Cobertura de hidrofibra com carboximetilcelulose (Aquacel Ag®) em pacientes queimados: Um relato de caso / Hydrofiber dressing with carboxymethylcellulose (Aquacel Ag®) in burn patients: A case report / Curativo de hidrofibra con carboximetilcelulosa (Aquacel Ag®) en pacientes quemados: Un relato de caso

Introdução: O tratamento de queimaduras sempre foi um grande desafio devido aos diferentes níveis de gravidade das lesões. Neste contexto, coberturas modernas a base de prata estão sendo cada vez mais utilizadas nesses pacientes. Relato de Caso: Descrever os benefícios do curativo Aquacel Ag® em lesões por queimadura de 2º grau profundo e 3º grau em paciente atendida na Unidade de Tratamento de Queimados em um hospital de referência em queimaduras e trauma. A paciente teve várias perdas de enxertia devido a quadros infecciosos, sendo a infecção uma das principais variáveis que atrasam a enxertia cutânea. Quando foi introduzido o Aquacel Ag® no tratamento, observou-se melhora da área a ser enxertada. O Aquacel Ag® em queimaduras parciais garantiu menor tempo de cicatrização, melhor resposta à dor, custo e efetividade em relação a outras coberturas, tempo de trabalho de enfermagem, maior conforto na hora da troca de curativo. Considerações Finais: O Aquacel Ag® mostrou-se uma boa escolha de cobertura para queimaduras de espessura parcial, um grande aliado para preparo de lesões de 3º grau para enxertia, além de promover outros benefícios ao paciente.

Introduction: The treatment of burns has always been a great challenge due to the different severity levels of the lesions. Taking this into consideration, modern silver-based wound dressings has been increasingly used in these patients. Case Report: To describe the benefits of the Aquacel Ag® dressing in burn lesions of 2nd and 3rd grade in patients treated at the Burn Treatment Unit in a reference hospital in burns and trauma. The patient had several grafting losses due to infectious conditions, with infection being one of the main variables that delay skin grafting. When Aquacel Ag® was introduced in the treatment, improvement of the area to be grafted was observed. The Aquacel Ag® in partial burns, guaranted a shorter healing time, better response to pain, cost and effectiveness in relation to other coverages, nursing work time, and greater comfort at the time of dressing change. Final Considerations: Aquacel Ag® has been shown to be a good choice of coverage for partial thickness burns, a great ally for the preparation of 3rd degree lesions for grafting, in addition to promoting other benefits to the patient.

Introducción: El tratamiento de quemaduras siempre ha sido un gran desafío debido a los diferentes niveles de gravedad de las lesiones. En este contexto, las cubiertas modernas a base de plata se están utilizando cada vez más en estos pacientes. Relato de Caso: Describir los beneficios del curativo Aquacel Ag® en lesiones por quemadura de 2º grado profundo y 3º grado en paciente atendida en la Unidad de Tratamiento de Quemados en un hospital referencia en quemaduras y trauma. La paciente tuvo varias pérdidas de injerto debido a cuadros infecciosos, siendo la infección una de las principales variables que retrasan la injerto cutáneo. Cuando se introdujo el Aquacel Ag® en el tratamiento, se observó una mejora del área a ser injertada. El Aquacel Ag® en quemaduras parciales garantizó un menor tiempo de cicatrización, mejor respuesta al dolor, costo y efectividad en relación a otras coberturas, tiempo de trabajo de enfermería, mayor confort a la hora del cambio de curativo. Consideraciones finales: Aquacel Ag® se mostró una buena elección de cobertura para quemaduras de espesor parcial, un gran aliado para la preparación de lesiones de 3º grado para injerto, además de promover otros beneficios al paciente.

Winter's concept of moist wound healing: a review of the evidence and impact on clinical practice.

Winter's concept of moist wound healing has had a major influence on wound care practice. This paper reviews the literature and demonstrates that the underlying wound healing process is complex and still not fully understood.

Hydropolymer dressings in the management of wound exudate.

In the UK the so-called 'foam' dressings are currently the most widely used absorbent dressings. They can, in certain cases, be particularly useful for the management of exuding wounds. One type of foam dressing--the Tielle hydropolymer adhesive dressing family (by Johnson & Johnson Wound Management)--is a range of five types of hydropolymer dressings: Tielle Original dressing, Tielle Lite dressing. Tielle Plus dressing, Tielle Borderless dressing and Tielle Packing dressing. The Tielle range shares a common basic composition that gives each dressing bacterial barrier properties and the capability of managing exudate by the combined process of absorption and moisture vapour transmission. Each type except Packing can be used as either a primary or as a secondary dressing. The choice should be based on the characteristics of the primary dressing, if any, on the degree of exudate that the wound is producing and on the condition of the surrounding skin. This article aims to give an overview of the Tielle range and a review of research-based clinical and scientific evidence to support the management of differing levels of exuding wounds in everyday clinical practice.

