Masterclass Guides: DACC-Coated Dressings: Leukomed® Sorbact®

May

- June 2022

GUIDES

Introduction

This Masterclass Guide is a concise overview of sterile single use bacterial binding wound dressings, for incorporation into your clinical practice.

Surgical site infections (SSI), are the most frequently reported healthcare acquired infection and carry the heaviest financial impact for healthcare systems.

Conventionally, wound infections are treated with antimicrobials. However, with the escalating threat of antimicrobial resistance, an alternative approach needs to be adopted.

Is

?

■ Leukomed® Sorbact® is a sterile single-use dressing developed for use in closed surgical wounds. It offers a dual effect of binding bacteria at the wound bed and protecting the wound from external contamination

■ A transparent, showerproof, and easily applied polyurethane film adhesive outer layer protects and keeps the wound moist, and covers an absorbent pad with a green contact layer coated with dialkylcarbamoyl chloride (DACC), (a fatty acid derivative), which irreversibly binds the bacteria (Figure 1)

■ The dressing utilizes a unique technology by irreversibly binding the bacteria and is proven to prevent surgical site infections (SSI)

■ Leukomed® Sorbact® is recommended for usage to prevent SSI by the National Institute for Clinical Excellence (NICE)1

■ Reducing the bioburden of a surgical wound will facilitate the healing process

■ These dressings work on the principle that two substances with hydrophobic properties will bind together when introduced in a moist environment (hydrophobic interaction)

■ The dressing comprises of an absorbent non-woven wound contact pad, and an outer, transparent, adhesive polyurethane film

■ The pad is made of a white viscose polypropylene and polyester mesh, coated with DACC. Upon contact, the bacteria are irreversibly bound with the DACC coated layer, their growth is inhibited and they can be removed from the wound area when the dressing is changed

■ Since the DACC method does not kill the bacteria, there is no release of endotoxins or cell debris. The purely physical method of binding and removing the bacteria also minimizes the risk of development of resistance

DACC-Coated Dressings: Leukomed® Sorbact®

Keywords

■ DACC (dialkylcarbamoyl chloride)

■ Leukomed® Sorbact®

■ Bioburden

■ Surgical site infection (SSI)

■ Antibiotic stewardship

■ Vascular surgery

■ Caesarean section (CS)

■ Wound

■ Wounds

How Does Leukomed® Sorbact® Work?

1 Prepare the wound according to local clinical practice. Ensure that the surrounding skin is clean and dry

2 Select an appropriate dressing size for the wound

3 Remove the dressing from the pouch using an aseptic technique

4 Remove the protective film from the wound contact side of the dressing and apply the dressing. Ensure that the green wound contact layer comes into direct contact with the complete wound surface. Do not stretch the film during application

5 Press the borders to the surrounding skin. Carefully remove the application film, using the blue handling strip. Slowly pull the application film backwards, pulling parallel to the skin to avoid it lifting

6 The dressing change frequency depends on exudate levels and the overall condition of the wound and surrounding skin. Should the clinical condition allow, the dressing can be left in place for up to 7 days

7 For gentle removal, stretch the dressing to release adhesion. Pull one edge of the dressing parallel to the skin. Do not pull up or backwards.

8 Avoid lifting the dressing for inspection

What

Leukomed® Sorbact®

Figure 1:

DACC-Coated Dressings:

Leukomed® Sorbact®

What Types of Wounds Are Suitable?

■ Surgical incisions and post-operative wounds

■ Dry to low exudate wounds

■ Lacerations

■ Cuts, abrasions and minor burns

What Types of Wounds Are Not Suitable?

■ Full thickness burns

■ High exuding surgical wounds

■ Degloved or necrotic tissue

RRR: Relative risk ratio

Figure 2: Leukomed® Sorbact® dressing, with green DACC-coated layer visible:

Figure 4: Leukomed® Sorbact® product packaging:

Figure 3: Evidence table:

Figure 5: Leukomed® Sorbact® dressing, presented by a clinician:

GUIDES

What Is the Evidence?

DACC-Coated Dressings: Leukomed® Sorbact®

Leukomed® Sorbact® can reduce the rate of surgical wound infections, antibiotic usage and associated hospital admissions

■ 65% reduction in SSI risk in postcaesarean section patients2

■ 47% relative risk reduction of SSI in vascular surgery, compared to standard dressings3

■ Leukomed® Sorbact® is cost effective1,2

Caesarean Section Wounds Vascular Surgery Wounds

■ SSI is a common complication following caesarean section, and the procedure has higher rates of this than other surgeries, affecting 1.8 - 9.2% of patients undergoing this procedure2, (Figure 2). The consequences are potentially devastating for the individual and costly for hospitals and healthcare systems

■ The success in use of Leukomed® Sorbact® dressings in the management of surgical wounds of patients following this procedure, to prevent SSI, is well evidenced1

