Opatrunek AQUACEL® Ag+ Extra™ znajduje zastosowanie w leczeniu ran trudno gojących się, w których doszło do wytworzenia biofilmu. Dzięki połączeniu dwóch technologii opatrunek firmy ConvaTec poradzi sobie w walce z najważniejszymi problemami w leczeniu ran, jakimi są wysięk i infekcje.
Sprawdź najważniejsze informacje o opatrunku AQUACEL® Ag+ Extra™:
- Jak działa opatrunek?
- Na jakie rany można go stosować?
- Opinia eksperta o opatrunku
- Przeciwwskazania w stosowaniu
- Czy opatrunek można przycinać?
- Jak założyć opatrunek?
- Jak często należy zmieniać opatrunek?
- Skuteczność opatrunku – case study
- Jakie rodzaje opatrunku są dostępne?
- Czy na opatrunek przysługuje refundacja?
- Gdzie kupić opatrunek?
Jak działa opatrunek AQUACEL® Ag+ Extra™?
Opatrunek AQUACEL® Ag+ Extra™ zbudowany jest z dwóch warstw, wykonanych z włókien karboksymetylocelulozy sodowej, wzmocnionych przeszyciami. Do jego stworzenia wykorzystano technologię Więcej niż srebro™ oraz technologię Hydrofiber™.
Technologia Więcej niż srebro™ to unikalna kompozycja, dzięki której opatrunek jest w stanie przerwać i naruszyć strukturę biofilmu, pozbawiając go ochronnej bariery. Technologia Więcej niż srebro™ oparta jest na srebrze oraz dwóch dodatkowych składnikach, które wspomagają niszczenie biofilmu. Składniki te to kwas etylenodiaminotetraoctowy (EDTA) i chlorek benzetoniowy (BEC). Z uwagi na zawartość srebra jonowego (1,2%) opatrunek wykazuje skuteczność przeciwko szerokiemu spektrum bakterii, w tym również szczepów antybiotykoopornych. W połączeniu z technologią Hydrofiber™ zapobiega także odnawianiu się biofilmu.
Unikalną właściwością opatrunku AQUACEL® Ag+ Extra™ wykonanego w technologii Hydrofiber™ jest przekształcanie się opatrunku w spójny żel pod wpływem wysięku z rany. Pozwala to na stworzenie idealnego środowiska wspomagającego proces gojenia rany. Dzięki technologii Hydrofiber™ opatrunek zamyka nadmiar wysięku, bakterie i biofilm w swojej strukturze. Minimalizuje to ryzyko infekcji krzyżowej i maceracji skóry wokół rany. Technologia Hydrofiber™ sprawia, że opatrunek dopasowuje się do łożyska rany, zapewniając optymalną wilgotność oraz redukując puste przestrzenie, w których może dojść do namnożenia się bakterii. Opatrunek reguluje ilość wysięku z rany i przekształca się w spoisty żel, zapewniając wilgotne środowisko w ranie, a także minimalizuje ból podczas zmiany opatrunku.
Na jakie rany można stosować opatrunek AQUACEL® Ag+ Extra™?
AQUACEL® Ag+ Extra™ znajduje zastosowanie w terapii ran przewlekłych, z podejrzeniem infekcji lub infekcją, trudno gojących się, z występującym biofilmem, z umiarkowanym lub obfitym wysiękiem, a także ran ostrych. Ponadto stosuje się go w leczeniu owrzodzeń w przebiegu stopy cukrzycowej, żylnych, tętniczych i mieszanych owrzodzeń goleni, odleżyn (pośredniej i pełnej grubości), ran chirurgicznych i pourazowych.
AQUACEL® Ag+ Extra™ to idealny opatrunek również na rany onkologiczne z wysiękiem takie jak ziarniaki, rak grzybiasty, przerzuty skórne, mięsak Kaposiego, mięsak naczyniowy.
Opinia eksperta o opatrunku – mgr Zuzanna Konrady, pielęgniarka, Członek Zarządu Stowarzyszenia Naukowego Leczenia Ran
– Opatrunek AQUACEL® Ag+ Extra™ stosuję u swoich pacjentów bardzo często – powiedziała mgr Zuzanna Konrady, pielęgniarka, Członek Zarządu Stowarzyszenia Naukowego Leczenia Ran. Opatrunek ten znajduje zastosowanie w leczeniu ran różnego pochodzenia i o różnej głębokości – zarówno ran trudno gojących się takich jak odleżyny, owrzodzenia podudzi czy stopa cukrzycowa, jak i w ranach chirurgicznych, urazowych, a także w ranach zakażonych, z wysiękiem i krwawieniem oraz w ranach powierzchownych. Opatrunek ten jest ponadto bezpieczny dla pacjentów w każdym wieku i może być stosowany zarówno u dzieci, jak i u dorosłych.
