Antibacterial efficacy in total safety

  • Description
  • Benefits
  • Indications
  • In Practice
  • FAQs
  • Evidence
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Lipido-colloid contact layer impregnated with silver salts

Promoting healing and preventing infection:

  • Broad spectrum antibacterial efficacy, including MRSA, when in contact with the wound bed
  • 99.9% removal of biofilm after 1 day (Pseudomonas aeruginosa, Staphylococcus aureus)
  • Pain-free dressing change

 

Pain-free and atraumatic dressing removal

A major benefit of TLC healing matrix (Technology Lipido-Colloid) is the non-adherence of the dressing which allows trauma-free removal from the newly-formed tissue with no pain for the patient.

Composition

UrgoTul Ag/Silver is an antibacterial, flexible contact layer with TLC-Ag, comprised of:

  • A conformable polyester mesh impregnated with fatty substances, hydrocolloid and silver particles.

 

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Mode of action

When in contact with wound exudate, the TLC-Ag of UrgoTul Ag/Silver gels and creates a moist environment, promoting healing. This ensures non-adherence and pain-free dressing changes. When the silver salt is broken down in contact with the wound exudate, UrgoTul Ag/Silver acts as a reservoir capable of continuously releasing a bactericidal concentration of silver ions while in contact with the wound.

 

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This website is an international website. Some products or sizes can therefore be unavailable in some countries. For more information, please contact us.

Benefits for the wound

  • Broad spectrum antibacterial efficacy, including MRSA

urgotul-ag-silver-benefits-2

  • 99.9% removal of biofilms within 1 day (Pseudomonas aeruginosa, Staphylococcus aureus)
  • Moist wound healing
  • No adherence to the wound (no damage to newly formed tissue)
  • Protection of surrounding skin

benefits-for-professionnalBenefits for health professionals

  • Easy to apply
  • Easy to remove with pain-free dressing change
  • Can be used in cavity wounds
  • Can be used under compression
  • Clinically proven in a Randomised Controlled Trial

benefits-for-patientBenefits for patients

  • No adherence to the wound: pain-free dressing change
  • Well tolerated
  • Very conformable to fit different wound shapes

UrgoTul Ag/Silver is indicated for the treatment of wounds with signs of local infection: chronic wounds (pressure ulcers and leg ulcers) and acute wounds (partial-thickness burns, dermabrasions, traumatic wounds, surgical wounds, etc).

Contraindications

Do not use when there is a known sensitivity to silver.
Do not use on patients undergoing Magnetic Resonance Imaging (MRI) examination.

Instructions for use

  • Clean the wound as per local protocol and rinse with normal saline.
  • If an antiseptic is first used, rinse the wound thoroughly with saline solution before applying UrgoTul Ag/Silver.
  • UrgoTul Ag/Silver can be cut using sterile scissors to fit the dressing size to the wound if necessary.
  • Using the tabs, remove the protective film.
  • Apply UrgoTul Ag/Silver to the wound.
  • Cover UrgoTul Ag/Silver with a secondary dressing suitable for the location and level of wound exudate.
  • Secure the dressing in place with a suitable bandage, adhesive tape. Apply a compression bandage when prescribed.
  • UrgoTul Ag/Silver should be changed every 1 to 3 days depending on the level of exudate and the clinical condition of the wound.

Precautions for use

  • As UrgoTul Ag/Silver can adhere to surgical gloves (latex), it is recommended that gloves should be moistened with normal saline to facilitate handling of the dressing.
  • Treatment with UrgoTul Ag/Silver should be carried out under medical supervision.
  • Concomitant use with other local treatments is not recommended.
  • Avoid contact with electrodes or conductive gels during electronic measurements, e.g. EEG and ECG.
  • In the absence of specific clinical data, use in pregnant or breast-feeding women, newborn and premature babies is not recommended.
  • Clinicians/healthcare professionals should be aware that there are very limited data on prolonged and repeated use of silver containing dressings, particularly in children and neonates.
  • Discard any unused parts of the dressing.
  • Check that the sterility protector is intact before use.
  • Single-use, individual and sterile dressing: re-using a single-use product may lead to risks of infection.
  • Do not re-sterilise the dressing.

urgotul_ag_silver_10x12Sizes available

  • 5×7 cm
  • 10×10 cm
  • 10×12 cm
  • 15×15 cm
  • 15×20 cm

This website is an international website. Some products or sizes can therefore be unavailable in some countries. For more information, please contact us.

