Adaptation of the stomatherapy service during the COVID-19 pandemic: an experience report.

OBJECTIVE: To report the experience of adapting the stomatherapy service during the COVID-19 pandemic. METHOD: Experience report related to adaptations in the work routine in times of COVID-19 pandemic, from March to May 2020, in a specialized stomatherapy center in a city in the South of Brazil. RESULTS: The work routines were adapted to suit the protection measures for workers and users who used stomatherapy services. Some assistance processes were implemented to make users' access to care more flexible, and to modify routines to increase the safety of health professionals and users. CONCLUSION: The need to adapt the physical area, rethink the dynamics of care, use personal protective equipment, and guidance for servers and patients were of fundamental importance to continue attending the population safely in times of pandemic.

Implementing a Locally Made Low-Cost Intervention for Wound and Lymphedema Care in Western Kenya.

In Western Kenya, the burden of chronic wounds and lymphedema has a significant impact on functionality and quality of life. Major barriers to provision of care include availability, affordability, and accessibility of bandages. At the Academic Model Providing Access to Healthcare, dermatologists and pharmacists collaborated to develop a 2-component compression bandage modeled after the Unna boot, using locally available materials, that is distributed through a revolving fund pharmacy network. In partnership with nursing, use of these bandages at a national referral hospital and a few county facilities has increased, but increasing utilization to an expanded catchment area is needed.

Curativos em queimaduras: Revisão da prática brasileira / Burns dressing: Review of Brazilian practice

OBJETIVO: Identificar quais os curativos e coberturas mais utilizados no tratamento de feridas por queimaduras no Brasil. MÉTODO: Trata-se de uma revisão narrativa, com artigos publicados no período de 2011 a 2020. A busca foi realizada na Biblioteca Virtual em Saúde a partir dos descritores: curativo, cobertura, queimadura e enfermagem, no mês de maio de 2021. RESULTADOS: Foram selecionados oito estudos para análise e, a partir da leitura desses artigos, as coberturas citadas foram: sulfadiazina de prata, ácido hialurônico e película de biocelulose, assim como gaze não aderente, hidrogel e hidrofibra de carboximetilcelulose sódica. CONSIDERAÇÕES FINAIS: Conhecer as coberturas utilizadas no tratamento de queimadura permite melhor e mais rápido resultado para o paciente, diminui os custos da instituição e favorece a equipe assistencial, que não sofre desgaste emocional, pois observa resultados positivos no tratamento das lesões.

OBJECTIVE: To identify which dressings are most used in the treatment of burn wounds in Brazil. METHODS: This is a narrative review, with articles published from 2011 to 2020. The search was carried out in the Virtual Health Library using the descriptors: dressing, coverage, burns, and nursing, in May 2021. RESULTS: Eight studies were selected for analysis, and from the reading of these articles, the coatings cited were: silver sulfadiazine, hyaluronic acid, and biocellulose film, as well as non-adherent gauze, hydrogel, and sodium carboxymethylcellulose hydrofiber. FINAL CONSIDERATIONS: Knowing the dressings used in the treatment of burns allows for better and faster results for the patient, reduces the institution's costs, and favors the care team, which does not suffer emotional distress, as it observes positive results in the treatment of injuries.

O uso de alta frequência como recurso para cicatrização de queimaduras: Um estudo de caso / The use of high frequency as a resource for burn healing: A case study

