Two Powerful

working together to eliminate
the villians of wound healing



  • Absorbs wound fluid and creates a soft gel, maintaining a moist wound environment and helps reduce pain associated with dressing changes.15-17
  • Locks in exudate and bacteria to help minimize the harmful effects of maceration and cross infection.18-23
  • Micro-contours to the wound bed, eliminating dead space where bacteria can grow.24-26

• *Compared with standard AQUACEL® Ag Dressing
• *Compared with standard AQUACEL® Ag Dressing

Aquacel Aquacel
  • Faster reduction of bacteria within the dressing compared to AQUACEL® Ag Extra and ACTICOAT™.*30-32
  • Kills a broad spectrum of bacteria within the dressing including antibiotic resistant microorganisms.*30, 33-35
  • Sustained antimicrobial activity in dressing up to 7 days and prevents microbial reformation.*30, 33-34

Aquacel Aquacel

In this in-vitro model, mature bioburden was grown on a gauze substrate and confirmed by microscopy. Gauze-bioburden substrates were then transferred to agar plates to create a simulated wound bioburden model; dressings were applied to the bioburden surface, hydrated and covered with an appropriate secondary dressing. Following incubation, the killing effect of the dressing on bioburden-embedded bacteria was assessed at several time points over a maximum of 120 hours. Bioburden reformation was also assessed by inoculating fresh bacteria onto the gauze substrate beneath the dressing, followed by assessment of bioburden's presence or absence over a maximum of 96 hours.
• *As demonstrated in-vitro

How Does the Advantage Technology Work?
Ethylenediaminetetraacetic (EDTA)
is a metal-chelating agent. EDTA helps make the transfer of the ionic silver from the dressing to bacteria more efficient.36-40
  • Helps break up bacterial aggregates and prevents their formation and reformation.
Benzethonium chloride (BEC)
is a surfactant that reduces the viscosity or surface tension of anything to which it comes in contact, including exudate and microorganisms.36
  • Reduced surface tension allows for increased mobility of EDTA and ionic silver within the dressing, enhancing the ionic silver’s ability to contact and kill microorganisms.39,40

AQUACEL® Ag Advantage kills antibiotic-resistant organisms within the dressing in < 7 days when tested in-vitro, i.e > 4 log10 reduction of:

**Microorganisms that are antibiotic resistant.
Gram Positive Microorganisms
  • Community-associated Methicillin Resistant Staphyloccocus aureus**
  • Vancomycin Resistant Enterococcus faecalis**
  • Staphylococcus epidermidis
  • Streptococcus pyogenes

Gram Negative Microorganisms
  • Pseudomanas aeruginosa** (streptomycin and cephalosporin resistant)
  • Klebsiella pneumoniae**
  • Acinetobacter baumannii**
  • Escherichia coli

