Cover UrgoTul Ag/Silver with a secondary dressing suitable for the location and level of wound exudate.

National Institute for Health and Care Excellence (NICE), UrgoStart for treating leg ulcers and diabetic foot ulcers, https://www.nice.org.uk/guidance/mtg42, April 2023UrgoClean Ag should be changed every 1 to 2 days during the wound desloughing phase, then as often as required (up to 7 days) depending on the exudate volume and the clinical condition of the wound. The maximum treatment duration with UrgoClean Ag is 1 month. If clinical signs of local infection are noted, treatment can be changed to an antibacterial dressing from the Urgo range, dependent on clinical judgement. Meaume S, Dissemond J, Addala A. Evaluation of two fibrous wound dressings for the management of leg ulcers: results of a European randomised controlled trial (EARTH RCT). J Wound Care 2014; 23: 3, 105–116. Franks P. J., Moody M., Moffatt C. J., Hiskett G., Gatto P., Davies C., et al.. (2007). Randomized trial of two foam dressings in the management of chronic venous ulceration. Wound Repair Regen. 15, 197–202. 10.1111/j.1524-475X.2007.00205.x [ PubMed] [ CrossRef] [ Google Scholar] Venous leg ulcers occur in 1–3% of the adult population and account for the majority of lower extremity ulcerations (1), and are an important patient health and safety concern. The prevalence of venous leg ulcers ranges from 0·6 to 1·6 per 1000 for the total adult population, increasing between 10 and 30 per 1000 in the population over the age of 85 years 2, 3, 4. Despite recent advances in wound care, ulcers can take months to heal, have frequent complications (e.g. infections and cellulitis), often recur, and are costly to treat (5). The refractory nature of venous leg ulcers can affect a patient's quality of life and productivity at work, causing significant morbidity (6).

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Secondary outcomes included the absolute wound area reduction: value W 8w−value W baseline. A t test or Wilcoxon test was used to compare the absolute wound area reduction between the two groups. The wound closure rate was calculated as (value W 8w−value W baseline)/ t, where t was the number of days between the two measurements. The results were expressed in cm 2/day. A chi‐square test was used and chances to reach a 40% wound area reduction at the last evaluation. A logistic regression model was used to compare the difference in the chance with reach a 40% wound area reduction after adjusting for the following factors: age, body mass index (BMI), ulcer duration and baseline ulcer area. CliniSorb is indicated for the management of malodorous wounds. It can be used on fungating wounds and a variety of other chronic wounds with good results.Foam dressing, hydrocolloids dressing, multi-layered soft silicone foam dressings, polyurethane film, Mepilex ® Ag dressing, polyurethane foam dressing Appropriate secondary dressings are C-View (film) or Biatain Silicone (foam) depending on the exudate level, location and skin state

Pieper B., Langemo D., Cuddigan J. (2009). Pressure ulcer pain: a systematic literature review and national pressure ulcer advisory panel white paper. Ostomy Wound Manage. 55, 16–31. [ PubMed] [ Google Scholar] Guo S., Dipietro L. A. (2010). Factors affecting wound healing. J. Dent. Res. 89, 219–229. 10.1177/0022034509359125 [ PMC free article] [ PubMed] [ CrossRef] [ Google Scholar] Sodium alginate (SA) dressings are fibrous products derived from brown seaweed, which can form a gel after binding to wound exudate (Dumville et al., 2013c; O'Meara and Martyn-St James, 2013). The SA dressings used in the clinic are generally made into sheet fibers, which can be freely cut according to the shape of the wound. SA is also often used to synthesize hydrogels. The SA dressings also possess excellent exudate absorption properties; hence, they can be used in infected and non-infected wounds with a large amount of exudate (Hess, 2000). Owing to the strong absorption property of alginates, their use in the treatment of dry wounds or wounds with minimal exudate should be avoided. Meanwhile, A study developed an alginate hydrogel contained both bioglass and desferrioxamine, which better facilitated diabetic skin wound healing. The results demonstrated that combination use of BG and DFO improved the migration and tube formation of HUVECs as compared with the use of either BG or DFO alone as BG and DFO could synergistically upregulate VEGF expression (Kong et al., 2018). Moore Z. E., Webster J. (2013). Dressings and topical agents for preventing pressure ulcers. Cochrane Database Syst. Rev. 8:CD009362Meaume S et al. A randomized, controlled, double-blind prospective trial with a Lipido-Colloid Technology-Nano-OligoSaccharide Factor wound dressing in the local management of venous leg ulcers. Wound Repair Regen. 2012; 20(4): 500-511. Edmonds M., Lazaro-Martinez J. L., Alfayate-Garcia J. M., Martini J. (2018). Sucrose octasulfate dressing versus control dressing in patients with neuroischaemic diabetic foot ulcers (Explorer): an international, multicentre, double-blind, randomised, controlled trial. Lancet Diabetes Endocrinol. 6, 186–196. 10.1016/S2213-8587(17)30438-2 [ PubMed] [ CrossRef] [ Google Scholar]