AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

For Over-the-Counter Use, AQUACEL® Ag with Hydrofiber® Silver Impregnated Antimicrobial Dressing may be used for:

  • Abrasions
  • Lacerations
  • Minor cuts
  • Minor scalds and burns

Under the supervision of a healthcare professional, AQUACEL® Ag Hydrofiber Dressing may be used for the management of:

  • Wounds as an effective barrier to bacterial penetration of the dressing as this may help reduce infection
  • Partial thickness (second degree) burns
  • Diabetic foot ulcers, leg ulcers (venous stasis ulcers, arterial ulcers and leg ulcers of mixed etiology) and pressure ulcers/sores (partial & full thickness)
  • Surgical wounds left to heal by secondary intention such as dehisced surgical incisions
  • Surgical wounds that heal by primary intent such as dermatological and surgical incisions (e.g., orthopedic and vascular)
  • Traumatic wounds
  • Wounds that are prone to bleeding such as wounds that have been mechanically or surgically debrided and donor sites
  • Oncology wounds with exudate such as fungoides-cutaneous tumors, fungating carcinoma, cutaneous metastasis, Kaposi's sarcoma and angiosarcoma
  • Management of painful wounds
  • Infected Wounds

For Over-the-Counter Use, AQUACEL® Hydrofiber® Wound Dressing may be used for:

  • Abrasions
  • Lacerations
  • Minor cuts
  • Minor scalds and burns

Under the supervision of a healthcare professional, AQUACEL® Hydrofiber® Wound Dressing may be used for the management of:

  • Leg ulcers, pressure ulcers (Stage II-IV) and diabetic ulcers
  • Surgical wounds (post-operative, donor sites, dermatological)
  • Partial thickness (second degree) burns
  • Traumatic or surgical wounds left to heal by secondary intention such as dehisced surgical incisions
  • Surgical wounds that heal by primary intent, such as dermatological and surgical incisions (e.g., orthopedic and vascular)
  • Traumatic wounds
  • Local management of wounds that are prone to bleeding, such as wounds that have been mechanically or surgically debrided and donor sites
  • Management of painful wounds
Device Description

AQUACEL® Ag Hydrofiber® (Silver Impregnated Antimicrobial Dressing) is a soft, sterile, non-woven pad or ribbon dressing composed of sodium carboxymethylcellulose and 1.2% ionic silver which allows for a maximum of 12mg of silver for a 4 inch x 4 inch dressing. The silver in the dressing kills wound bacteria held in the dressing and provides an antimicrobial barrier to protect the wound bed. This dressing absorbs high amounts of wound fluid and bacteria and creates a soft, cohesive gel that intimately conforms to the wound surface, maintains a moist environment and aids in the removal of non-viable tissue from the wound (autolytic debridement). The moist wound healing environment and control of wound bacteria supports the body's healing process and helps reduce the risk of wound infection.

AQUACEL® Hydrofiber® Wound Dressings are soft, sterile, non-woven pad or ribbon dressings composed of hydrocolloid fibers (sodium carboxymethylcelulose) These conformable and highly absorbent dressings absorb wound fluids and create a soft sel which maintains a moist environment which supports the body's healing process.

AI/ML Overview

Based on the provided text, the document is a 510(k) Summary for the AQUACEL® Ag with Hydrofiber® Silver Impregnated Antimicrobial Dressing and AQUACEL® Hydrofiber® Wound Dressing. This type of regulatory submission demonstrates substantial equivalence to a legally marketed predicate device, rather than proving that the device meets specific acceptance criteria through a newly conducted study with detailed statistical analysis.

The document discusses clinical studies, but these are literature reviews of existing studies on the predicate device (AQUACEL® Hydrofiber® Wound Dressing) or similar Hydrofiber® technology, used to support the safety and effectiveness for new indications or the new device (AQUACEL® Ag). It does not present a new, dedicated study designed to explicitly meet pre-defined acceptance criteria for the current 510(k) submission in the way one might assess a high-tech diagnostic algorithm.

Therefore, many of the requested categories for a study proving device acceptance criteria cannot be directly answered from this regulatory summary. However, I can extract the relevant information that is present.

Here's a breakdown of what can be inferred or explicitly stated:

1. Table of Acceptance Criteria and Reported Device Performance

This document does not present explicit acceptance criteria or target device performance values in a table format for a specific new study to demonstrate device capabilities against defined metrics. Instead, it relies on the established safety and effectiveness of the predicate device and the literature.