Product

What is UrgoTul Ag/Silver?

UrgoTul Ag/Silver is an antibacterial, flexible contact layer with TLC-Ag, comprised of a conformable polyester mesh impregnated with fatty substances, hydrocolloid and silver particles.

How does UrgoTul Ag work?

When in contact with wound exudate, the TLC-Ag of UrgoTul Ag/Silver gels and creates a moist environment promoting healing. When the silver salt is broken down in contact with the wound exudate, UrgoTul Ag/Sliver acts as a reservoir capable of continuously releasing a bactericidal concentration of silver ions while in contact with the wound.

Is silver released into the wound bed to kill bacteria or are bacteria killed in contact with the dressing?

TLC Ag contains silver sulphate, whose antibacterial effect is only activated when in contact with wound exudate, the TLC creates a gel and the silver sulphate is transformed into silver ions and SO42-.
These Ag+ ions stay in the lipido-colloid gel and are not released in the wound bed.

What is the amount of silver required to kill pathogens?

It varies depending on the pathogen. However, the silver amount in the TLC gel is greater than what is needed to kill 99,99% of the pathogen.
(according to an in vitro study : 7 days-8 tested bacteria)

Does silver go into the blood stream?

TLC Ag contains silver sulphate, whose antibacterial effect is only activated when in contact with wound exudate, the TLC creates a gel and the silver sulphate is transformed into silver ions and SO42-.
These Ag+ ions stay in the lipido-colloid gel, their antibacterial activity remains on the wound surface, and is not released in the wound bed, even less so at a systemic level.

Do silver dressings remove biofilms?

Yes. TLC-Ag dressings have been proven to be effective on biofilms. It was demonstrated in an in vitro study carried out on the biofilms of Staphylococcus aureus and Pseudomonas aeruginosa. After a day in contact with a TLC-Ag dressing, 99.97% and 99.98% of the biofilms were removed respectively.

The amount of silver in TLC-Ag products is low, are they as effective as other silver dressings? Do I need to change those more often?

In TLC Ag dressings, the Ag+ ions have a bactericidal effect with an amount of silver that is enough to be effective on the most resistant pathogens, for up to 7 days (in vitro).

Other dressings may require more silver to be effective as their mechanism of action is different. They quickly release silver and need to have a higher silver amount to be effective over time. This may represent a risk of reduced effectiveness.

Against which pathogens are the TLC-Ag dressings effective?

Ag ions’ mode of action is effective against a wide range of different pathogens. Tests have even been carried out on resistant pathogens, proving the efficacy of TLC-Ag.

TLC-Ag has a demonstrated antibacterial activity for up to 7 days on:

  • Methicillin-Resistant Staphylococcus aureus (MRSA)
  • Vancomycin-Resistant Enterococcus faecalis
  • Staphylococcus aureus
  • Pseudomonas aeruginosa
  • Streptococcus pyogenes
  • Escherichia coli
  • Candida albicans

Indications

When should I use UrgoTul Ag/Silver?

UrgoTul Ag/Silver is indicated for the treatment of non to low exuding wounds with signs of local infection.

Can I use UrgoTul Ag/Silver during the desloughing stage?

Yes, however, UrgoClean is the recommended treatment option for desloughing.

Can I use UrgoTul Ag/Silver with a gel?

Yes, it can be combined with a hydrogel.

What are the contraindications of UrgoTul Ag/Silver?

UrgoTul Ag/Silver should not be used where there is a known sensitivity to silver.
Do not use on patients undergoing Magnetic Resonance Imaging (MRI) examination

Is there any adverse event related to Ag in the TLC-Ag products?

TLC Ag contains silver sulphate, whose antibacterial effect is only activated when in contact with wound exudate. These Ag+ ions stay in the lipido-colloïd geland are not released in the wound bed, preventing from argyrism or systemic toxicity.

Can I use TLC-Ag products in children?

No clinical studies have been carried out. However, TLC Ag has been widely used for the treatment of traumatic wounds and burns in children from the age of one.

Use

UrgoTul Ag/Silver can adhere to gloves. How should I avoid this?

It is recommended to moisten the gloves with normal saline and to use the protective wings to facilitate application.

Can I use UrgoTul Ag/Silver in combination with another dressing (such as UrgoClean)?

Yes.

Can I use UrgoTul Ag/Silver under compression?

Yes.

cutting-dressing-guide

Cutting Guide

Can I cut UrgoTul Ag/Silver?

