Many patients with chronic wounds will develop infection (Landis et al, 2007; Sibbald et al, 2011). Worldwide consensus on the specific use of silver antimicrobials recommends that silver dressings should be used initially for a ‘two-week challenge’ (Wounds International, 2012). Sixteen different individual case studies were carried out to evaluate the efficacy of a biofilm remover/cleanser in gel form, Prontosan® (B Braun), together with the use of an ionic releasing silver alginate, Askina® Calgitrol® Paste (B Braun) or Askina® Calgitrol® Thin (B Braun), when used on infected wounds. This study was completed in an advanced wound management centre in Pretoria, South Africa, during 2016. Selection criteria included wounds showing clinical signs of infection with delayed healing for more than 2 weeks. The study results showed that 50% of the wounds’ clinical signs of infection resolved within the 2-week antimicrobial challenge and by week 3, 81% of all clinical signs resolved. Ninety-three per cent of the wounds had improved wound progress and healing, and continued a healing trajectory path. All of the patients experienced a decrease in pain and improvement in their quality of life within 24 hours of their treatment. In conclusion, the use of an anti-biofilm wound cleanser product, such as Prontosan, together with a silver dressing or silver paste as an antimicrobial, demonstrated significant improvement in healing time and resolution of the infection proved to be cost effective within the clinical environment irrespective of the underlying aetiology and adjunctive treatment programme. The shorter healing time and resolution of infection within the 2–4 week period has resulted in a more than 60% cost reduction compared to the cost of treatment prior to application of the protocol.