  • Candida krusei**
  • Aspergillus brasiliensis
Back to AQUACEL® Ag Advantage

* From a 2009 study of 723,490 surgical hospitalizations in which 6,891 cases of surgical site infection were identified. 1. World Union of Wound Healing Societies (WUWHS). Principles of best practice: wound exudate and the role of dressings. A consensus document. London: MEP Ltd; 2007. 2. Bishop SM, Walker M, Rogers AA, Chen WYJ. Importance of moisture balance at the wound dressing interface. J Wound Care. 2003; 12(4):125-128. 3. Hurlow J, Bowler PG. Potential implications of biofilm in chronic wounds: a case series. J Wound Care 2012; 21:38–49. 4. Lenselink E, Andriessen A. A cohort study on the efficacy of a polyhexanide-containing biocellulose dressing in the treatment of biofilms in wounds. J Wound Care 2011; 20:534–539. 5. Leaper D, Ossadian O, Edmiston CE. Approach to chronic wound infections. Brit J Dermatol. 2015; DOI 10.1111/bjd.13677 (Infection delays healing claim). 6. de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009;37(5):387-397. 7. US Food and Drug Administration (FDA). Battle of the bugs: fighting antibiotic resistance. Accessed May 6, 2016. 8. Wolcott RD, Rumbaugh KP, James G, Schultz G, Phillips P, Yang O, et al, 2010. Biofilm maturity studies indicate sharp debridement opens a time dependent therapeutic window. J Wound Care; 19: 320- 328. 9. Wolcott RD, Kennedy JP, Dowd SE, 2009. Regular debridement is the main tool for maintaining a healthy wound bed in most chronic. J Wound Care; 18: 54-56. 10. Bjarnsholt T, 2013. The role of bacterial biofilms in chronic infections. APMIS. 121. 1-51. 11. James GA, Swogger E, Wolcott R, Pulcini EL, Secor P, Sestrich J, et al, 2008. Biofilms in Chronic Wounds. Wound Rep Regen; 16: 37-44. 12. Metcalf D, Bowler P, 2013. Biofilm delays wound healing: A review of the evidence. Burns & Trauma. 1: 5-12. 13. Percival SL, Bowler PG, 2004. Biofilms and their potential role in wound healing. WOUNDS, 16: 234-240. 14. Hurlow, J., Couch, K., Laforet, K., Bolton, L., Metcalf, D., Bowler, P. Clinical Biofilms: A Challenging Frontier in Wound Care. Advances in Wound Care, DOI: 10.1089/wound.2014.0567. 15. Barnea Y, Armir A, Leshem D, Zaretski A, Weiss J, Shafir R, et al, 2004. Clinical comparative study of Aquacel and paraffin gauze dressing for split-skin donor site treatment. Ann Plast Surg; 53: 132-136. 16. Kogan L, Moldavsky M, Szvalb S, Govrin-Yehudain J, 2004. Comparative study of Aquacel and Silverol treatment in burns. Ann Burns Fire Disasters; 17: 201-207. 17. Brunner U, Eberlein T, 2000. Experiences with hydrofibers in the moist treatment of chronic wounds, in particular of diabetic foot. VASA; 29: 253-257. 18. Newman GR, Walker M, Hobot JA, Bowler PG, 2006. Visualization of bacterial sequestration and bacterial activity within hydrating Hydrober™ wound dressings. Biomaterials; 27:1129-1139. 19. Walker M, Hobot JA, Newman GR, Bowler PG, 2003. Scanning electron microscopic examination of bacterial immobilization in a carboxymethyl cellulose (AQUACEL™) and alginate dressing. Biomaterials; 24: 883-890. 20. Bowler PG, Jones SA, Davies BJ, Coyle E, 1999. Infection control properties of some wound dressings. J. Wound Care; 8: 499-502. 21. Walker M, Bowler PG, Cochrane CA, 2007. In vitro studies to show sequestration of matrix metalloproteinases by silver-containing wound care products. Ostomy/Wound Management. 2007; 53: 18-25. 22. Walker M and Parsons D, 2010. Hydrofiber Technology: its role in exudate management. Wounds UK; 6: 31-38. 23. Parsons D, Bowler PG, Myles V, Jones SA, 2005. Silver antimicrobial dressings in wound management: A comparison of antibacterial, physical and chemical characteristics. WOUNDS; 17: 222-232. 24. Jones SA, Bowler PG, Walker M, 2005. Antimicrobial activity of silver-containing dressings is influenced by dressing conformability with a wound surface. WOUNDS; 17: 263-270. 25. Bowler P, Jones S, Towers V, Booth R, Parsons D, Walker M, 2010. Dressing conformability and silver-containing wound dressings. Wounds UK; 6: 14-20. 26. Walker M, Jones S, Parsons D, Booth R, Cochrane C, Bowler P, 2011. Evaluation of low-adherent antimicrobial dressings. Wounds UK; 7: 32-45. 27. Assessment of the in vitro physical properties of AQUACEL Ag, AQUACEL Ag EXTRA and AQUACEL Ag+ Dressings, Scientific Background Report. WHRI3817 TA297, 2013, Data on file, ConvaTec Inc. 28. Harding K, Ivans N, Cains J, An opened randomized comparative study to evaluate the clinical and economic performance of two absorbent dressings in venus leg ulcers. Poster presented at EWMA; May 15-17 2013; Copenhagen, Denmark. 29. Parsons D, Mustoe T, Seth A. A new anti-biofilm Hydrofiber™ dressing: an in vivo investigation. Poster presented at Wounds UK; Nov 11-13 2013; Harrogate, UK. 30. WHRI5446 MA304: The antimicrobial activity of AQUACEL Ag+ Extra wound dressing using an in vitro direct inoculation simulated wound fluid model. 31. Antimicrobial activity against CA-MRSA and prevention of biofilm reformation by AQUACEL™ Ag+ EXTRA Dressing and Acticoat 7 Dressing. Scientific Background Report. WHRI3876 MA240, 2013, Data on file, ConvaTec Inc. 32. Antimicrobial Activity and Prevention of Biofilm Reformation by AQUACEL® Ag+ EXTRA Dressing and Acticoat 7 Dressing. WHRI3858 MA237, 2013, Data on file, ConvaTec Inc. 33. Antimicrobial activity and prevention of biofilm reformation by AQUACEL™ Ag+ EXTRA dressing. Scientific Background Report. WHRI3857 MA236, 2013, Data on file, ConvaTec Inc. 34. Antimicrobial activity against CA-MRSA and prevention of biofilm reformation by AQUACEL™ Ag+ EXTRA dressing. Scientific Background Report. WHRI3875 MA239, 2013, Data on file, ConvaTec Inc. 35. Bowler PG, Welsby S, Towers V, Booth V, Hogarth A, Rowlands V, Joseph A, et al, 2012. Multidrug-resistant organisms, wounds and topical antimicrobial protection. Int Wound J. 9: 387-396. 36. Composition comprising antimicrobial metal ions and a quaternary cationic surfactant WO12136968 ‐ Parsons World patent application ‐ 11th October 2012. 37. Banin E., Brady K.M. & Greenberg E.P. (2006). Chelator‐Induced Dispersal and Killing of Pseudomonas aeruginosa Cells in Biofilm. Appl. Environ. Microbiol. 72. 2064‐2069. 38. Chen X, Stewart PS, 2000. Biofilm removal caused by chemical treatments. Wat. Res.,34: 4229‐4233. 39. Seth AK, Zhong A, Nguyen KT, Hong SJ, Leung KP, Galiano RD, Mustoe TA. Impact of a novel, antimicrobial dressing on in vivo, Pseudomonas aeruginosa wound biofilm: quantitative comparative analysis using a rabbit ear model. Wound Repair Regen. 2014; 22: 712–719. DOI: 10.1111/wrr.12232. 40. Said J, Walker M, Parsons D, Stapleton P, Beezer AE, Gaisford S. An in vivo test of the efficacy of an anti-biofilm wound dressing. Int J Pharmaceutics. 2014; 474: 177–181. DOI: 10.1016/j.ijpharm.2014.08.034. 41. Walker M.; Metcalf D.; Parsons, D.; Bowler P. A real-life clinical evaluation of a next-generation antimicrobial dressing on acute and chronic wounds. Journal of Wound Care 2015; 24:1, 11-22. 42. Harding KG, Szczepkowski M, Mikosi ski J, Twardowska-Saucha K, Blair S, Ivins NM, Saucha W, Cains J, Peters K, Parsons D, Bowler P. Safety and performance evaluation of a next-generation antimicrobial dressing in patients with chronic venous leg ulcers. Int Wound J 2015; doi: 10.1111/iwj.12450

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