What is hydrophobic interaction?
Hydrophobic interaction is a basic principle of physics: When two hydrophobic (= water repellent) particles come into contact with one another in an aqueous environment they will bind to each other with help from the water molecules which surround the two particles and hold them together. (top)
What is Sorbact's mode of action - How does it work?
Micro-organisms are removed from wounds by hydrophobic interaction and without using any antiseptic or antibiotic agents. This works due to the strongly hydrophobic coating of Cutimed Sorbact and the hydrophobic properties of bacterial cell surfaces. (top)
What gives Cutimed Sorbact its strongly hydrophobic properties?
DACC (a derivative of a natural fatty acid) that the fabric of Cutimed Sorbact is coated with. (top)
What is DACC?
The derivative of a natural fatty acid: dialkyl carbamoyl chloride. At the coating process, the DACC forms covalent bonds with the fabric of Cutimed Sorbact
Chloride. Its long alkyl groups make the DACC hydrophobic. (top)
Can DACC separate from the dressing?
No. The substance is firmly bound to the fabric by covalent bonds. It cannot be released into the wound. (top)
What kind of fabric is Cutimed Sorbact made of?
Cellulose acetate except for the ribbon gauze which is made of cotton for higher conformability and hence easier handling. The dressing pad contains an absorbent core made from polyester / viscose. (top)
What is the advantage of the acetate fabric?
It is a smooth fine meshed material which reduces the risk of tissue ingrowth and of sticking to the wound. (top)
What part of the Cutimed Sorbact dressings is hydrophobic?
Always the green part. (top)
What are the indications for Cutimed Sorbact?
Unclean, colonised or infected exudating wounds regardless of aetiology, e.g. chronic wounds (diabetic foot ulcers, leg ulcers, pressure sores), post-operative wounds, traumatic wounds, excisions of fistulae or abscesses. (top)
When should Cutimed Sorbact be used?
Where the primary goal is to remove micro-organisms (bacteria as well as fungi) from wounds in order to activate or support the natural wound healing process. This also includes preventive antiseptic treatment of wounds at risk of infection (e.g. traumatic wounds). (top)
Why is it important to decrease the number of bacteria in a wound?
The healing process slows down or stops in critically colonised or infected wounds. (top)
Which are the most common wound pathogenic micro-organisms which can be found in infected wounds?
Bacteria: Staphylococcus aureus, haemolytic Streptococci, Escherichia coli, Klebsiella, Enterococci, Pseudomonas, Enterococcus, ... Yeast: Candida albicans (top)
Which kind of bacteria bind to Cutimed Sorbact?
All wound pathogenic bacteria as well as yeasts and fungus. This also includes antibiotic resistant bacteria like MRSA, VRE (top)
Why do micro-organisms have hydrophobic areas on their surface, and what is their natural purpose?
Cell surface hydrophobicity is one of the micro-organism’s natural mechanisms to take in food, to bind on surfaces or to each other e.g. for DNA exchange. (top)
Which factors influence the cell surface hydrophobicity of bacteria?
The level of hydrophobicity is inherited to the micro-organisms and further depends on their growth conditions. Studies have shown that growth conditions which are present in a wound increase the cell surface hydrophobicity. (top)
Is the binding to Cutimed Sorbact non-reversible or might some micro-organisms overcome the binding?
The binding is irreversible. (top)
What about micro-organisms located in the pus or debris of the wound?
Debris and pus are also hydrophobic. They will bind to Cutimed Sorbact as well as the micro-organisms. (top)
Can the micro-organisms bound to Cutimed Sorbact continue to grow?
No, the bound micro-organisms do not replicate. This is due to the micro-organism’s natural behaviour of slowing down their metabolism when bound to a surface. This also means that the production of bacterial toxins is slowed down or stopped. (top)
Is Cutimed Sorbact effective in treatment of MRSA?
It has been proven that strains of MRSA (methicilin resistant Staphylococcus aureus) express cell surface hydrophobicity just as the non-resistant bacteria do. Hence Cutimed® Sorbact® is also effective on MRSA. (top)
In the context of wound infection, what does the number 10 to the power 5 stand for?