AQUACEL® Ag+ Extra™ dzięki zawartości srebra skutecznie likwiduje biofilm z łożyska rany. Ponadto pozwala zarządzać wysiękiem. Opatrunek ten skutecznie pochłania wszelkie wydzieliny z rany, a ponadto sekwestruje drobnoustroje i zatrzymuje je w swojej strukturze, dzięki czemu zapobiega maceracji i nadkażaniu. Jednocześnie utrzymuje też w ranie wilgotne środowisko, dzięki czemu stymuluje procesy autolitycznego oczyszczania rany.
Także struktura opatrunku AQUACEL® Ag+ Extra™ ma wiele zalet. Po pierwsze jest to opatrunek bardzo miękki, dzięki czemu łatwo można go dopasować do ran o dowolnych kształtach, również do ran drenujących i z przetokami. Dzięki temu nie powstają martwe przestrzenie, w których może się rozwinąć zakażenie. Opatrunek nie przykleja się podczas aplikacji do rękawiczek ani do sprzętu, nie sprężynuje. AQUACEL® Ag+ Extra™ ma też specjalne przeszycia, które pozwalają na łatwe przycinanie, a jednocześnie zapobiegają rozrywaniu opatrunku przy usuwaniu go z rany.
Co istotne, ze względu na dużą chłonność opatrunek może pozostawać na ranie nawet do 7 dni, co jest ważne dla pacjenta ze względów ekonomicznych. Opatrunek AQUACEL® Ag+ Extra™ czyści i chroni ranę, a jednocześnie stymuluje procesy naprawcze, a więc spełnia wszystkie role przewidziane w strategiach nowoczesnego zarządzania raną.
Przeciwwskazania w stosowaniu
Opatrunek nie powinien być stosowany u osób z alergią na srebro lub inny składnik opatrunku.
Czy opatrunek AQUACEL® Ag+ Extra™ można przycinać?
Opatrunek można docinać w celu uzyskania kształtu odpowiadającego wielkości i kształtowi rany. Pod wpływem cięcia opatrunek nie traci właściwości, a dzięki przeszyciom włókna zachowują swój pierwotny kształt i nie ulegają rozerwaniu.
Jak założyć opatrunek AQUACEL® Ag+ Extra™?
Przed nałożeniem opatrunku należy dokładnie oczyścić ranę ze wszystkich zalegających w niej rozkładających się tkanek, nadmiaru wysięku i biofilmu. Można zastosować mechaniczne oczyszczanie, np. gazikiem lub gąbkami z dodatkiem środka do oczyszczania ran. W ranach płytkich opatrunkiem AQUACEL® Ag+ Extra™ należy pokryć ranę z uwzględnieniem co najmniej 1 cm zdrowej skóry wokół rany.
W przypadku ran głębokich ranę wypełnia się opatrunkiem jedynie do 80%. Mają na to wpływ właściwości opatrunku, który w kontakcie z wysiękiem początkowo lekko obkurcza się w trakcie żelowania, a następnie zwiększa objętość i wypełnia pustą przestrzeń.
Opatrunek AQUACEL® Ag+ Extra™ zaleca się stosować w połączeniu:
- w ranach z niewielkim lub średnim wysiękiem z opatrunkami nieprzepuszczającymi wilgoci, np. opatrunkami Granuflex®, Granuflex® Extra Thin,
- w ranach silnie sączących z nieprzylepnymi lub przylepnymi opatrunkami wtórnymi takimi jak AQUACEL®
W ranach suchych opatrunek umieszcza się w ranie, a następnie moczy wyłącznie obszar nad raną za pomocą sterylnego roztworu 0,9% NaCl, czyli tzw. soli fizjologicznej. Pionowa absorpcja opatrunku pomaga w utrzymaniu wilgotnego obszaru wyłącznie nad raną i zmniejszeniu tym samym ryzyka maceracji skóry wokół. Można także zamiast moczenia opatrunku nałożyć na ranę kroplę lub więcej (w zależności od wielkości rany) hydrożelu hydrokoloidowego GranuGel® i pokryć go opatrunkiem AQUACEL® Ag+ Extra™. Aby ograniczyć ryzyko wyschnięcia opatrunku, a w konsekwencji jego przyklejenia do rany, opatrunek należy przykryć opatrunkiem nieprzepuszczającym wilgoci, takim jak np. Granuflex® czy Granuflex® Extra Thin.
Jak często należy zmieniać opatrunek?
Opatrunek może pozostawać na ranie do 7 dni (do 14 dni w przypadku oparzeń), jednak częstość zmian należy dostosować do stanu rany, a przede wszystkim do ilości wysięku. Zazwyczaj opatrunek jest zmieniany co 3 do 4 dni lub w przypadku przesiąknięcia wysięku do opatrunku wtórnego i wyczerpania jego chłonności.
Jeśli opatrunek jest suchy, w celu usunięcia należy zwilżyć go sterylną wodą lub sterylnym 0,9% roztworem NaCl na 15 do 30 minut przed usunięciem i odczekać, aż opatrunek przybierze formę miękkiego, koherentnego żelu. W przypadku ran oparzeniowych opatrunek AQUACEL® Ag+ Extra™ przylega do rany, tworząc jakby „drugą skórę” zabarwioną na kolor wysięku. W miarę narastania zdrowego naskórka opatrunek samoistnie odkleja/odwarstwia się od rany oparzeniowej. Jeśli tak się nie dzieje i nie występują inne niepokojące objawy, nie zdejmujemy go do 14 dni od założenia, a w dniu zmiany opatrunku postępujemy zgodnie z zaleceniami dla suchego opatrunku przedstawionymi powyżej.