TIELLE Plus fluid handling capacity can lead to cost savings.

The cost of care plays an increasing role in treatment decisions. As the costs of wound care are largely driven by the costs associated with nurse visits to change patients' dressings, attempts to reduce the number of dressings used and thus the frequency of nurse visits should be welcomed. The acquisition cost of the dressing alone is a poor indicator of the total cost of care. Other factors--especially factors influencing the frequency of nurse visits, such as wear time--need to be considered when making treatment and formulary decisions. This paper assesses the theoretical wear time of a number of dressings based on laboratory data on their fluid-handling capacities. The monthly treatment cost associated with each dressing is based on the theoretical wear time. The results suggest that the superior fluid-handling capacity of TIELLE Plus hydropolymer adhesive dressing can reduce the costs associated with wound care.

TIELLE* hydropolymer dressings: wound responsive technology.

Wound healing may be compromised by many different factors. Certain underlying illnesses, for example diabetes and malignancy, and wound-specific factors such as critical colonization, infection and protease imbalance can all delay or impair healing. Moist wound healing is now generally accepted in clinical practice to facilitate optimum healing under the correct conditions of wound moisture. Johnson & Johnson Wound Management have provided a solution for the clinician by developing TIELLE* hydropolymer dressings, which provide wound-responsive technology for patient care. This unique mode of action achieves positive outcomes for the patient and clinician in terms of cost-effectiveness, patient compliance, healing rates and reduced rates of undesirable adverse effects such as allergic skin reactions, wound pain and maceration.

Clinical and scientific data of a hydropolymer range of dressings.

The Tielle trade mark family (Johnson and Johnson Medical) is a range of hydropolymer foam dressings that come in a variety of shapes and sizes, and are designed to fit the different types and locations of wounds that occur in practice. There are three types: Tielle, Tielle Lite and Tielle Plus. Each can be based on the characteristics of the primary dressing, if any, and on the degree of exudate that the wound is producing. This article aims to give an overview of the range and a summary of research-based clinical and scientific evidence to support clinical practice.

The Tielle family of dressings: overview of the product range.

The Tielle family (Johnson & Johnson Medical) is a range of dressings that come in a variety of shapes and sizes, designed to fit the different types and locations of wounds that occur in practice. There are three types--Tielle, Tielle Lite and Tielle Plus--and the choice of dressing should be based on the degree of exudate that the wound is producing. This product focus aims to give an overview of the range and provides research-based evidence for application in clinical practice.

Wound care: Askina Transorbent and Askina Biofilm Transparent.

Selecting the correct dressing for a wound can be complicated as there are so many products from which to choose. The selection process is made easier once the healthcare professional has performed a holistic assessment. This article discusses some of the principles of wound management and the efficacy of Askina Transorbent and Askina Biofilm, two new products from B/Braun. Both of these maintain the moist environment required for optimum wound healing to take place.

Intrasite Gel and Intrasite Conformable: the hydrogel range.

Wound management can be a confusing area of nursing practice. Even when an holistic patient assessment has been undertaken healthcare professionals frequently ask for guidance when faced with choosing the most appropriate wound management product. This article reviews two hydrogels from Smith & Nephew Healthcare--Intrasite Gel and Intrasite Conformable, which is the latest addition to the hydrogel range.

Alginates and hydrofibre dressings.

Alginates are versatile dressings able to support moist wound healing. They can absorb large amounts of wound exudate. Although similar to alginates, hydrofibre dressings are hydrocolloids.

The effect of hydrogel dressings on maggot development.

The effect of six different hydrogels on the development of sterile larvae (Lucilia sericata) was examined in a laboratory study. Five of the products had a marked adverse effect on maggot survival but one appeared to facilitate growth of the larvae when compared to control values. These results are consistent with clinical observations that larvae may not survive well in wounds containing residues of some hydrogel dressings.

Hydrogels and hydrocolloids: an objective product comparison.

It is difficult for providers to make selections from the vast array of currently available wound care products. There has been a paucity of objective data generated by a non-biased source comparing one product to another. In order for our Wound Care Team to recommend products for system-wide formulary purchase and patient use, we needed to develop a process for product comparison. A strategy for objective evaluation of hydrocolloid and amorphous hydrogel products was created, and these products were assessed clinically by experienced wound care providers. Laboratory testing included measurement of each product's ability to absorb water versus normal saline versus actual patient wound fluid. There were major differences in various products' abilities to absorb the fluids. These objective data from the laboratory, along with the subjective comparison of clinical performance, allowed our Wound Care Team to objectively rank the hydrocolloids and hydrogels and include those preferred products in our Wound Care Product Formulary.

An overview of moist wound dressings: the under cover story.

The variety of wound dressings available is growing as more is learned about wound healing. The major types of moist dressings are discussed with descriptions of their uses, advantages, and disadvantages.