteria in the wound bed.3
Traditional wound cleansing with saline and water is ineffective at removing coatings and debris in many wounds, especially complex biofilms. 4 Prontosan® Irrigation Solution and Prontosan® Wound Gel/Gel X are specifically indicated for the prevention and removal of biofilms. Prontosan® contains two key ingredients: Betaine and Polyhexanide.
Betaine is a gentle surfactant which is able to disturb, penetrate, clean and remove biofilm and wound debris.
Polyhexanide (PHMB) is a broad spectrum antimicrobial with demonstrated good clinical safety, no evidence of resistance and minimal toxicity. It functions as a preservative which inhibits the growth of micro-organisms.5,6,7
The unique combination of Polyhexanide and Betaine have a double effect on the wound bed to create a wound environment optimal for healing.
How it works?
- C Dowesett: Adopting the two-week challenge in practice: making the case for silver dressings, Wounds UK, Vol 10,N”2, 2014
- Attinger, Christopher and Randy Wolcott “Clinically Addressing Biofilm In Chronic Wounds” Advances in Wound Care 1.3 (2012): 127-132. Web.
- Davis SC, Harding A, Gill J, Parajon F, Valdes J, Solis M & Higa A “Effectiveness of polyheanide irrigation soulution on MRSA biofilms in a porcine wound model” IWL 1742-4801, 2017, 1-8.
- Murphy C, et al. International consensus document. Defying hard-to-heal wounds with an early antibiofilm intervention strategy: wound hygiene. J Wound Care 2020.
- Fabry, W. & Kock, In-vitro activity of polyhexanide alone and in combination with antibiotics against Staphylococcus aureus. H.-J. Journal of Hospital Infection. 2014
- Hirsch et al., Evaluation of Toxic Side Effects of Clinically Used Skin Antiseptics In Vitro, Journal of Surgical Research 2010 202010 Volume 164, Issue 2.
- Bradbury S, Fletcher J. Prontosan® made easy. www.woundsinternational.com 2011;