Criteria to evaluate the quality of alginate wound dressings


Code	Author/Title	Year	Type of study
01	Dabiri G, Damstetter E, Phillips T. Choosing a Wound Dressing Based on Common Wound Characteristics⁽¹¹⁾.	2014	Critical Review
02	Dumville JC, Keogh SJ, Liu Z. et al. Alginate dressings for treating pressure ulcers (Review). Cochrane Database of Systematic Reviews⁽¹²⁾.	2015	Systematic review
03	Saco M, Howe N, Nathoo R. et al. Comparing the efficacies of alginate, foam, hydrocolloid, hydrofiber, and hydrogel dressings in the management of diabetic foot ulcers and venous leg ulcers: a systematic review and meta-analysis examining how to dress for success⁽13Saco M, Howe N, Nathoo R, Cherpelis B. Comparing the efficacies of alginate, foam, hydrocolloid, hydrofiber, and hydrogel dressings in the management of diabetic foot ulcers and venous leg ulcers: a systematic review and meta-analysis examining how to dress for success. Dermatol O J [Internet]. 2016 [cited 2020 May 3];22(8):3-17. Available from: https://escholarship.org/uc/item/7ph5v17z https://escholarship.org/uc/item/7ph5v17... ⁾.	2016	Systematic review and meta-analysis
04	Vowden K, Vowden P. Wound dressings: principles and practice⁽14Vowden K, Vowden P. Wound dressings: principles and practice. Surgery. 2017;1-6. https://doi.org/10.1016/j.mpsur.2017.06.005 https://doi.org/10.1016/j.mpsur.2017.06.... ⁾.	2017	Critical Review
05	Clark M. Alginates in Dressings and Wound Management. Alginates and Their Biomedical Applications⁽¹⁰⁾.	2018	Systematic review
06	Aderibigbe BA, Buyana B. Alginate in Wound Dressings. Pharmaceutics⁽15Aderibigbe BA, Buyana B. Alginate in Wound Dressings. Pharmaceutics. 2018;10(42):1-19. https://doi.org/10.3390/pharmaceutics10020042 https://doi.org/10.3390/pharmaceutics100... ⁾.	2018	Systematic review
07	Braunberger TL, Fatima S, Vellaichamy G. et al. Dress for Success: a Review of Dressings and Wound Care in Hidradenitis Suppurativa⁽16Braunberger TL, Fatima S, Vellaichamy G, Nahhas AF, Parks-Miller A, Hamzavi IH. Dress for success: a review of dressings and wound care in hidradenitis suppurativa. Current Dermatol Rep. 2018;9p. https://doi.org/10.1007/s13671-018-0231-z https://doi.org/10.1007/s13671-018-0231-... ⁾.	2018	Critical Review

