WHY IS PRONTOSAN CALLED PRONTO-SAN?
Pronto = Fast/quickly. San (from sanare in Italian) = "to heal"
So "Prontosan" literally means: "To heal quickly"!
WHAT IS THE CLASSIFICATION STATUS OF PRONTOSAN®?
Prontosan® Wound Irrigation Solution, Prontosan® Wound Gel and Prontosan® Wound Gel X are Class III medical devices, based on EU Medical Device Directive 2007/47/EC (MDD). The Prontosan Debridement Pad is a Medical Device Class I Sterile product.
WHAT IS PRONTOSAN® MADE OF?
All Prontosan® products contain a betaine surfactant, polyhexanide (PHMB) and purified water. Additionally, Prontosan® Wound Gel X contains glycerol and hydroxyethylcellulose.
Betaine is a gentle effective surfactant (detergent) which is able to penetrate, disturb, clean and remove biofilm and wound debris, such as slough.
Polyhexanide (PHMB) is a highly effective broad spectrum antimicrobial that is active against gram negative and gram positive bacteria, fungi and yeast, including MRSA, Pseudomonas aeruginosa, VRE etc. PHMB has been in general use for about 60 years; it has demonstrated good clinical safety data with no evidence of resistance and minimal toxicity.
WHAT ARE THE ADVANTAGES OF PRONTOSAN®?
Prontosan® – The unique combination of Betaine and Polyhexanide work in combination;
- reduces healing time
- removes and prevents biofilm
- prevents infections
- prepares the wound bed
- loosens and cleanses slough and debris
WHICH TYPE OF WOUNDS CAN BE TREATED WITH PRONTOSAN®?
Prontosan® can be used for the treatment of acute wounds, chronic wounds and 1st and 2nd degree burns (Prontosan® Wound Gel X is also indicated for 3rd degree burns).
DOES PRONTOSAN® HELP WITH DESLOUGHING, AND IF SO HOW?
Yes. Betaine helps to remove wound coatings including slough and necrotic tissue by softening, loosening and subsequently detaching them.
HOW SHOULD YOU USE PRONTOSAN?
Prontosan® Irrigation Solution
- If no desloughing is required, irrigate the wound directly from the bottle
- For wounds with slough or visible debris – apply a gauze or compress for 0-10 minutes, depending on desired effect. For infected wounds a 10-15 minute soak is recommended initially.
- Prontosan Solution can be applied directly to encrusted dressings to assist in removal
Prontosan® Wound Gel and Prontosan® Wound Gel X
- Apply the Gel X after cleansing the wound with Prontosan® Wound Irrigation Solution.
- The Gel is a leave on product and will create a film on the wound bed. This ensures desloughing continues and bioflm build up is prevented.
- Leaving the Gel X on the wound provides a continuous coverage.
- The choice between Prontosan® Wound Gel X and Gel allows an optimal application in large surface area as well as tunnelling or cavity wounds.
- Apply an appropriate secondary dressing.
I HAVE BEEN TOLD OTHER PRODUCTS WORK QUICKER THAN PRONTOSAN, IS THIS CORRECT?
Prontosan has tested efficacy on multiple species of bacteria within 60 seconds1 this means Prontosan is suitable for irrigation in wounds where only planktonic bacteria is a concern.
For wounds suspected of containing biofilm, irrigation with Prontosan is shown to be more effective than other cleansers over 3 – 6 day periods2, however for maximum benefit in wounds where biofilm is a possibility, an enhanced contact time is recommended. The betaine within Prontosan provides the surfactant / cleansing effect for biofilm disruption and cleansing of slough and PHMB is present as an adjuvant ingredient.
WHICH PRONTOSAN PRODUCTS SHOULD I USE ON DIFFERENT WOUND TYPES?
Treatment strategies should be based on the cycle of biofilm, the use of the Prontosan range aim to disrupt and prevent reformation of biofilm for effective wound bed preparation.
- For acute wounds, consider irrigation with Prontosan Solution only
- For granulating chronic wounds, consider a 0-5 minute soak with Prontosan Solution to prevent biofilm and apply a thin layer of Prontosan Gel X
- For chronic wounds with light to moderate slough, consider a 5-10 minute soak with Prontosan Solution to provide a desloughing or softening effect, debride with Prontosan Debridement Pad and apply a thin layer of Prontosan Gel X
- For chronic wounds with local or spreading infection, consider a 10-15 minute soak with Prontosan Solution and apply a thin layer of Prontosan Gel X
After using Prontosan for wound bed preparation on any wounds, apply your dressing as per wound care formulary and local policy.
Download a copy of our Wound Bed Preparation Pathway
CAN PATIENTS USE PRONTOSAN THEMSELVES?
Yes, patients who can self-manage can apply a Prontosan soak. For example, a community patient who removes their dressings to shower prior to a nurse visit can pop a gauze soaked in Prontosan on their wound after their shower until the nurse arrives, this will aid in maintaining moisture in the wound and keeping the wound covered; the wound will receive enhanced biofilm and desloughing activity due to the longer contact time.