The "performance" is reported in terms of clinical outcomes from existing studies, showing the benefits of Hydrofiber® dressings.

Performance Metric (Based on Literature Review)Reported Device Performance (AQUACEL® / AQUACEL® Ag)ComparatorStatistical Significance / Effect Size
Likelihood of no wound complications5.8 times more likely to result in no complicationsControl95% CI 2.8-12.5; p<0.00001
Dressing pain scoreStatistically lowerControlp<0.001
Dressing changes required43% of patients (AQUACEL® group)77% of patients (Control group)p=0.001
Reductions observedBlister formation, hematoma, edemaStandard dressingsNot quantified in text.
Other benefitsFewer dressing changes, less mechanical irritation/damage to woundConventional dressingsNot quantified in text.
Antimicrobial barrier (AQUACEL® Ag)Kills wound bacteria held in dressing, protects wound bed, reduces risk of infection.Not directly compared in this summary for Ag version, but inferred from silver impregnation.Qualitative statement.

2. Sample Size Used for the Test Set and Data Provenance

The "test set" here refers to the patient cohorts involved in the summarized clinical trials, which are part of a literature review rather than a new standalone validation study for this 510(k).

  • Study 1 (Ravenscroft et al.): 183 patients (85 patients randomized to AQUACEL® / Tegaderm™, 98 patients to control).
  • Study 2 (Abuzakuk et al.): 61 patients (30 patients allocated to AQUACEL® hydrofiber dressing group, 31 patients to control group).
  • Study 3 (Harle et al.): 100 hip replacement patients (50 patients randomized to AQUACEL® hydrofiber dressing, 50 patients to control).

Data Provenance: The studies are clinical trials, implying prospective data collection. The countries of origin are not explicitly stated, but the journal publications cited (Ann R Coll Surg Engl; Int Wound J; Journal of Orthopedic Nursing) suggest an international origin, likely including the UK (Ann R Coll Surg Engl), given the author names.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of those Experts

This question is not applicable in the context of wound care dressing clinical trials. "Ground truth" in this scenario would typically be established by clinical assessments made by healthcare professionals (e.g., surgeons, nurses) managing the patients in the trials, following established medical protocols for wound assessment and treatment. The document does not specify the number or qualifications of clinicians involved in making these assessments for the referenced studies.

4. Adjudication Method for the Test Set

The document describes the studies as "randomized controlled trials." This implies a systematic approach to patient assignment, but it does not specify any particular adjudication method (e.g., 2+1, 3+1) for evaluating outcomes. Outcomes were likely assessed by treating clinicians or independent researchers involved in the respective studies based on clinical measures (e.g., wound complications, pain scores, dressing change frequency).

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

This question is not applicable. The device is a wound dressing, not an AI-powered diagnostic or assistive technology for human readers. Therefore, an MRMC study or AI assistance is irrelevant to this submission.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) was done

This question is not applicable. The device is a physical wound dressing and does not involve an algorithm.

7. The Type of Ground Truth Used (expert consensus, pathology, outcomes data, etc.)

The ground truth or clinical endpoints for the summarized studies were based on outcomes data directly observed in patients, such as:

  • Wound complications (e.g., presence/absence of complications)
  • Patient-reported pain scores
  • Frequency of dressing changes
  • Observations of blister formation, hematoma, and edema

These are clinical outcomes directly measured or observed in patients during the course of their treatment.

8. The Sample Size for the Training Set

This question is not applicable. The device is a wound dressing, not a machine learning algorithm that requires a training set. The clinical data summarized are for demonstrating safety and effectiveness for regulatory clearance, not for training an AI model.

9. How the Ground Truth for the Training Set was Established

This question is not applicable, as there is no training set for a wound dressing.