Yes.

How can I secure UrgoTul Ag/Silver?

Cover UrgoTul Ag/Silver with a secondary dressing suitable for the location and level of wound exudate. Secure the dressing in place with a suitable bandage, adhesive tape, or apply a compression bandage when prescribed.

How long should I keep the dressing in place?

A maximum of four weeks use is recommended due to the good efficacy of TLC-Ag on most pathogens.
Dressing should be renewed every 1 to 3 days, depending on level of wound exudate.

Can I keep the contact layer in place and change only the secondary dressing?

The contact layer may remain in contact with the wound for 1 to 3 days. If necessary, the secondary dressing can be changed more frequently to manage exudate.

When should I stop using silver dressings and switch back to a neutral dressing?

A maximum of four weeks use is recommended due to the good efficacy of TLC-Ag on most pathogens.
If the wound evolves well before the end of the 4 weeks treatment, you can switch to a neutral dressing.

Evidence

What evidence do you have on TLC-Ag?

UrgoTul Ag/Silver is the only silver dressing which has been shown to be effective on wounds with signs of critical colonisation. The clinical study demonstrated that the use of UrgoTul Ag/Silver over 4 weeks followed by a neutral dressing (UrgoTul), reduced the size of the wound area faster than using a neutral dressing alone.

Why did you compare your silver dressing with a neutral one, rather than a silver dressing?

TLC-Ag was compared to the neutral TLC, in order to show the real effectiveness of silver.

Urgo_Review_resize_A4_web UrgoReviewTC23Feb_Web  
Supporting evidence-based practice: a clinical review of TLC technology Efficacy of a silver lipidocolloid dressing on heavily colonised wounds: a republished RCT  
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The Role of a Silver Releasing Lipido-colloid Contact Layer in Venous Leg Ulcers Presenting Inflammatory Signs Suggesting Heavy Bacterial Colonization: Results of a Randomized Controlled Study

Lazareth I. et al, WOUNDS 2008;20(6):158–166

  • Objective: Clinical interest of silver in the management of chronic wounds is not fully established. The main objective of this clinical study was to assess the ability of a new silver releasing lipido-colloid contact layer to promote the healing process of venous leg ulcers (VLU) presenting inflammatory signs suggesting a heavy bacteria colonization and then a delayed healing, in comparison to the same wound dressing not impregnated with silver salts.
  • Methods : This was an open-labeled, randomized, controlled trial. VLU presenting at least 3 out of 5 clinical signs suggesting heavy bacterial colonization were recruited. Patients were treated with contact layer silver dressing ([CLS], Restore® Contact Layer, Silver* (Hollister Wound Care, Libertyville, Ill) or contact layer dressing ([CL] Restore® Contact Layer**, Hollister Wound Care, Libertyville, Ill) for 4 weeks, then all treated ulcers were treated with CL for the 4 additional weeks. Wound evaluation and area measurements were conducted weekly during the first 4 weeks and then at week 6 and 8. Main efficacy criterion was absolute wound area decrease (AD) at week 4 and week 8.
  • Results: Patients (N = 102) were randomized and treated. Ulcers were present for nearly 11 months on average; 65% were recurrent and mean area was 20.0 ± 17.8 cm2. Almost 80% of the treated VLU were stagnating/ aggravating with their previous treatment. By week 4, mean surface area decreased by 6.5 ± 13.4 cm2 (median: 4.2 cm2) and 1.3 ± 9.0 cm2 (median: 1.1 cm2) in CLS and CL groups, respectively (P = 0.023). At week 8, median decrease was 5.9 cm2 versus 0.8 cm2 (P = 0.002) with a wound percentage decrease of 47.9% and 5.6% (P = 0.036). Median closure rate was 0.145 versus 0.044 cm2/day (P = 0.009) at week 4 and remained higher in the CLS group up to week 8 even after switching to CL dressing in these patients (P = 0.01). Odds ratio (multinomial logistic regression) of the chance to reach a ≥ 40% wound area reduction was 2.7 (95% CI: 1.1 to 6.7; P = 0.038) for silver treated ulcers. Dressing tolerance was good in both groups.
  • Conclusion: A 4-week treatment with silver releasing lipido-colloid contact layer promotes a sustained increase of closure rate of venous leg ulcers presenting inflammatory signs suggesting a high bacterial load. Also marketed as *Urgotul® Silver and **Urgotul®, Laboratoires Urgo, (France).
Last update : November 23, 2017