FOR HOW LONG CAN A WOUND BE TREATED WITH PRONTOSAN® ?
There is no limit set for the treatment duration with Prontosan® Wound Irrigation Solution. In clinical trials, the longest documented treatment duration was 6 months3. In fact, Prontosan® is especially designed for the long term treatment of hard-to-heal wounds. Prontosan Wound Gel and Wound Gel X should be cleansed off at every dressing change, continual contact should not exceed 30 days, most likely dressing changes occur more regularly than this and usually within 7 days.
HOW EXTENSIVE IS THE CLINICAL EXPERIENCE WITH PRONTOSAN® ?
Hundreds of thousands of patients are treated with Prontosan® in Europe, comparative literature covering chronic wounds includes over 1,700 patients treated with Prontosan and this grows every year, every year. The clinical evidence demonstrates that by routinely introducing a Prontosan regime as part of your patient pathway you will achieve a better result.
- Improved patient outcomes, including time to healing
- Helps to prevent complications and reduce infection
- Reduces spend on antimicrobials and antibiotics
- Reduces nursing time
You can find downloadable journal articles and case studies on our clinical evidence hub pages
WHAT IS THE SHELF LIFE OF PRONTOSAN® PRIOR TO OPENING?
Prontosan® Wound Irrigation Solution, Prontosan® Wound Gel and Prontosan® Wound Gel X have a shelf life of 3 years after manufacture – the expiry date is present on each product.
WHAT IS THE SHELF LIFE OF PRONTOSAN® AFTER FIRST OPENING?
8 weeks for the Prontosan® product range, the 40ml pods are single use as they cannot be recapped. Prontosan® does NOT need to be refrigerated to maintain this shelf life. It can be warmed up to body temperature before using for patient comfort.
CAN PRONTOSAN BE USED FOR SEVERAL WOUND TREATMENTS ON DIFFERENT PATIENTS?
No, Prontosan is single patient use.
HOW IS PRONTOSAN® PACKAGED?
Prontosan® Wound Irrigation Solution is produced using a blow, fill, seal process. In a single step, each container is blown into its given size and shape, filled with Prontosan® before being sealed completely.
The Prontosan® 350 ml and 1000 ml bottles feature a special safety protection. It is a spike, integrated into the inside of the cap. First, the cap has to be unscrewed, then the white collar ring must be removed prior to putting the cap back on and screwing it tight. This way, the spike pierces the bottle’s sealing and the product is ready for application.
To open the 40 ml Solution as well as the 30 ml Gel ampoules just turn the toggle closure. The Prontosan® Wound Gel X originality seal can be opened by utilizing the cap turned upside down.
ARE PRONTOSAN® CONTAINERS AND LABELS ENVIRONMENTALLY FRIENDLY?
Yes. Prontosan® containers and labels are PVC-free, DEHP-free as well as latex-free.
Prontosan in use
WHEN SHOULD YOU USE PRONTOSAN GEL AND WHEN SHOULD YOU USE PRONTOSAN GEL X?
For the application in deep or tunnelling wounds, wound cavities and difficult to access areas, cover the entire area with a 3 - 5 mm layer of Prontosan® Wound Gel and apply a secondary bandage.
On large surface area wounds apply a 3 - 4 mm thick layer of Prontosan® Wound Gel X and cover with a secondary bandage. Vary the product application depending on time until next dressing change and amount of desloughing required – sloughy wounds with longer times until dressing change will require a thicker layer of gel than e.g. a granulating wound with shorter periods between dressing change.
Application of the Gels will prevent biofilm reformation and provide a desloughing effect.
WHAT DRESSINGS CAN YOU USE ON TOP OF GEL X?
Virtually any dressing can be used on top of Gel X – Foams, Super absorbers, non-adherents, post-surgical dressings. Enzymes and ointments are not recommended to be used in conjunction with Prontosan products – please refer to the IFUs.
You can download instructions for use documents via the product pages here: > Learn More
If you are using an “active” dressing – for example a silver containing dressing – Gel X can still be used and may even enhance the effect of some dressings – but if you are not sure please check with your local B. Braun wound care representative.
DO I NEED TO USE A DRESSING WITH GEL X?
If a dressing is not suitable then Gel X can be applied to a wound with no dressing. Gel X will help to prevent the build-up of biofilm even on exposed wounds.
Examples include post-surgical wounds with no dressing or wounds in awkward areas where the dressings are unlikely to stay in place e.g. episiotomy wounds. A thin layer of Gel X applied 2-3 times a day is suitable. Residue can simply be rinsed off when showering /bathing each day.
IS PRONTOSAN® WOUND IRRIGATION COMPATIBLE WITH CALGITROL PASTE?
Yes, Prontosan® Irrigation Solution can be used prior to application of Calgitrol Paste.
IS PRONTOSAN® WOUND IRRIGATION COMPATIBLE WITH SILVER-DRESSINGS?
Yes, Prontosan® Irrigation Solution and Gel X can be used with silver dressings.
CAN PRONTOSAN® BE USED IN COMBINATION WITH AN ALGINATE DRESSING?
Prontosan® Solution may be used in combination with an alginate dressing as a wound cleansing agent to clean the wound. Alginates contain anionic ingredients which may deactivate the PHMB component of Prontosan, Prontosan Gel X can be used with this consideration in mind.
DO I NEED TO USE A DRESSING WITH GEL X?
If a dressing is not suitable then Gel X can be applied to a wound with no dressing. Gel X will help to prevent the build-up of biofilm even on exposed wounds.
Examples include post-surgical wounds with no dressing or wounds in awkward areas where the dressings are unlikely to stay in place e.g. episiotomy wounds. A thin layer of Gel X applied 2-3 times a day is suitable. Residue can simply be rinsed off when showering /bathing each day.
CAN PRONTOSAN GEL BE USED WITH HONEY OINTMENT DRESSINGS?
There is no problem to use Prontosan Solution for the debridement & cleansing of the wound prior to use a honey dressing.
USE OF PRONTOSAN (PHMB SOLUTIONS) ON HYALINE CARTILAGE
Due to insufficient evidence Prontosan is contraindicated in the presence of hyaline cartilage.
CAN PRONTOSAN® WOUND IRRIGATION BE USED FOR ORTHOPAEDIC SURGERIES?
Yes although care has to be taken in the case of partial joint replacement where intact hyaline cartilage is still present (which is a contraindication of use) if contact occurs, this should be rinsed with saline or Ringers solution immediately. For total joint replacements (hip and knees) the cartilage is completely removed and therefore the use of Prontosan® is possible. B. Braun also makes a product called LavaSurge which may be more appropriate for this situation.
CAN PRONTOSAN SOLUTION OR GEL/GEL X BE USED ON RADIOTHERAPY BURNS?
Yes, but please note they should be completely removed prior to radiotherapy commencing, as topical moisturisers and gels can create a “bolus effect” which artificially increases the radiation dose delivered to the epidermis.
It is important to instruct patients to gently clean and dry the skin in the radiation field before each radiation session.
IS THERE ANY SYSTEMIC ABSORPTION OF PRONTOSAN INTO THE BODY?
PHMB is not absorbed by human cells and tissue, therefore is cannot interfere with the metabolism of the body.
Technical questions
WHAT IS THE STORAGE TEMPERATURE FOR PRONTOSAN® WOUND IRRIGATION SOLUTION AND WOUND GEL/GELX?
+5° to +30° Celsius
WHAT IS THE DENSITY OF PRONTOSAN® WOUND GEL/GELX?
Density of Prontosan Wound Gel X: 1.04 g/cm3 Density of Prontosan Wound Gel: 1.02 g/cm3
WHAT IS THE VISCOSITY OF PRONTOSAN?
Prontosan Solution: 0.5 – 5 mPa*s
Prontosan Wound Gel: 1800 – 5000 mPa*s
WHERE IS IT PRODUCED AND WHO IS THE RESPONSIBLE MANUFACTURER?
For all Prontosan Range B. Braun Medical AG, Switzerland is the responsible manufacturer. For UK representative support please click the button below.
If you have any other questions please send us a message
Contact us now
Wound Care Blog
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Prontosan® Debridement Pad | Before and After
The Prontosan® Debridement Pad is intended to support the soft mechanical debridement of chronic wounds in combination with Prontosan® Wound Irrigation Solution.
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Award Winners! Integrating a Wound Cleansing Pathway into standard care.
The Doncaster Skin Integrity Team recently received a Bronze JWC award in the Infection and Biofilm category for their work on their local Wound Cleansing Pathway.
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The role of Prontosan® in a pathway for biofilm based wound care
Anita Kilroy-Findley, Clinical Lead Tissue Viability, Leicestershire Partnership NHS Trust, shares her experience of using the Prontosan in a pathway for biofilm based wound care.
References
1. López-Rojas R, Fernández-Cuenca F, Serrano-Rocha L, Pascual Á. In vitro activity of a polyhexanide-betaine solution against high-risk clones of multidrug-resistant nosocomial pathogens. Enferm Infecc Microbiol Clin. 2017 Jan;35(1):12-19. doi: 10.1016/j.eimc.2016.02.008. Epub 2016 Mar 19. PMID: 27004429.
2. Davis, SC, Harding, A, Gil Rodriguez, J, Parajon, F, Valdes, J, Solis, M & Higa, A 2017, 'Effectiveness of a polyhexanide irrigation solution on methicillin-resistant Staphylococcus aureus biofilms in a porcine wound model', International Wound Journal. https://doi.org/10.1111/iwj.12734
3. Andriessen AE, Eberlein T. Assessment of a wound cleansing solution in the treatment of problem wounds. Wounds 2008; 20(6):171–175