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Exudate can be an excellent indicator of what is happening within a wound and, therefore, provides valuable information during patient assessment. The volume, consistency, and particularly odour and colour, of any exudate will inform the practitioner about bacterial contamination, infection and stage of healing (Hampton and Collins, 2003). However, in the chronic wound, exudate must be effectively managed if the optimal moist environment necessary for wound healing is to be created, the negative effects of chronic exudate on fibroblasts are to be avoided (Phillips et al, 1998), and the surrounding skin protected from the risks of maceration (White, 2006). It is, therefore, important to understand chronic exudate and its effects so that appropriate treatment for the wound and peri-wound area is provided. Flivasorb® (Activa Healthcare) dressings, which include superabsorber particles, can absorb the exudate and retain it firmly within the dressing, ensuring that the potentially damaging chronic wound exudate does not reflect back onto the wound, causing maceration. This article will describe the role of exudates in wound healing, the problems associated with chronic wound exudates and how Flivasorb dressings with superabsorbent particles can provide an optimum healing environment in highly exuding wounds.

Wound care provides many challenges but none moreso than the management of high levels of exudate. The challenge is not only to be cost-effective and prevent maceration, but to improve the quality of life for the patient. Chronic wound fluid can be damaging to the wound healing process giving an added problem. This article examines the properties of Flivasorb® (Activa Healthcare), a wound dressing containing super absorbent polymer particles which not only absorbs high levels of exudate, but can retain the damaging particles in exudate, locking them inside the dressing.

Chronic wounds contain elevated levels of proteases, proinflammatory cytokines, and free radicals. The presence of bacteria further exaggerates the tissue-damaging processes. For successful treatment, the wound dressing needs to manage wound exudates, create a moist environment, inhibit infection, bind pathophysiological factors that are detrimental to wound healing, and provide thermal isolation. Furthermore, it has to relieve pain, be easy to use, show no allergic potency, and not release toxic residues. The present study suggests a comprehensive in vitro approach to enable the assessment of wound dressings to support optimal conditions for wound healing. Three alginate-based wound dressings: alginate alone, alginate containing ionic silver, and alginate with nanocrystalline silver, were tested for biocompatibility, antimicrobial activity, and influence on chronic wound parameters such as elastase, matrix metalloproteases-2, tumor necrosis factor-alpha, interleukin-8, and free radical formation. Alginate was found to bind considerable amounts of elastase, reduce the concentration of proinflammatory cytokines and inhibit the formation of free radicals. Furthermore, alginate showed antibacterial activity and high biocompatibility. Incorporation of silver into alginate fibers increased antimicrobial activity and improved the binding affinity for elastase, matrix metalloproteases-2, and the proinflammatory cytokines tested. Addition of silver also enhanced the antioxidant capacity. However, a distinct negative effect of silver-containing alginates on human HaCaT keratinocytes was noted in vitro.