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K080383 pag

Revised April 21, 2008

SECTION 5: 510(k) SUMMARY

MAY - 2 2008

AQUACEL® Ag with Hydrofiber® Silver Impregnated Antimicrobial Dressing

Applicant:

ConvaTec A Division of E. R. Squibb & Sons, LLC 200 Headquarters Park Drive Skillman, New Jersey 08558

Contact:

Marilyn Konickv Associate Director, US and International Regulatory Affairs 908-904-2541 fax: 908-904-2235 email: marilyn.konicky@bms.com

Device:

AQUACEL® Ag with Hydrofiber® Silver Impregnated Antimicrobial Dressing

Classification Name: Dressing, Wound, Drug

Device Class: Unclassified

Product Code: FRO

Substantially Equivalent Device:

AQUACEL® Hydrofiber® Wound Dressing K943258,K982116,K063271

AQUACEL® Ag Hydrofiber® (Silver Impregnated Antimicrobial Dressing) is a soft, sterile, non-woven pad or ribbon dressing composed of sodium carboxymethylcellulose and 1.2% ionic silver which allows for a maximum of 12mg of silver for a 4 inch x 4 inch dressing. The silver in the dressing kills wound bacteria held in the dressing and provides an antimicrobial barrier to protect the wound bed. This dressing absorbs high amounts of wound fluid and bacteria and creates a soft, cohesive gel that intimately conforms to the wound surface, maintains a moist environment and aids in the removal of non-viable tissue from the wound (autolytic debridement). The moist wound healing environment and control of wound bacteria supports the body's healing process and helps reduce the risk of wound infection.

AQUACEL® Ag dressing is indicated for the management of wounds and can be used over-the-counter for minor wounds such as abrasions and lacerations, minor cuts, and minor scalds and burns. Under the direction of a healthcare professional. AOUACEL® Ag dressing may be used for more serious wounds such as diabetic foot and leg ulcers, pressure ulcers (partial and full-thickness), surgical wounds or traumatic wounds left to

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K080383

page 2 of 6

Revised April 21, 2008

heal by secondary intent, and partial thickness burns (second degree), wounds that are prone to bleeding, oncology wounds and management of painful wounds.

AQUACEL® Ag Hydrofiber® Dressing is indicated for the management of infected wounds, as the silver in the dressing provides an antimicrobial barrier that, as a protocol of care, may be helpful in managing these wounds. In addition, the moist wound healing environment and control of wound bacteria provided by AQUACEL® Ag Dressings support the body's healing process and help reduce the risk of wound infection.

A majority of postoperative surgical incisions are sutured, stapled or glued and are covered with some form of dressing. This first dressing, frequently referred to as the primary dressing, acts to absorb drainage, maintain a clean environment and serve as a barrier against further trauma to the delicate incision surface. Careful selection of nonadherent, absorptive dressings that do not become incorporated within the incision serves greatly to reduce the potential of surgical incision injury, and reduce pain upon dressing change when the time comes for the initial dressing to be removed.

A careful and thorough review of the literature suggests that Hydrofiber® dressings have been used safely and effectively in clinical trials for the management of surgical incisions healing with primary intent. The capacity to absorb, conform and the relative ease of removal are important attributes of AQUACEL® Ag, which probably play an important role in healing by primary intent for surgical wounds. Hydrofiber® dressings absorb fluid directly into the body of the dressing, significantly increasing the volume of fluid that can be absorbed - a process called vertical wicking. This process removes excess exudate from the wound, prevents lateral wicking that can cause maceration of the wound edges, but still maintain a moist environment for wound healing. All the studies which have been reviewed suggest that, compared to standard dressings, using a Hydrofiber® dressing (AQUACEL®) leads to significantly less dressing changes.

In addition, reduction in blister formation, hematoma and edema and decreased pain were observed in some of the studies. It is important to note that a majority of the clinical trials were randomized controlled trials. More importantly, there were no undue safety concerns which were observed in the trials. Although the studies were predominantly in orthopedic surgery, utilization of Hydrofiber® dressings (AQUACEL®) in vascular surgery also has been discussed.

Based on the evidence provided, we propose that Hydrofiber® based products (AQUACEL® dressings and AQUACEL® Ag dressings) can be used safely and effectively as primary dressings on surgical incisions which heal by primary intent. A brief summary of some of the clinical information follows:

AQUACEL® hydrofiber dressing has been shown to be safe and effective as a primary dressing on surgical incisions which heal by primary intent. The studies consisted of randomized, controlled, clinical trials in hip, knee and arthroplasty surgeries comparing the use of AQUACEL® / Tegaderm™ to control treatment. AQUACEL® /Tegaderm™