OBJETIVO: Avaliar a eficácia da alta frequência na cicatrização de feridas por queimadura durante internação hospitalar. MÉTODO: Trata-se de um estudo de caso, realizado com uma voluntária do sexo feminino, 19 anos, em um hospital de pronto-socorro. Foram aplicados a alta frequência e curativos convencionais, com a amostra única sendo dividida em área de intervenção e área controle. Foram avaliados dados clínicos e sociodemográficos, registros fotográficos pré e pós as intervenções, dimensão da área da ferida por meio de planimetria digitalizada, aspecto da cicatriz através da Escala Vancouver e a qualidade de vida por meio do questionário Burn Specific Health Scale. RESULTADOS: A área da ferida teve redução de 54% na área de intervenção e 26% na área controle. Aspectos como vascularização e flexibilidade também apresentaram discreta melhora. O questionário de qualidade de vida reduziu dois pontos, relacionados à melhora da sensibilidade da pele e aos cuidados com a queimadura. CONCLUSÃO: A utilização de alta frequência combinada com uso de curativos durante a internação hospitalar mostrou resultados favoráveis em comparação a apenas o uso de curativos na cicatrização de feridas. Contudo, mais estudos são necessários.

OBJECTIVE: To evaluate the effectiveness of the high frequency in the healing of burn wounds during hospitalization. METHODS: This is a case study, conducted with a 19-year-old female volunteer, in an emergency room. The high frequency and conventional dressings were applied, with the single sample being divided into the intervention area and the control area. Clinical and sociodemographic data, photographic records before and after the interventions, dimension of the wound area through digitalized planimetry, the aspect of the scar through the Vancouver Scale and quality of life through the Burn Specific Health Scale questionnaire were evaluated. RESULTS: The wound area decreased 54% in the intervention area and 26% in the control area. Aspects such as vascularity and flexibility also showed a slight improvement. The quality of life questionnaire reduced two points, related to the improvement of skin sensitivity and care for burns. CONCLUSION: The use of the high frequency combined with the use of dressings during hospitalization showed favorable results compared to only the use of dressings in wound healing. However, more studies are needed.

Chronic wounds dressing.

Essential facts A chronic wound is usually defined as any wound that has not healed for six weeks or more. In the UK, about 200,000 people are experiencing a chronic wound at any one time, with an estimated annual cost to the NHS of around £4 billion. According to the National Institute for Health and Care Excellence (NICE) the selection of dressings is hindered by the relative lack of clinical evidence, while the prescription of advanced dressing, such as hydrocolloids, alginates, hydrofibre and antimicrobial dressings, for chronic wounds account for about £110 million a year in primary care in England.

Does the postoperative dressing regime affect wound healing after hip or knee arthroplasty?

OBJECTIVE: The aim of this literature review is to enable practitioners to make informed decisions about how to manage patients with hip or knee arthroplasty wounds. METHOD: A systematic critique of the evidence in relation to how the postoperative dressing regime may affect wound healing after hip or knee arthroplasty, was undertaken. RESULTS: No single treatment emerged as the ideal postoperative dressing regime for hip and knee arthroplasty wounds. CONCLUSION: A selection of dressings is recommended for hip and knee arthroplasty wounds, on the basis of reducing the incidence of postoperative blistering and wound infection.

Key principles involved in applying and removing wound dressings.

This article aims to help practitioners consider a variety of wound dressings and develop their knowledge about the use of dressings to ensure patients are protected and care is cost-effective. The article focuses on which dressing should be used depending on wound type and how different dressings should be applied and removed. Author

Exudate, infection and patient quality of life.

Efficient and cost-effective management of excessive wound exudate continues to present unique challenges to nurses. Accurate patient and wound assessment is essential to inform the treatment and selection of suitable dressings. The wide range of modern wound management products should be sufficient to meet the needs of every wound type at all phases of healing, and as circumstances change. However, there are still situations in which nurses are having to change dressings a number of times in 24 hours to prevent maceration (i.e. the softening and whitening of skin that is kept constantly wet), soiling, and the potential for cross-infection. There is no easy solution to the problem, but as nurses become more knowledgeable about identifying and managing the causes of excessive exudate, the available management options, and, as dressing materials become more sophisticated, practice should improve in this area.

Barrier dressings in surgical site infection prevention strategies.

