A Review of Calcium Alginate Dressings

1. Calcium Alginate A Review of Calcium Alginate Dressings

2. Calcium Alginate dressings are highly beneficial for managing moderate-high exuding wounds. They are used as primary dressings and require a secondary fixture to secure them to the skin. A primary dressing is the first layer applied directly to the wound bed. A secondary dressing is applied afterwards and often contains an adhesive to secure it to the skin. Historically, alginates were first described in 1928 and have since been considered a reliable and popular treatment for wounds due to their versatility⁵. Originally, alginate dressings were available as a loose fleece formed from calcium alginate fibres. More recently, they are fabricated with fibres woven to create a more cohesive structure, which increases the fabric’s strength when soaked with wound fluid¹. This material is commonly used because it is biocompatible. This means it is chemically compatible with various elements present in wounds, such as sodium and wound exudate, allowing it to remain in place for up to 7 days¹. Alginates can also be used as conduits for creams and topical wound care. Due to their gelling capacity when exposed to wound exudate, topical agents are gradually released onto the wound bed and then secured with the gel on top². In simple terms, alginates act as a lid on a saucepan to contain moisture and regulate heat. This dramatically helps maintain a moist wound environment. The primary raw material of alginates is brown seaweed, specifically Phaeophyceae and its sub-species². livingstone.com.au sales@livingstone.com.au 1300 883 733 2

3. Alginate fibres soak up wound exudate, creating a gel-like structure. This absorption triggers an ion exchange process: calcium ions from the alginate fibres swap places with sodium ions from the exudate. As more calcium ions are replaced by sodium, the fibres expand, forming a gel over the wound. This gel formation facilitates the removal of the dressing; therefore, if the dressing is stuck to the wound bed, add saline to the dressing to loosen the fibres further. Calcium Calcium Calcium Sodium Sodium Calcium alginates are recommended for use during the transition from debridement to the repair phase of wound healing. While not officially categorised as an antibiotic, alginate possesses notable absorbent and antibacterial qualities and can expedite wound healing. Alginate fibres have been shown to absorb and retain bacteria during the formation of the gel matrix, which can be removed during dressing changes as a method of debridement³. Dry wounds should not be treated with these dressings because they have no hydrating properties. livingstone.com.au sales@livingstone.com.au 1300 883 733 3

4. Faster wound healing occurs in a moist environment. Moist wound environment aids your body's natural enzyme-based debridement. Similarly, this environment reduces pain and scarring, activates collagen production, and sustains the presence and function of essential nutrients in the wound microenvironment. Immediate treatment with moist dressings has been found to reduce tissue loss, particularly in burn cases³. Research has demonstrated that wet or moist wound treatment promotes re-epithelialisation⁴ (fresh tissue growth) and diminished scar formation compared to dry environment treatment. Additionally, the inflammatory response is alleviated in the wet environment, thus reducing injury advancement⁵. Calcium alginate dressings have shown hemostatic properties. Hemostatic properties are found in agents that assist in blood flow regulation and promote blood clotting. Calcium alginates achieve this by discharging the calcium ions from the dressing into the wound. This stimulates prothrombin activation in the clotting cascade (a natural clotting process in the body). Similarly, the dense fibre arrangement in the dressing aids in the blood coagulation process⁶. Calcium alginate rope dressings are beneficial as a packing dressing for managing wound cavities and active bleeding. livingstone.com.au sales@livingstone.com.au 1300 883 733 4

5. References: Winter, R. (2022) Chronic wounds and their therapy with alginate-based dressings, Journal of personalized medicine. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503979/ 1 2 Ye, S. et al. (2023) Alginates from Brown Seaweeds as a promising natural ..., Alginates from Brown Seaweeds as a Promising Natural Source: A Review of Its Properties and Health Benefits. Available at: https://www.tandfonline.com/doi/full/10.1080/87559129.2023.2279583 3 Wathoni, N. et al. (2024) Alginate & Chitosan-based hydrogel antibacterial activity: IDR, Alginate and Chitosan-Based Hydrogel Enhance Antibacterial Agent Activity on Topical Application. Available at: https://www.dovepress.com/alginate-and-chitosan-based-hydrogel-enhance-antibacterial-agent-activ-peer- reviewed-fulltext-article- IDR#:~:text=Although%20not%20classified%20as%20an,drug%20delivery%20to%20infected%20wounds 4 Nuutila, K. and Eriksson, E. (2021) Moist wound healing with commonly available dressings, Advances in wound care. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568799/ 5 Junker, J.P.E. et al. (2013) Clinical impact upon wound healing and inflammation in moist, wet, and Dry Environments, Advances in Wound Care. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842869/#:~:text=Clinical%20Relevance-,Wet%20or%20moist%20treatm ent%20of%20wounds%20has%20been%20shown%20to,environment%2C%20thereby%20limiting%20injury%20progression 6 Agarwal, A. et al. (2011) Polymeric materials for chronic wound and burn dressings, Advanced Wound Repair Therapies. Available at: https://www.sciencedirect.com/science/article/abs/pii/B9781845697006500073 This white paper is intended for informational purposes only and should not be construed as medical advice or a substitute Contact Livingstone: 1300 LIV BUY (1300 548 289) Livingstone.com.au sales@livingstone.com.au for professional medical consultation. While the information presented is based on research and testing, individual results may vary. Always consult with a healthcare professional before using any cleaning or disinfectant product, especially if you have any underlying health conditions. The information contained herein does not constitute any guarantee or warranty, expressed or implied, regarding the product's efficacy or safety. Livingstone International assumes no liability for any damages arising from the use of the information provided in this white paper. Copyright Notice: All rights reserved. No part of this white paper may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of Livingstone International. 5