■ Stanirowski et al. conducted a randomized, single-blinded controlled study which assessed the efficacy of Leukomed® Sorbact® in preventing SSI in women after a caesarean section. The participants were randomly assigned to two groups, one given standard surgical dressings and the other group given Leukomed® Sorbact® dressings2

■ Stanirowski notes a decreased rate of SSI in the group given Leukomed® Sorbact® dressings2 (Figure 2)

■ Bua et al. report on a prospective, nonrandomized comparative study in a single vascular surgery center, involving two groups of 100 participants, one which was treated with Leukomed® Sorbact® dressings, and the other group given the standard inert surgical dressings normally used by the clinicians of the facility, concluding:

■ “DACC coated dressings were associated with a significant reduction in SSI rates in the early post-operative period.”3 (Figure 2)

■ “Dialkylcarbamoyl chloride (DACC)coated dressings in the management and prevention of wound infection: a systematic review’ considers 17 studies involving 3408 patients, to conclude that: “DACC-coating of dressings shows promise in both the prevention and treatment of wound infections... the available evidence that is presented is in support of DACC-coated dressings, and such promise does allow for the undertaking of further high-quality research into their clinical and costeffectiveness.”4

Costs

■ Stanirowski notes reduced costs in treatment of the study group treated with Leukomed® Sorbact®, due to reduced need for further treatment resulting from SSI2 (Figure 2)

■ The NICE (The National Institute for Health and Care Excellence) guidance for Leukomed® Sorbact® further supports the cost effectiveness, efficacy and safety in use of Leukomed® Sorbact® dressings1

■ “Hydrophobic dressing application seemed to result in a decreased rate of SSI and a considerably milder course, with no need for systemic antibiotic therapy and hospital readmissions.”

“Total cost of SSI treatment was lower… and was a result of ambulatory visits only.”2

■ “Leukomed Sorbact is cost saving across a wide range of SSI costs, device costs, comparator costs and relative risk reduction.”1

■ “DACC coated hydrophobic dressings have effects in preventing SSI in a number of different patient groups and may have a significant role in future surgical wound management.”3

DACC-Coated Dressings:

Key Points

■ 65% reduction in SSI risk in post-caesarean section patients2

■ 47% relative risk reduction of SSI in vascular surgery compared to standard dressings3

■ Potential for use for other types of surgery, supported by clinical experts1

■ Provides high patient comfort

■ Reliable adhesion; dressing remains securely in place

■ Breathable and showerproof

■ Adverse effects are minor and uncommon1

References

1. NICE. 2021. Leukomed Sorbact for preventing surgical site infection. NICE National Institute for Health and Care Excellence. MTG55

2. Stanirowski PJ, Bizoń M, Cendrowski K, Sawicki W. Randomized Controlled Trial Evaluating Dialkylcarbamoyl Chloride Impregnated Dressings for the Prevention of Surgical Site Infections in Adult Women Undergoing Cesarean Section. Surg Infect (Larchmt). 2016 Aug;17(4):427-35. doi: 10.1089/sur.2015.223. Epub 2016 Feb 18. PMID: 26891115; PMCID: PMC4960475.

3. Bua N, Smith GE, Totty JP, Pan D, Wallace T, Carradice D, Chetter IC. Dialkylcarbamoyl Chloride Dressings in the Prevention of Surgical Site Infections after Nonimplant Vascular

4. Totty JP, Bua N, Smith GE, Harwood AE, Carradice D, Wallace T, Chetter IC. Dialkylcarbamoyl chloride (DACC)-coated dressings in the management and prevention of wound infection: a systematic review. J Wound Care. 2017 Mar 2;26(3):107-114. doi: 10.12968/jowc.2017.26.3.107. PMID: 28277989.

5. Surgery. Ann Vasc Surg. 2017 Oct;44:387-392. doi: 10.1016/j.avsg.2017.03.198. Epub 2017 May 5. PMID: 28483629.

6. Stanirowski PJ, Kociszewska A, Cendrowski K, Sawicki W. Dialkylcarbamoyl chloride-impregnated dressing for the prevention of surgical site infection in women undergoing

7. Caesarean section: a pilot study. Arch Med Sci. 2016 Oct 1;12(5):1036-1042. doi:

Leukoplast®

Leukomed® Sorbact®

SSIs are the third most commonly reported type of healthcare-acquired infection and the most costly¹. They place a significant impact on patient welfare² as well as presenting a heavy financial burden for the NHS³.

New NICE Medical Technologies Guidance

New NICE medical technologies guidance recommends the use of Leukomed® Sorbact® for prevention of surgical site infection (SSI) in wounds with low to moderate exudate after caesarean section and vascular surgery.

To view please go to https://www.nice.org.uk/guidance/mtg55

The guidance states that Leukomed Sorbact:

• reduces SSI in caesarean section and vascular surgery

• may reduce antibiotic use

• may reduce readmissions from wound complications

For more information, please contact support.leukomedsorbact@leukoplast.com