10 to the power 5 is the critical number of micro-organisms per gram wound tissue resulting in delayed wound healing and risk of infection (based on findings in chronic wounds). (top)
How is the binding kinetics, is there a "saturation point" and if so could this point be reached during usage of the product?
The in-vitro study by Ljungh et al in 2006 showed that the binding capacity of Cutimed Sorbact exceeds the bacterial load you would expect to find in an infected wound. The study also showed that the binding takes place within seconds (100,000 bacteria per cm2 dessing in 30 sec, up to 100,000,000 bacteria per cm2 after 2 h). (top)
How is Cutimed Sorbact applied to the wound?
Cutimed Sorbact must be in direct contact with the wound surface. Superficial wounds should be covered with an absorbent dressing pad. Deep wounds should be dressed/filled with tupfers, ribbon gauze or fluffed swabs before covering with a dressing pad in order to ensure the contact of the dressing to the wound. (top)
How long should Cutimed Sorbact be used?
Until the wound is clean and there is no risk for further colonisation. After that, it is recommended to change to other suitable types of wound dressings e.g. moist wound healing products. (top)
How often do you have to change the Cutimed Sorbact dressings?
The frequency depends on the amount of exudate and the bacterial load and varies from once a day to three times a week. A high amount of exudate will require a high frequency of dressing changes. In infected wounds, the ideal frequency is once daily, to be decreased according to how the wound improves during the treatment. (top)
Are there any recommendations of use for Cutimed Sorbact?
Yes. Please bear in mind that the Sorbact method / hydrophobic interaction requires a certain amount of moisture, so do not use Cutimed Sorbact on dry wounds. Please note that the Sorbact mode of action requires the direct contact of the dressing to the wound surface. (top)
Does Cutimed Sorbact stick to the wound?
By frequent dressing changes and when used on exudating wounds, Cutimed Sorbact will not stick to the wound. When the wound is clean and enters the healing phase, there is a risk that the dressing might stick to the now dry wound bed. Therefore it is recommended to use Cutimed Sorbact only for wound cleansing and not for the subsequent healing phase. (top)
Can Cutimed Sorbact be applied on top of another dressing such as an ointment dressing or gel dressing?
No, the hydrophobic surface of Cutimed Sorbact has to be in direct contact with the wound surface. Ointments and other fatty substances will affect the efficacy of Cutimed® Sorbact®. (top)
Can other types of dressing be applied on top of Cutimed Sorbact, e.g. foam dressings or hydrocolloids?
Yes, as long as Cutimed Sorbact is in direct contact to the wound surface, and as long as the other dressing does not contain any fatty substances (e.g. ointment dressings). (top)
Can Cutimed Sorbact be used while the patient is treated with systemic antibiotics?
Yes. (top)
Are there any restrictions concerning the use of wound cleansing agents prior to application of Cutimed Sorbact?
The wound can be cleaned as usual unless cleansing agents containing fat or tensides are used which might decrease the efficacy of Cutimed Sorbact due to their hydrophobic properties. (top)
Why doesn't Cutimed Sorbact have any side effects?
Cutimed Sorbact does not use any antiseptic or antibiotic agents which might be cytotoxic and affect the wound healing process, or might cause irritations or allergies. (top)
Why isn't there any risk of development of bacterial resistance when using Cutimed Sorbact?
Hydrophobic interaction is vital for micro-organisms, so development of resistance should be self-destructive. (top)
Are there toxicological data on DACC, is there any risk of allergies or irritations?
Cutimed Sorbact has a CE mark ensuring the safety of the product ingredients. Cytotoxicity testing and tests on the irritation and the sensitization potential have proven the biological safety. (top)
What is the shelf life of Cutimed Sorbact?
5 years. (top)
Will the efficacy of Cutimed Sorbact still be same if using either Cavilon* and Prontosan*, assuming Prontosan* is used for irrigation purposes only and Cavilon used on the periwound only?
Cavilon is not a problem as it dries like a second skin and applied to the peri-wound area only. Considering that Prontosan follows the same principle and is mainly a sterile aqueous solution with only 0.2% active ingredient, it is compatible and will not interfere with the bacteria binding concept. (top)
*All trademarks acknowledged.
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