Criterion	Source of information		Expected result
Criterion	Code	Author/Year	Expected result
1) Non-traumatic removal of the injury	01	Dabiri G, Damstetter E, Phillips T. 2014⁽¹¹⁾	1. Absence of adherence of the dressing in the site of the injury at the moment of its removal. 2. Absence of trauma (pain/bleeding) after removal.
	02	Dumville JC, Keogh SJ, Liu Z. et al. 2015⁽¹²⁾
	05	Clark M. 2018⁽¹⁰⁾
	06	Aderibigbe BA, Buyana B. 2018⁽15Aderibigbe BA, Buyana B. Alginate in Wound Dressings. Pharmaceutics. 2018;10(42):1-19. https://doi.org/10.3390/pharmaceutics10020042 https://doi.org/10.3390/pharmaceutics100... ⁾
2) Exudate absorption	01	Dabiri G, Damstetter E, Phillips T. 2014⁽¹¹⁾	1. Gelatinous aspect at the moment of removal.
	02	Dumville JC, Keogh SJ, Liu Z. et al. 2015⁽¹²⁾
	03	Saco M, Howe N, Nathoo R. et al. 2016⁽13Saco M, Howe N, Nathoo R, Cherpelis B. Comparing the efficacies of alginate, foam, hydrocolloid, hydrofiber, and hydrogel dressings in the management of diabetic foot ulcers and venous leg ulcers: a systematic review and meta-analysis examining how to dress for success. Dermatol O J [Internet]. 2016 [cited 2020 May 3];22(8):3-17. Available from: https://escholarship.org/uc/item/7ph5v17z https://escholarship.org/uc/item/7ph5v17... ⁾
	04	Vowden K, Vowden P. 2017⁽14Vowden K, Vowden P. Wound dressings: principles and practice. Surgery. 2017;1-6. https://doi.org/10.1016/j.mpsur.2017.06.005 https://doi.org/10.1016/j.mpsur.2017.06.... ⁾
	05	Clark M. 2018⁽¹⁰⁾
	06	Aderibigbe BA, Buyana B.2018⁽15Aderibigbe BA, Buyana B. Alginate in Wound Dressings. Pharmaceutics. 2018;10(42):1-19. https://doi.org/10.3390/pharmaceutics10020042 https://doi.org/10.3390/pharmaceutics100... ⁾
	07	Braunberger TL, Fatima S, Vellaichamy G. et al. 2018⁽16Braunberger TL, Fatima S, Vellaichamy G, Nahhas AF, Parks-Miller A, Hamzavi IH. Dress for success: a review of dressings and wound care in hidradenitis suppurativa. Current Dermatol Rep. 2018;9p. https://doi.org/10.1007/s13671-018-0231-z https://doi.org/10.1007/s13671-018-0231-... ⁾
3) Wound hemostasis	01	Dabiri G, Damstetter E, Phillips T. 2014⁽¹¹⁾	1. Being capable of interrupting small bleedings, inducing the formation of coagulation, with no further bleeding at removal.
	04	Vowden K, Vowden P. 2017⁽14Vowden K, Vowden P. Wound dressings: principles and practice. Surgery. 2017;1-6. https://doi.org/10.1016/j.mpsur.2017.06.005 https://doi.org/10.1016/j.mpsur.2017.06.... ⁾
	05	Clark M. 2018⁽¹⁰⁾
	06	Aderibigbe BA, Buyana B. 2018⁽15Aderibigbe BA, Buyana B. Alginate in Wound Dressings. Pharmaceutics. 2018;10(42):1-19. https://doi.org/10.3390/pharmaceutics10020042 https://doi.org/10.3390/pharmaceutics100... ⁾
	07	Braunberger TL, Fatima S, Vellaichamy G. et al. 2018⁽16Braunberger TL, Fatima S, Vellaichamy G, Nahhas AF, Parks-Miller A, Hamzavi IH. Dress for success: a review of dressings and wound care in hidradenitis suppurativa. Current Dermatol Rep. 2018;9p. https://doi.org/10.1007/s13671-018-0231-z https://doi.org/10.1007/s13671-018-0231-... ⁾
4) Filling-in of dead space	03	Saco M, Howe N, Nathoo R. et al. 2016⁽13Saco M, Howe N, Nathoo R, Cherpelis B. Comparing the efficacies of alginate, foam, hydrocolloid, hydrofiber, and hydrogel dressings in the management of diabetic foot ulcers and venous leg ulcers: a systematic review and meta-analysis examining how to dress for success. Dermatol O J [Internet]. 2016 [cited 2020 May 3];22(8):3-17. Available from: https://escholarship.org/uc/item/7ph5v17z https://escholarship.org/uc/item/7ph5v17... ⁾	1. Being able to fill in the cavity/depth; fitting in the space of the wound without provoking trauma as it is introduced. 2. Not disintegrating or dissolving at the moment it is introduced in the cavity/depth of the wound. 3. Not disintegrating or dissolving at the moment of removal from the cavity/depth of the wound.
	04	Vowden K, Vowden P. 2017⁽14Vowden K, Vowden P. Wound dressings: principles and practice. Surgery. 2017;1-6. https://doi.org/10.1016/j.mpsur.2017.06.005 https://doi.org/10.1016/j.mpsur.2017.06.... ⁾
	05	Clark M. 2018⁽¹⁰⁾
	07	Braunberger TL, Fatima S, Vellaichamy G. et al. 2018⁽16Braunberger TL, Fatima S, Vellaichamy G, Nahhas AF, Parks-Miller A, Hamzavi IH. Dress for success: a review of dressings and wound care in hidradenitis suppurativa. Current Dermatol Rep. 2018;9p. https://doi.org/10.1007/s13671-018-0231-z https://doi.org/10.1007/s13671-018-0231-... ⁾
5) Comfortable	01	Dabiri G, Damstetter E, Phillips T. 2014⁽¹¹⁾	1. Pain does not continue, when it presents itself, after 30 to 40 minutes at the site of the wound. Time needed for the temperature and physiological humidity to return.
	02	Dumville JC, Keogh SJ, Liu Z. et al. 2015⁽¹²⁾
	03	Saco M, Howe N, Nathoo R. et al. 2016⁽13Saco M, Howe N, Nathoo R, Cherpelis B. Comparing the efficacies of alginate, foam, hydrocolloid, hydrofiber, and hydrogel dressings in the management of diabetic foot ulcers and venous leg ulcers: a systematic review and meta-analysis examining how to dress for success. Dermatol O J [Internet]. 2016 [cited 2020 May 3];22(8):3-17. Available from: https://escholarship.org/uc/item/7ph5v17z https://escholarship.org/uc/item/7ph5v17... ⁾
6) Integrity	01	Dabiri G, Damstetter E, Phillips T. 2014⁽¹¹⁾	1. Remaining intact (not disintegrating, tearing) when applied to the site of the lesion. 2. Not leaving residue at the site of the lesion upon removal.
	03	Saco M, Howe N, Nathoo R. et al. 2016⁽13Saco M, Howe N, Nathoo R, Cherpelis B. Comparing the efficacies of alginate, foam, hydrocolloid, hydrofiber, and hydrogel dressings in the management of diabetic foot ulcers and venous leg ulcers: a systematic review and meta-analysis examining how to dress for success. Dermatol O J [Internet]. 2016 [cited 2020 May 3];22(8):3-17. Available from: https://escholarship.org/uc/item/7ph5v17z https://escholarship.org/uc/item/7ph5v17... ⁾
	05	Clark M. 2018⁽¹⁰⁾
7) Hypoallergenic	03	Saco M, Howe N, Nathoo R. et al. 2016⁽13Saco M, Howe N, Nathoo R, Cherpelis B. Comparing the efficacies of alginate, foam, hydrocolloid, hydrofiber, and hydrogel dressings in the management of diabetic foot ulcers and venous leg ulcers: a systematic review and meta-analysis examining how to dress for success. Dermatol O J [Internet]. 2016 [cited 2020 May 3];22(8):3-17. Available from: https://escholarship.org/uc/item/7ph5v17z https://escholarship.org/uc/item/7ph5v17... ⁾	1. Triggering the minimal number of possible reactions, a proportion of 1:100 patients. When used in patients with a history of allergies (to other products), the proportion of allergic reactions cannot reach 2:100 patients.
7) Hypoallergenic	06	Aderibigbe BA, Buyana B. 2018⁽15Aderibigbe BA, Buyana B. Alginate in Wound Dressings. Pharmaceutics. 2018;10(42):1-19. https://doi.org/10.3390/pharmaceutics10020042 https://doi.org/10.3390/pharmaceutics100... ⁾

