What NICE guidance means for antimicrobial wound dressings

We’re excited to share that the latest evaluation from the National Institute for Health and Care Excellence (NICE) provides important clarity on the use of topical antimicrobial dressings such as Aquacel® Ag+ Extra™ for infected leg ulcers.

The guidance forms part of NICE’s Late-Stage Assessment (LSA) framework, which evaluates categories of technologies already in widespread NHS use within the UK and Ireland.

Key findings:¹⁻²

1. Silver agents assumed to be used up to 12 weeks
2. Evidence favours silver agents for achieving complete wound healing
3. The faster patients progress to healing, the more likely that outcome will be cost-effective
   
   

What does the NICE LSA say?

The LSA looked at a range of clinical evidence, including randomised controlled trials (RCTs), real-world case studies, and expert opinion. Aquacel® Ag+ Extra™, with its three-component formula, was identified as a dressing that may offer better patient outcomes and faster healing times in the presence of infection risk.

NICE's LSA highlights Aquacel® Ag+ Extra™ as a clinically effective and potentially cost-saving solution for wounds where infection or biofilm is suspected. Its evaluation recognised that certain silver dressings, particularly those designed with biofilm-disrupting technologies, such as More Than Silver™ technology can play a vital role in hard-to-heal wound care.

Why this matters for HCPs

With increasing focus on antimicrobial stewardship, many clinicians have been cautious about silver dressings, including the long-standing myth that silver-containing dressings can only be used for 2 weeks. 

NICE’s latest review provides reassurance that, when used appropriately, dressings like Aquacel® Ag+ Extra™ offer measurable benefits and are assumed for use for 12 weeks, reviewing every 2 weeks and to keep using if needed.³

The biofilm battle

Biofilms are mixed communities of bacteria and other microorganisms living together⁴ and when free floating bacteria attach to a surface, this is when they can begin forming a biofilm. Biofilm is a major barrier to wound healing, thought to be present in almost 8 out of 10 hard-to-heal wounds⁵ – therefore it should be assumed present in every hard-to-heal wound.⁶

Biofilm is not always visible to the naked eye⁷ and can be difficult to remove, even after aggressive debridement, even reforming within 24 hours.⁸

When to use Aquacel® Ag+ Extra™

The 3 components of Aquacel® Ag+ Extra™ with its More Than Silver™ technology, ensure that it’s specifically designed to address the issue of biofilm and contribute to wound healing.

1. Chelating agent to disrupt, breaking down biofilm matrix⁹⁻¹¹
2. Surfactant to weaken, loosen and remove biofilm allowing absorption by the dressing¹⁰⁻¹³ 
3. 1.2% ionic silver, a broad spectrum antimicrobial

Aquacel® Ag+ Extra™ in action

Baseline: 14-year old static wound

-    Venous insufficiency
-    Maanged with cleansing, debriding and antimicrobial dressings
-    Compression and superabsorbent cover dressing for exudate

Intervention: 6 weeks with Aquacel® Ag+ Extra™

-    Exudate managed with Hydrofiber®, reduced peri-wound maceration
-    Healthy granulation formed, epithelialisation started
-    Static wound progressing to healing

When to choose Aquacel® Ag+ Extra™

Managing wounds appropriately with Aquacel® Ag+ Extra™ gives your patients the chance to heal wounds

Key Takeaways

Silver dressings are not all created equally. NICE's LSA affirms that targeted use of advanced antimicrobial dressings like Aquacel® Ag+ Extra™ is supported by robust evidence and can be a significant dressing in infection and biofilm management.