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Prior to surgery, the surgical staff scrub the patient’s skin to rid the site of pathogens. Unfortunately, there’s really no way to achieve skin sterilization.
So, what can you do about that dilemma? Kimberly-Clark has come up with a novel answer to the question: InteguSeal.

InteguSeal is a blue-violet-tinted, free-flowing, liquid cyanoacrylate contained in a glass ampule. It’s released by pressing on a plunger, just as if it were a large syringe, then painting the product on. As it’s painted on the skin surface, InteguSeal bonds to the skin and encases everything in its path, including bacteria. It does not need to be removed; eventually it just wears off. A real plus is that, because it’s a microbial sealant and not an antimicrobial, it doesn’t promote bacterial resistance. Who isn’t happy about that?

John Amat, vice president–global sales and marketing, Kimberly-Clark Health Care, Roswell, GA, described it in further detail: "The Kimberly-Clark InteguSeal Microbial Sealant seals and immobilizes pathogens to help protect against migration into surgical incisions, reducing the risk of skin flora contamination, a major source of SSI. InteguSeal is meant to be used following skin prep treatments and does not require the surgical team to change its preoperative process."

According to Amat, its virtues include its adaptability: "InteguSeal can be used with electrocautery, sutures, staples, and wound adhesives. It does not need to be removed for suture or closing. The film bonds to skin surfaces with different curvature, hair-content, or amounts or types of flora present. Wound contamination by the patient’s endogenous skin flora is a key factor in the development of SSI, and absolute skin sterilization prior to surgery is not possible. Having a solution like InteguSeal, which helps to prevent a patient’s own skin flora from contaminating the wound, will bring hospitals one step closer to reducing the risk of SSI. On prepped skin, pathogens from the patient’s own skin can be transferred into the surgical incision by any number of vehicles used over the course of the procedure, including irrigation fluids, gloves, instruments, sponges, or implants."

Amat told Healthcare Purchasing News that InteguSeal can very successfully take on the big-gun pathogens. "In an in vitro surgical-incision model, InteguSeal reduced the amount of methicillin-resistant Staphylococcus aureus recovered by 99.9%, Staphylococcus epidermidis by 99.5%, and Escherichia coli by 96.6%."

If you want to see InteguSeal in action, go to http://www.kchealthcare.com/integuseal/integvideo.html.

Closing a wound after surgery also can contribute to the potential for infection, because bacteria can cling to needles and sutures as they are worked in and out of the skin. 3M has an answer to the problem for low-tension surgical wounds.

Caroline Krubsack, marketing analyst, 3M Company, St. Paul, MN, described the product, which can be used in lieu of needles and sutures or staples: "3M Steri-Strip S Surgical Skin Closure is a non-invasive, adhesive-based device designed to close low-tension surgical incisions or lacerations."

According to Krubsack, 3M Steri-Strip S Surgical Skin Closure’s virtues include the following:

• Fast application

• Good cosmetic results

• Precise wound-edge alignment and approximation

• Less potential for infection than sutures and staples

• Helps limit tissue trauma and patient discomfort

• Adjunct to suture closures for higher tension wounds or as reinforcement for wounds after early suture or staple removal

• Devices can be combined to achieve the length needed or to close a curved wound.

3M Steri-Strip S Surgical Skin Closure (formerly marketed as ClozeX) was found, in a study by Kuo et al "to be a safe and effective closure device. The cosmetic outcome seems to be at least as good as simple running suture. Physicians and patients were generally more satisfied with ClozeX. No difference was found in the rate of dehiscence or infection between the groups."3

To view a video demonstrating how to use 3M Steri-Strip S Surgical Skin Closure or to request a free trial, go to http://solutions.3m.com/wps/portal/3M/
en_US/SH/SkinHealth/brands/steri-strip/application/.

Unfortunately, not all wounds, surgical or otherwise, heal well or quickly. Ionic silver is a dynamite answer to many of those situations. Ionic silver has some important advantages going for it: it’s a natural broad-spectrum antibiotic; bacteria are actually attracted to it; and the silver is activated by wound exudate.

Mölnlycke Health Care US, LLC, Norcross, GA, is one company employing silver in their offering of wound dressings. Andrew Myers, director of marketing, described their new silver dressing: "Mepilex Ag is a new antimicrobial dressing that provides a unique combination of silver, Safetac technology, and fluid management. The dressing is indicated for the management of exudating wounds such as leg and foot ulcers, pressure ulcers, donor sites, and partial thickness burns. Mepilex Ag features patented Safetac soft silicone adhesive technology, which minimizes trauma to the wound bed and pain for the patient. The dressing also manages wound exudate effectively, which helps to reduce the risk of maceration. In vitro studies have demonstrated that Mepilex Ag kills common pathogens within 30 minutes and offers an effective sustained release of silver for up to 7 days."

Myers highlighted the need for healthcare givers to select the correct type of dressing for different kinds of wounds: "Clinicians are getting smarter about how and when they use specific dressings, recognizing it’s important to use the right dressing for the right wound type. Many patients have underlying factors, such as diabetes, that don’t permit them to heal as well as others. The right wound dressing can jump start the healing process."

Many dressings have latex as a component, and that’s perfectly fine for most of the population; however, for someone allergic to latex, the allergic reaction has the potential to be more dangerous to the patient than the wound. Reactions can run from an itchy, burning rash formed around an already painful wound to life-threatening anaphylactic shock. Some companies are addressing the problem with latex-free products.

Andover Healthcare, Inc, Salisbury, MA, recently released CoFlex LF2, a latex-free, foam, cohesive bandage they say sticks and performs as well as latex bandages. A gentle, non-irritating, open-cell foam absorbs and holds the latex-free cohesive, delivering a long-lasting and comfortable cohesive bond. An added attraction is that, because CoFlex LF2 is unaffected by water, wet dressings stick and hold in place. It can be used for treatment of edema, holding dressings in place, stabilizing infusion lines, and as a light compression wrap. It’s easy to tear, and it’s appropriate for extended wear because it doesn’t unravel.

We are very fortunate to live in a time when there are so many options available for treating wounds. Unfortunately, there is no "one-size-fits-all" solution to wound care. Deciding which products to stock can be a big job. Budgets always have to be taken into consideration, too. There’s only one thing for purchasers and users to do: research, research, research. The time spent on research is well worth it; it can result in better quality of life—or perhaps life itself—for your facility’s patients. When you examine wound care products, never forget the wound is attached to a person who needs help. How you perform your job can make such a difference, a very important difference, to many, many people.