Struktura opatrunku:
Struktura opatrunku Aquacel Ag+ Extra.
Opatrunek Aquacel Ag+ Extra częściowo zżelowany.
Skuteczność opatrunku – case study
Skuteczność w działaniu opatrunku AQUACEL® Ag+ Extra™ potwierdzają badania. Testy laboratoryjne wykazały nadzwyczajną zdolność do niszczenia biofilmu i zapobiegania jego odnawianiu w przypadku ran zakażonych Pseudomonas aeruginosa czy MRSA (metycylinooporny gronkowiec złocisty). W niezależnym badaniu przeprowadzonym przez badaczy z Perfectus Biomed Limited na modelu rany z biofilmem, aby naśladować warunki ran, opracowano trudny, wielogatunkowy model biofilmu in vitro, bazujący na akredytowanym przez UKAS modelu reaktora stworzonego przez CDC (Centres for Disease Control).
Zastosowano zawiesinę gatunków mieszanych zawierającą Staphylococcus aureus, Pseudomonas aeruginosa i Candida albicans. Mikroorganizmy inkubowano przez 72 godz., by uzyskać dojrzały biofilm. Opatrunki AQUACEL® Ag+ Extra™ oraz 4 inne nakładano na 24 godz. Wyniki pokazały, że jedynie opatrunek AQUACEL ® Ag+ Extra ™ zmniejszył liczbę żywych drobnoustrojów do niewykrywalnego poziomu po 24-godzinnej eskpozycji. Dodatkowo ten sam zestaw opatrunków poddano testowi z zastosowaniem modelu reaktora przepływowego Drip Flow. Zastosowano ponownie zawiesinę gatunków mieszanych zawierającą Staphylococcus aureus, Pseudomonas aeruginosa i Candida albicans. Mikroorganizmy inkubowano przez 72 godz., by uzyskać dojrzały biofilm. Podczas inkubacji zapewniony był ciągły przepływ substancji odżywczej. Opatrunki nakładano na 72 godz. Ponownie jedynie AQUACEL® Ag+ Extra ™ zmniejszył liczbę żywych drobnoustrojów do niewykrywalnego poziomu po 72-godzinnej eskpozycji.
Opatrunek AQUACEL® Ag+ Extra™ znajduje również zastosowanie w gojeniu ran w praktyce klinicznej. Dzięki zaopatrywaniu ran opatrunkiem AQUACEL® Ag+ Extra™ powierzchnia zainfekowanych owrzodzeń goleni zmniejszyła się o 70%. Potwierdziło to badanie przeprowadzone na 42 pacjentach z owrzodzeniem goleni, infekcją w ranie lub podejrzeniem infekcji. Dzięki połączeniu obu technologii opatrunek zredukował o 54% powierzchnię owrzodzeń wszystkich ran, a także o 70% powierzchnię owrzodzeń z cechami infekcji.
Jakie rozmiary opatrunku AQUACEL® Ag+ Extra™ są dostępne?
Opatrunek AQUACEL® Ag+ Extra™ dostępny jest w czterech rozmiarach:
– 5 cm x 5 cm,
– 10 cm x 10 cm,
– 15 cm x 15 cm,
– 20 cm x 30 cm.
Czy na opatrunki AQUACEL® Ag+ Extra™ przysługuje refundacja?
Opatrunek AQUACEL® Ag+ Extra™ jest objęty refundacją. W przypadku pacjentów z przewlekłym owrzodzeniem poziom odpłatności wynosi 30%. Natomiast w przypadku pacjentów z Epidermolysis bullosa opatrunek jest bezpłatny do limitu. Dla przykładu w dniu 08.09.2020 r. cena po refundacji wynosi odpowiednio:
dla pacjentów z przewlekłymi owrzodzeniami:
– 5 cm x 5 cm (2,76 zł za 1 szt.),
– 10 cm x 10 cm (9,26 zł za 1 szt.),
– 15 cm x 15 cm (18,49 zł za 1 szt.),
– 20 cm x 30 cm (43,24 zł za 1 szt.).
Dla pacjentów z Epidermolysis bullosa:
– 5 cm x 5 cm (1,70 zł za 1 szt.),
– 10 cm x 10 cm (5,01 zł za 1 szt.),
– 15 cm x 15 cm (8,93 zł za 1 szt.),
– 20 cm x 30 cm (17,75 zł za 1 szt.).
Gdzie kupić opatrunki specjalistyczne AQUACEL® Ag+ Extra™?
Opatrunki AQUACEL® Ag+ Extra™ dostępne są w niemalże każdej aptece na terenie całej Polski oraz w sklepie internetowym mojarana.pl.
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