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K080383

page 3 of 6

Revised April 21, 2008

was used as a primary dressing in hip and knee surgeries compared to control in 183 patients (85 patients were randomized to AQUACEL® / Tegaderm™ and 98 patients to control) and the results demonstrated that AQUACEL® / Tegaderm™ was 5.8 times more likely to result in a wound with no complications than control* (95% CI 2.8-12.5; p<0.00001). Dressing pain score was statistically lower for patients on AQUACEL® / Tegaderm™ dressing compared to control' (p<0.001). AQUACEL® was compared to control treatment when used as a primary dressing for orthopedic wounds left to heal by primary intention following lower limb arthroplasty. This study evaluated the wired of dressing changes post surgery in 61 patients (30 patients were allocated to the AQUACEL® hydrofiber dressing group and 31 patients to the control group). Dressing changes were required in (43%) patients in the AQUACEL® hydrofiber dressing recoun compared to (77%) patients in the control group (p=0.001)2. In addition, the use of AQUACEL® hydrofiber as a primary dressing was compared to conventional dressings in a randomized clinical trial in 100 hip replacement patients (50 patients were randomized to AQUACEL® hydrofiber dressing and 50 patients were randomized to control). In this study, dressing changes were fewer with the use of AQUACEL® hydrofiber dressing potentially limiting mechanical irritation and damage to the wound3. In conclusion, the studies demonstrate that AQUACEL® hydrofiber dressing is safe and effective as a primary dressing on surgical incisions which heal by primary intent. For more details regarding the studies, please see the following references:

References

    1. Ravenscroft MJ, Harker J, Buch KA. A Prospective randomized controlled trial comparing wound dressings used in hip and knee surgery: AQUACEL® and Tegaderm™ versus Cutiplast*. Ann R Coll Surg Engl 2006; 88: 18-22
    1. Abuzakuk T, Coward P, Sheneva Y, Kumar S, Skinner JA. The management of wounds following primary lower limb arthroplasty: a prospective randomized study comparing hydrofiber® and central pad dressing. Int Wound J 2006; 3; 133-137
    1. Harle S, Korhonen A, Jyrki A et al. A randomized clinical trial of two different wound dressing materials for hip replacement patients. Journal of Orthopedic Nursing (2005) 9, 205-210

Additional clinical information can be found in Section 20: Performance Testing-Clinical.

  • Cutiplast is a trademark of Smith & Nephew

Tegaderm™ is a trademark of 3M Company

AQUACEL® Hydrofiber® Wound Dressing and AQUACEL® Ag with Hydrofiber® Silver Impregnated Antimicrobial Dressing are registered trademarks of E.R. Squibb & Sons, L.L.C.

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K080383

page 4 of 6

Revised April 21, 2008

SECTION 5: 510(k) SUMMARY

AQUACEL® Hydrofiber® Wound Dressing

Applicant:

ConvaTec A Division of E. R. Squibb & Sons, LLC 200 Headquarters Park Drive Skillman, New Jersey 08558

Contact:

Marilyn Konicky Associate Director, US and International Regulatory Affairs 908-904-2541 fax: 908-904-2235 email: marilyn.konicky@bms.com

Device:

AQUACEL® Hydrofiber® Wound Dressing

Classification Name: Dressing, Wound, Hydrophilic

Device Class: Class I

Product Code: NAC

Substantially Equivalent Device:

AQUACEL® Hydrofiber® Wound Dressing K943258, K982116, K063271

AQUACEL® Hydrofiber® Wound Dressings are soft, sterile, non-woven pad or ribbon dressings composed of hydrocolloid fibers (sodium carboxymethylcelulose) These conformable and highly absorbent dressings absorb wound fluids and create a soft sel which maintains a moist environment which supports the body's healing process.

AQUACEL® dressing is indicated for the management of wounds and can be used overthe-counter for minor wounds such as abrasions, lacerations, minor cuts, and minor scalds and burns. Under the direction of a healthcare professional, AQUACEL® dressing may be used for more serious wounds such as leg ulcers, pressure ulcers (Stages III). diabetic ulcers, surgical wounds, donor sites, second degree burns, wounds that are prone to bleeding and the management of painful wounds.

The Hydrofiber® technology in AQUACEL® dressings aids in removing necrotic material from the wound without damaging newly formed tissue. AQUACEL® dressings are currently indicated for the management of post-operative surgical wounds and surgical or traumatic wounds that have been left to heal by secondary intention.