Criteria	Completely agree n (%)	Expected result	Completely agree n (%)
Non-traumatic removal of the injury	9 (100.0)	1. Absence of adherence of the dressing in the site of the injury at the moment of its removal.	9 (100.0)
Non-traumatic removal of the injury	9 (100.0)	2. Absence of trauma (pain/bleeding) after removal.	9 (100.0)
Exudate absorption	9 (100.0)	1. Gelatinous aspect at removal.	9 (100.0)
Wound hemostasis	8 (88.9)	1. Being able of interrupting small bleedings, inducing coagulation, and not presenting further bleeding at removal.	8 (88.9)
Filling-in of dead space	9 (100.0)	1. Being able to fill in the cavity/depth; fitting in the space of the wound without provoking trauma as it is introduced.	9 (100.0)
		2. Not disintegrating or dissolving when introduced in the cavity/depth of the wound.	9 (100.0)
		3. Not disintegrating or dissolving when removed from the cavity/depth of the wound.	9 (100.0)
Comfort	9 (100.0)	1. Pain that does not continue, when it presents itself, after 30 to 40 minutes at the site of the wound (time needed for the temperature and physiological humidity to return).	9 (100.0)
Integrity	9 (100.0)	1. Remaining intact (not disintegrating, tearing) when applied to the site of the lesion.	9 (100.0)
Integrity	9 (100.0)	2. Not leaving residue at the site of the lesion upon removal.	9 (100.0)
Hypoallergenic	9 (100.0)	1. Triggering the minimal number of possible reactions, a proportion of 1:100 patients. When used in patients with a history of allergies (to other products), the proportion of allergic reactions cannot reach 2:100 patients.	9 (100.0)