Healthcare-associated infections (HCAIs) are a matter of priority for the NHS. They are associated with significant morbidity, and frequently lead to increased length of hospital stay, pain and discomfort for the patient, and in some cases even permanent disability. It is estimated that surgical site infections (SSIs) constitute around 14% of all HCAIs. Any break in the skin affords a portal of entry for microbial pathogens, and hence places the patient at an increased risk of infection. To address the issue, a multi-factorial strategy for the prevention of SSIs is essential, with postoperative dressings playing a key part alongside universal precautions such as hand hygiene and aseptic technique. The available guidance specifies the need for a postoperative dressing which provides an effective physical barrier and a moist environment for optimal wound healing. Vapour-permeable barrier dressings appear to be effective in meeting both of these criteria and also offer additional advantages both to patients and practitioners, such as patient comfort and the ability to stay in place whilst the patient showers. However, regular wound assessment must be carried out to ensure the vapour-permeable postoperative dressing is the right choice for a specific patient at a given time.

Ward nurses' use of wound dressings before and after a bespoke education programme.

A survey of ward nurses in medical, surgical, orthopaedic and rehabilitation specialties in relation to their care of wounds and their choice and use of wound dressings was carried out in May and August 2009 at St Mary's Hospital. Isle of Wight, UK. The objectives were to find out the distribution of wound types, and their characteristics, that were treated by ward nurses in the hospital, and to assess clinical practice in the use of wound dressings, before and after a bespoke programme of education and training. A visual framework to aid the ward nurses in the choice of dressings and frequency of change was introduced after the May 2009 survey. Following the nurses' education and training programme a repeat survey, using the same methodology, was conducted in August 2009. In the initial survey, 172 wounds were included (mean number of wounds per patient 1.64) and in the repeat one, 159 (mean number of wounds per patient 1.54). In both phases of the survey, the most common wound type was pressure ulcers, followed by surgical wounds; over 60% of the wounds were pressure ulcers, of which around half were category 1, and one-third were category 2. No category 4 ulcers were recorded. About one-third of the wounds had a duration of more than 21 days. On average, wound dressings were left in place for between two and three days, with 35% of dressings being changed on a daily basis. The mean cost of dressings per wound per week was observed to be lower in the repeat survey than in the initial one (£9.02 and £11.23 respectively). The number of undesirable reasons for changing the dressing was lower in the second phase than the first. The methodology of the surveys provided meaningful and valuable results over a short timescale, and increased understanding of wound types, their characteristics, and clinical practice. The surveys showed that data that can be collected in a short period using a simple tool can yield complex and revealing data trends. They also showed that an education programme followed by a re-survey can improve practice and reduce the costs of wound care.

Vascular access devices: securement and dressings.

Many patients admitted to hospital will require a vascular access device (VAD). Insertion of VADs is often viewed as a routine procedure, with little attention given to the importance of appropriate securement and dressing and how these factors can affect patient outcomes. This article discusses the types of VAD available and the rationale for VAD securement and appropriate dressings to minimise complications.

[Treating wounds in pediatrics, new practices]. / Traitements des plaies en pédiatrie, nouvelles pratiques.

The treatment of wounds has been the subject of a number of research works and a wide range of dressings is now available. However, few studies have been carried out into their application in and suitability for paediatrics. Protocols have however been put in place, as an extension to their use with adults, to meet the specific needs of this section of the population.

Managing wound exudate and promoting healing.

Exudate is a product of the normal wound healing process. It is usually clear or amber coloured but variations in the colour, consistency, odour and amount can indicate disruption to the normal healing process. Certain types of chronic wound commonly seen in the community can be associated with the production of excessive exudate. Copious exudate can be distressing for patients and expensive for community health-care providers. Effective management depends on the accurate diagnosis and treatment of the underlying condition and skill in selecting the most appropriate dressing regime.

Atualização no tratamento local das queimaduras / Updating in the local treatment of the burns

Nesse artigo, os autores discutem condutas recentes no tratamento local das queimaduras, curativos locais e tratamento cirúrgico.

In this article, the authors discuss recent conduct in the local treatment of burns, local dressings and surgical treatment.