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K080383

page 5 of 6

Revised April 21. 2008

A majority of post-operative surgical incisions are sutured, stapled or glued and are covered with some form of dressing. This first dressing, frequently referred to as the primary dressing, acts to absorb drainage, maintain a clean environment and serve as a barrier against further trauma to the delicate incision surface. Careful selection of nonadherent, absorptive dressings that do not become incorporated within the incision serves greatly to reduce the potential of surgical incision injury, and reduce pain upon dressing change when the time comes for the initial dressing to be removed.

A careful and thorough review of the literature suggests that Hydrofiber® dressings have been used safely and effectively in clinical trials for the management of surgical incisions healing with primary intent. The capacity to absorb, conform and the relative ease of removal are important attributes of AQUACEL® which probably play an important role in healing by primary intent for surgical wounds. Hydrofiber® dressings absorb fluid directly into the body of the dressing, significantly increasing the volume of fluid that can be absorbed - a process called vertical wicking. This process removes excess exudate from the wound, prevents lateral wicking that can cause maceration of the wound edges, but still maintains a moist environment for wound healing. All the studies which have been reviewed suggest that, compared to standard dressings, using AQUACEL® leads to significantly less dressing changes.

In addition, reduction in blister formation, hematoma and edema and decreased pain were observed in some of the studies. It is important to note that a majority of the clinical trials were randomized controlled trials. More importantly, there were no undue safety concerns which were observed in the trials. Although the studies were predominantly in orthopedic surgery, utilization of AQUACEL® dressings in vascular surgery also has been discussed.

Based on the evidence provided, we propose that Hydrofiber® based products can be used safely and effectively as primary dressings on surgical incisions which heal by primary intent. A brief summary of some of the clinical information follows:

AQUACEL® hydrofiber dressing has been shown to be safe and effective as a primary dressing on surgical incisions which heal by primary intent. The studies consisted of randomized, controlled, clinical trials in hip, knee and arthroplasty surgeries comparing the use of AQUACEL® / Tegaderm™ to control treatment. AQUACEL® /Tegaderm™ was used as a primary dressing in hip and knee surgeries compared to control in 183 patients (85 patients were randomized to AQUACEL® / Tegaderm™ and 98 patients to control) and the results demonstrated that AQUACEL® / Tegaderm™ was 5.8 times more likely to result in a wound with no complications than control* (95% CI 2.8-12.5; p<0.00001). Dressing pain score was statistically lower for patients on AQUACEL® / Tegaderm™ dressing compared to control1 (p<0.001). AQUACEL® was compared to control treatment when used as a primary dressing for orthopedic wounds left to heal by primary intention following lower limb arthroplasty. This study evaluated the number of dressing changes post surgery in 61 patients (30 patients were allocated to the AQUACEL® hydrofiber dressing group and 31 patients to the control group). Dressing

{5}------------------------------------------------

K080383

page 6 of 6

Revised April 21, 2008

changes were required in (43%) patients in the AQUACEL® hydrofiber dressing group compared to (77%) patients in the control group (p=0.001)2. In addition, the use of AQUACEL® hydrofiber as a primary dressing was compared to conventional as oressings in a randomized clinical trial in 100 hip replacement patients (50 patients were randomized to AQUACEL® hydrofiber dressing and 50 patients were randomized to control). In this study, dressing changes were fewer with the use of AQUACEL® hydrofiber dressing potentially limiting mechanical irritation and damage to the wound 3. In conclusion, the studies demonstrate that AQUACEL® hydrofiber dressing is safe and effective as a primary dressing on surgical incisions which heal by primary intent. For more details regarding the studies, please see the following references.

References

    1. Ravenscroft MJ, Harker J, Buch KA. A Prospective randomized controlled trial comparing wound dressings used in hip and knee surgery: AQUACEL® and Tegaderm™ versus Cutiplast*. Ann R Coll Surg Engl 2006; 88: 18-22
    1. Abuzakuk T, Coward P, Sheneva Y, Kumar S, Skinner JA. The management of wounds following primary lower limb arthroplasty: a prospective randomized study comparing hydrofiber® and central pad dressing. Int Wound J 2006; 3; 133-137
    1. Harle S, Korhonen A, Jyrki A et al. A randomized clinical trial of two different wound dressing materials for hip replacement patients. Journal of Orthopedic Nursing (2005) 9, 205-210

Additional clinical information can be found in Section 20: Performance Testing-Clinical.

*Cutiplast is a trademark of Smith & Nephew

Tegaderm™ is a trademark of 3M Company

AQUACEL® Hydrofiber® Wound Dressing and AQUACEL® Ag with Hydrofiber® Silver Impregnated Antimicrobial Dressing are registered trademarks of E.R. Squibb & Sons, L.L.C.

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Image /page/6/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the perimeter. Inside the circle is a stylized symbol that resembles an abstract caduceus or a person embracing another, rendered in a thick, black line.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAY - 2 2008

Convatec. Division of ER Squibb & Sons, LLC % Ms. Marilyn Konicky Associate Director 200 Headquarters Park Drive Skillman, New Jersey 08558

Re: K080383

Trade/Device Name: AQUACEL® Ag with Hydrofiber® Silver Impregnated Antimicrobial Dressing AQUACEL® Hydrofiber® Wound Dressing Regulatory Class: Unclassified Product Code: FRO, NAC Dated: February 8, 2008 Received: February 12, 2008

Dear Ms. Konicky:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA), You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set

{7}------------------------------------------------

Page 2 - Ms. Marilyn Konicky

forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section 510/k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance. please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at (240) 276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at (240) 276-3464. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Mark M. Milliman

Mark N. Melkerson Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Page 1 of 2

SECTION 4: INDICATIONS FOR USE STATEMENT, CONTINUED

510(K) Number (if known): K080383

Device names: AQUACEL® Ag with Hydrofiber® Silver Impregnated Antimicrobial Dressing

For Over-the-Counter Use, AQUACEL® Hydrofiber® Wound Dressing may be used for:

  • Abrasions u
  • Lacerations -
  • Minor cuts -
  • Minor scalds and burns -

Indications for Use:

Under the supervision of a healthcare professional, AQUACEL® Ag Hydrofiber Dressing may be used for the management of:

  • Wounds as an effective barrier to bacterial penetration of the dressing as this may help reduce infection
  • Partial thickness (second degree) burns ،
  • Diabetic foot ulcers, leg ulcers (venous stasis ulcers, arterial ulcers and leg ulcers of mixed ၊ etiology) and pressure ulcers/sores (partial & full thickness)
  • Surgical wounds left to heal by secondary intention such as dehisced surgical incisions' i
  • Surgical wounds that heal by primary intent such as dermatological and surgical r incisions (e.g., orthopedic and vascular)
  • Traumatic wounds ເ
  • Wounds that are prone to bleeding such as wounds that have been mechanically or surgically i debrided and donor sites
  • Oncology wounds with exudate such as fungoides-cutaneous tumors, fungating carcinoma, cutaneous metastasis, Kaposi's sarcoma and angiosarcoma
  • Management of painful wounds
  • . Infected Wounds4

1 Clarified / New Indication, not previously included in this format under K013814 or K063271

Prescription UseXAND/OROver-the-Counter UseX
(Part 21 CFR 801 Subpart D)(21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED

Concurrence of CDRH (Division Sign-Off (ODE))

Division of General, Restorative, and Neurological Devices

510(k) NumberK090343
------------------------

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Page 2 of 2

Revised April 17, 2008

SECTION 4: INDICATIONS FOR USE STATEMENT

510(K) Number (if known): K080383

Device name: AQUACEL® Hydrofiber® Wound Dressing

For Over-the-Counter Use, AQUACEL® Hydrofiber® Wound Dressing may be used for:

  • Abrasions
  • Lacerations
  • Minor cuts
  • Minor scalds and burns

Indications for Use:

Under the supervision of a healthcare professional, AQUACEL® Hydrofiber® Wound Dressing may be used for the management of:

  • Leg ulcers, pressure ulcers (Stage II-IV) and diabetic ulcers
  • Surgical wounds (post-operative, donor sites, dermatological)
  • Partial thickness (second degree) burns
  • Traumatic or surgical wounds left to heal by secondary intention such as dehisced surgical incisions+

Surgical wounds that heal by primary intent, such as dermatological and surgical incisions (e.g., orthopedic and vascular)1

  • Traumatic wounds2
  • Local management of wounds that are prone to bleeding, such as wounds that have been mechanically or surgically debrided and donor sites
  • Management of painful wounds

1 Clarified / New Indication, not previously included in the format under K943258, K982116, or K063271

2 Indication re-positioned within Indications for Use statement

Prescription Use X AND/OR (Part 21 CFR 801 Subpart D)

Over-the-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED

Concurre ce of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off) Division of General, Restorative, and Neurological Devices

510(k) Number

N/A