Criterion	Completely agree	Expected result	Completely agree
Exudate absorption^ᶖ ᶖ Maintained item.	9 (100)	1. Presenting gelatinous aspect at removal and not causing macerations in the surrounding skin^† † Modified item; .	8 (88.9)
Exudate absorption^ᶖ ᶖ Maintained item.	9 (100)	2. Maintaining absorption capabilities for at least 48 hours, having a wound with moderate exudate as a reference point^£ £ Added item; .	8 (88.9)
Wound hemostasis^ᶖ ᶖ Maintained item.	9 (100)	1. Being capable of interrupting small bleedings that result from the trauma in micro-vessels, inducing coagulation and not presenting further bleeding at removal.^ᶖ ᶖ Maintained item. Not appropriate for the hemostasis of more pronounced bleedings^† † Modified item; .	9 (100)
Autolytic debridement^£ £ Added item;	8 (88.9)	1. Promoting the reduction of necrotic tissue by slough in up to 15 days of wound treatment	8 (88.9)

Criterion	Expected result
1) Non-traumatic removal of the injury	1. The dressing does not adhere to the site of the injury at the moment of removal. 2. No trauma (pain/bleeding) after removal.
2) Exudate absorption	1. Presenting a gelatinous aspect at the moment of removal. 2. Maintaining absorption capabilities for at least 48 hours, having a wound with moderate exudate as a reference point.
3) Wound hemostasis	1. Being capable of interrupting small bleedings that result from the trauma in micro-vessels, inducing coagulation and not presenting further bleeding at removal. Not appropriate for the hemostasis of more pronounced bleedings.
4) Filling-in of dead space	1. Being able to fill in the cavity/depth and fitting in the space of the wound without provoking trauma as it is introduced. 2. Not disintegrating or dissolving at the moment it is introduced in the cavity/depth of the wound. 3. Not disintegrating or dissolving at the moment of removal from the cavity/depth of the wound.
5) Comfort	1. Pain that does not continue, if it presents itself, after 30 to 40 minutes at the site of the wound. Time needed for the temperature and physiological humidity to return.
6) Integrity	1. Remaining intact (not disintegrating, tearing) when applied to the site of the lesion. 2. Not leaving residue at the site of the lesion upon removal.
7) Hypoallergenic	1. Triggering the minimal number of reactions, a proportion of 1:100 patients. When used in patients with a history of allergies (to other products), the proportion of allergic reactions cannot reach 2:100 patients.
8) Autolytic debridement	1. Promoting the reduction of necrotic tissue by slough in up to 15 days of wound treatment.

[1] Corresponding author: Taysa de Fátima Garcia E-mail: taysafati@hotmail.com

Brasil

Brasil

Criteria to evaluate the quality of alginate wound dressings

Criterios para evaluación de la calidad de coberturas de alginato en tratamiento de heridas

ABSTRACT

Objectives:

Methods:

Results:

Final Considerations: