Questions & Answers
Q. What is Abilar Resin Salve?
A. Abilar Resin Salve is a modern CE Marked woundcare product, based on a traditional medication that has been used in treating wounds and burns in Finland for over 400 years. Resin, from the Norwegian Spruce Tree (Picea abies) is collected from trees in Northern Finland that have been damaged by events such as lightning strikes.
Q. What are the main properties of Abilar?
A. Abilar has been shown in scientific testing to be highly antimicrobial against common wound pathogens including MRSA and VRE. It is capable of deactivating and preventing the appearance of biofilms, exhibits anti-inflammatory properties and promotes re-epithelialisation of wounds.
Q. How is Resin different from colophony (rosin)?
A. The source material that produces colophony is not the same as that which produces Abilar.
Rosin (colophony) is manufactured from liquid sap resin which is heated in its production process. Heating of resin can denature some components of the product, producing tars etc. that can have deleterious effects on the skin.
By contrast, the resin used to create Abilar is not produced from the liquid sap resin which exudes from a wound in the tree but from hardened sap which is collected several weeks or months after it has been exuded from the tree wound. This means that some of the volatile elements of the resin have evaporated and some of the other components of the tree are added to it.
Abilar production involves no heating of the resin whatsoever so there is no potential to create allergens which are quite commonly seen in colophony use.
Q. How are the efficacy claims justified?
A. All these claims are supported by laboratory and published clinical trial data. See reference section.
Q. What common wound pathogens has Abilar been shown to be active against?
A. Abilar possess the wide-range antimicrobial properties against the common gram+ and gram- bacteria, as well as certain species of yeasts and fungi. Abilar is antibacterial e.g. against MRSA and VRE pathogens.
Q. Is the product "sterile"?
A. Abilar is not labelled as being "sterile" in that it has not undergone any external sterilisation process. However the product is self-preserving due to its antimicrobial activity and is suitable for reuse over a 12 month period.
Q. Is there bacterial resistance to Abilar?
A. No, there have not been any reports of bacterial resistance.
Q. Does Abilar work on Biofilm?
A. In vitro studies using a recognised method of assessing effectiveness of agents against biofilm have demonstrated that Abilar has the ability to both eradicate existing biofilm and prevent its regrowth.
Q. Is Abilar haemostatic?
A. Abilar is not haemostatic.
Q. Can Abilar be used on heavily exuding wounds?
A. Yes. Abilar can be used on heavily exuding wounds and is compatible with exudate absorbing dressings. The frequency of application may be high at the beginning of treatment, in line with the need to change dressings often but will reduce as the wound comes under control and exudate production reduces.
Q. Does Abilar have any action on the inflammatory stage of wound healing?
A. Yes. Abilar reduces bacterial load in the wound and reduces the expression of certain pro-inflammatory cytokines. In other words, due to its anti-inflammatory properties, it enhances the wound healing strongly in the inflammatory stage.
Q. Does Abilar reduce hypergranulation?
A. In addition to the antimicrobial and anti-inflammatory effects, Abilar strongly enhances the epithelialization. The effect on hypergranulation has not been studied so far.
Q. Can Abilar be used on children?
A. Children's wounds tend to heal without the need to resort to antimicrobial products. However in certain circumstances they are required and there is no contra-indication on the use of Abilar in children.
Q. Can Abilar be used on infants who are glucose intolerant?
A. Yes it can.
Q. Are there any age restrictions on the use of Abilar?
A. No. Abilar has been successfully used in children and in adults aged over 100 years.
Q. Can diabetics use Abilar?
A. Yes, diabetic patients can use Abilar to treat diabetic wounds.
Q. How is the resin cultivated?
A. When a tree is damaged it produces a sticky resin to plug the wound and protect the tree from infection. Over a period of 3 or more years this resin seals the tree wound. At this time the resin is harvested by hand.
Q. How is the resin cleaned?
A. To purify the resin it must be separated from dirt and bark chippings, collected with it in the harvesting process. This is done by a patented method at low temperature which prevents the production of potentially hazardous tars.
Q. What else is in the resin salve?
A. Abilar contains a mixture of 10% resin salve combined with a standard pharmaceutical ointment which has been designed to mimic the consistency of the traditional home-made product which was mixed with butter or lard. Tests have shown that the pharmaceutically prepared form of the product exhibits all the efficacy of the home-made version. For a full ingredient listing please refer to the pack.
Q. What is the preservative system?
A. As the resin within the salve exhibits both antibacterial and antifungal properties there is no need for a preservative system in Abilar. This means that the product has a 5 year shelf life when unopened and a 12 month "in use" shelf life. However, Abilar is intended for use on a single patient in line with infection control procedures
Q. Can Abilar be stored in the refrigerator?
A. Yes. Abilar can be stored in the refrigerator. However, it is not mandatory. Abilar should not be stored in the freezer or in temperatures over 40°C.
Q. Is Abilar poisonous if ingested?
A. No, Abilar is not poisonous even if ingested.
Q. What do I stop using when I start using Abilar?
A. The use of Abilar can enable clinicians to make significant savings on their wound care cost by:
- Replacing expensive silver and PHMB dressings with basic dressings and Abilar
- Reducing the use of honey dressings with basic dressings and Abilar
- Reducing the costs associated with enzyme alginogel dressings. Equivalent Abilar usage could save between 20 and 70% of the cost associated with this product.
For a more detailed explanation related to your own respective issues please contact us.
Where Can I Use Abilar
Q. What type of wounds can I use it on?
A. Abilar can be used as a primary dressing on many types of infected or uninfected wounds. The type of wound can range from pressure ulcers, diabetic foot wounds, ischaemic leg wounds, burns and surgical wounds that have failed to heal by primary intent.
Q. Can Abilar be used where a wart or mole has been removed?
A. Yes it can be used.
Q. Can Abilar be used on suture lines?
A. Yes. Cover and protect the suture line with a proper dressing after applying Abilar.
Q. Is there any benefit to using Abilar on suture lines?
A. Yes there is, Abilar prevents surgical wound infection and reduces scarring. Apply Abilar on the suture line and cover it with an appropriate dressing.
Q. Can Abilar be used on blisters associated with EB?
A. Yes. Abilar can be applied directly to the blisters / erupted blister or it can be put on the dressing and then applied via the dressing to the blisters / erupted blister. The dressing should be changed daily.
Q. Can Abilar be used on split skin grafts?
A. Yes it can.
Q. Can Abilar be used with hyperbaric treatments?
A. Yes it can.
Q. Can Abilar be used with cellulitis?
A. Yes it can. However, one has to take into account, that cellulitis is normally treated with antibiotics.
Q. Can Abilar be used on heel ulcers?
A. Yes it can. Apply Abilar on heel ulcer and cover it with a gauze or other appropriate dressing.
Q. Can Abilar be used as a treatment against thrush?
A. Abilar is effective against several species of fungi that are a causative for thrush e.g. Candida albicans.
How Do I Use Abilar
Q. Do I need to debride the wound first?
A. Yes. Basically, all normal wound care practices are valid when using Abilar i.e. "bed-side" or surgical debridement is recommended when needed. However, the need of debridement is always assessed by the physician or wound care nurse. All wounds need to be clean and dried prior to the application of Abilar. Any necrotic tissue needs to be removed as it will hamper the wound healing process.
Q. Can Abilar be used on wounds that have been rinsed with diluted vinegar?
A. Yes it can. Acetic acid (vinegar) and other acids used in rinsing liquids are compatible with Abilar.
Q. Can I use Abilar if the wound is not infected?
A. Yes. Clinical results have shown that even uninfected wounds resolve quicker when Abilar is applied.
Q. How do I use Abilar?
1. Clean and rinse the wound as you would normally do
2. Dab / let the wound dry carefully
3. Apply a thin layer of Abilar to the wound. If the surrounding skin is macerated, protect it with an appropriate product.
4. Cover with an appropriate dressing.
Q. Can Abilar be used on the wound margins?
A. In normal healthy wound margins there is no need to apply any additional barrier methods in order to protect the margins. However in frail, fragile skin where contact with wound exudate could damage the skin around the wound it is recommended that the margins be protected with a barrier cream such as Cavilon.
Q. Do I have to keep the wound dry after applying Abilar?
A. Yes, it is necessary to keep the wound dry. If you need to shower when the Abilar and dressing is in place, remove the dressing, shower the wound and reapply the Abilar and then re-dress the wound.
Q. What is the recommended amount to be applied?
A. This depends upon the nature of the wound, levels of exudate and frequency of dressing change. In a heavily exuding wound there may be a requirement to change the dressing every day. For non-infected or less exuding wounds this may be extended to every 2 or 3 days. There is currently no evidence to support usage on a once a week basis but this is not contra-indicated either.
Q. When should the dressing be changed?
A. The dressing is replaced depending on the amount of exudate, in line with your current practice. In the case of slightly exudating wounds, it generally means for every 3-4 days. In terms of high exudate wounds, dressings are usually changed for every 1-2 days.
Q. How much wound surface will a single tube of Abilar cover?
A. One of the published clinical studies measured the daily usage of Abilar during the course of the study. Using the recommended application directions the authors concluded that in their case a level of 0.4g of product was used per day. Extrapolating from their results it can be calculated that a 20g tube will cover a wound with a surface area of 200cm2 at the recommended application level. This is, of course an estimate as all wounds will differ.
Q. How often does the tube need replacing?
A. Again, this very much depends upon the number and size of wounds being treated and the frequency of dressing change. Once opened it is recommended that the tube can be re-used on the same patient for up to 12 months.
Q. Can Abilar be applied directly to a dressing rather than into the wound?
A. Yes. Abilar can be applied directly to the secondary dressing, if required.
Q. How do I use Abilar in fistulas and small deep cavities?
A. Impregnate appropriate dressing or ribbon gauze with Abilar by spreading the salve directly on the dressing. Fill the cavity with the dressing and protect the surface.
Q. How is Abilar cleaned from a wound?
A. Any residual Abilar can be easily washed from the wound by normal irrigation and cleaning methods. No additional agents or method changes are required.
Q. Is there a maximum length of time that Abilar can be used?
A. There is no theoretical limit to the time that Abilar can be used on a wound. Abilar has been used regularly for many months in frail and elderly patients with multiple illnesses. Many of the patients have achieved full resolution of their wounds with no reported side effects.
Q. Can Abilar be applied directly onto bone and/or tendon?
A. In the case that the wound extends to bone or tendon, consult your physician. If no additional treatment is required, Abilar can be applied on bone. If tendon is visible on the wound bed, an operative treatment is often required.
What About Dressing Choice
Q. What dressings are suitable for use with Abilar?
A. Abilar is compatible with the vast majority of secondary dressings. The only major incompatibilities are those dressings containing antimicrobial substances such as silver or PHMB as their antimicrobial action is redundant. Significant cost savings can therefore be achieved by using Abilar with the lowest cost secondary dressing which is fit for purpose for the particular wound concerned. This is in line with current NICE Woundcare Guidelines published in January 2015.
Q. Can I use foam dressings with Abilar?
A. Yes, foam dressings can be used.
Q. Can Abilar be used together with Acticoat?
A. When Abilar is used, no other dressing with other antimicrobial active ingredients i.e. silver, honey, PHMB or iodine etc. is needed.
Q. Can Abilar be used with agents such as Sorbact?
A. Yes. Abilar has been directly applied to Sorbact dressings which are designed to help reduce exudate. There have been no reports of interactions between Abilar and Sorbact.
What Should I Look Out For
Q. What side effects have been reported with Abilar?
A. Abilar has been in everyday use in over 100 hospitals in Finland since 2008 with over 350,000 tubes consumed during that time. Only one type of adverse reaction has been reported that can directly be attributed to Abilar, a contact allergy which diminishes upon discontinuation. In over 7 years the manufacturer has received less than 25 reports of such a reaction and the equivalent of the UK Yellow Card reporting system in Finland has only logged 2 events.
Q. Are there any known contra-indications to Abilar use?
A. Resins are in common use in a multitude of household products. Abilar should not be used on mucous membranes or in patients with a known allergy to spruce resin. Its safety in pregnancy and lactation has not been established.
Q. Can Abilar used during pregnancy?
A. It is not recommended so far. Data regarding the use of Abilar during pregnancy is not available.
Q. Can Abilar be used on the eyelids or in the eyes?
A. No, Abilar should not be used in or around the eyes.
Q. Abilar seems to have made the wound larger?
A. In the initial stage of treatment, this is perfectly normal. The reason is that the Abilar debrides the dead tissue around the wound that simulates wound growth.
Q. I've noticed an odour when using Abilar?
A. This is perfectly normal. Abilar contains natural resin compounds from a Norway Spruce tree that have specific odour.
Q. I've been using Abilar, but the wound seems very runny?
A. In the case of strong exudation, use absorbable dressing together with Abilar. If necessary consult your physician.
A Few Other Questions
Q. Is Abilar expensive?
A. No. A 20g tube of Abilar has an NHS price of £8.00. Given that the average wound will require 0.4g of Abilar per day then the daily cost will equate to 16 pence per treatment day.
Q. How do I obtain Abilar?
A. Initially Abilar will be available from certain wholesalers or direct from Espère Healthcare by telephoning 01462 346100. Once usage is established it is our intention to make it available through NHS Supplies.