Evaluation of a superabsorbent wound dressing, patient and clinician perspective: a case series.

OBJECTIVE: The primary objective of this study was to evaluate the fluid management capabilities of a superabsorbent wound dressing (Zetuvit Plus Silicone), with secondary objectives related to parameters that support whether the dressing enables undisturbed healing. METHOD: This study was an open labelled non-comparative study. Patients included in the study were selected by the clinical investigator(s) according to whether the patient required a dressing for the management of moderately to highly exuding wounds. RESULTS: A total of 50 patients were included in the study. Results related to the primary objective demonstrated that the superabsorbent wound dressing was able to absorb all levels of exudate across the range (low to high). At each assessment time point these results show that in 98% of assessments the superabsorbent dressing was rated as 'very good' (91%) or 'good' (7%) at exudate management. Secondary objectives relating to wound bed preparation, healing and management of pain were also positive. Additionally, at the end of each patient treatment, the dressing's fluid management capabilities were rated overall as 'excellent' (100% of cases). There was little pain associated with the wound or at dressing change throughout the study and its flexibility/conformability allowed for comfort and patient satisfaction aligned with increased quality of life. Additionally, inclusion of a silicone adhesive layer allowed painless and atraumatic removal of the dressing, increasing patient comfort, both during wear and at dressing removal, and supported the description of enabling undisturbed wound healing. CONCLUSION: The superabsorbent wound dressing achieved the primary objective relating to wound exudate management in all the assessments undertaken in this study. In addition, the silicone interface allowed for undisturbed healing as evidenced by little or no adherence of the dressing to underlying tissue, preventing damage to periwound skin. Overall, the superabsorbent wound dressing with the addition of the silicone interface could offer advantages over other superabsorbent polymer dressings (that might adhere to the wound surface) or silicone wound dressings (that might not have the absorbent properties of this type of dressing).

An observational study of a superabsorbent polymer dressing evaluated by clinicians and patients.

OBJECTIVE: This open, non-comparative, multi-centre investigation examines the use of a new superabsorbent polymer (SAP) wound dressing used for exudate management (in medium-to-high exuding wounds) in a patient population with a variety of wound types. The primary objective of this study was to evaluate the fluid management capabilities of the dressing. METHOD: Both acute and chronic wounds with moderate-to-high exudate production levels were assessed (over a period of two weeks) as requiring exudate management, with a SAP dressing, Zetuvit Plus (designated Resposorb Super in Europe), as part of their normal treatment regimen. Clinicians recorded a subjective assessment of exudate management and its impact on periwound skin conditions. In addition, wound bed preparation, healing trajectory and pain level reduction were monitored to give an insight into the clinical implications of using this dressing. Data was also collected from clinicians and patients on clinical performance of the dressing. RESULTS: The SAP dressing achieved ratings of 'very good'/'good' (83% and 13%, respectively) in relation to its wound exudate handling properties. The dressing supported improved wound healing, reduced damage to and enhanced the status of the periwound skin. Pain levels were reduced and, as a consequence, patient reported outcomes were improved. Patients commented that the exudate handling capabilities of the dressing, its conformability and comfort allowed them to resume a semblance of normality in their life. All participating clinicians indicated that they would continue to use the SAP dressing. A sub-population cost analysis has highlighted that, when compared to alternative (historical) exudate management treatments, the SAP dressing was less expensive. The cost reduction arises from data that shows product use and frequency of dressing change (that impacts on nurse time) are both reduced. For the 10 patients evaluated, total costs were £2,491 and £1,312 before and during use, respectively; a saving of £1,179.00 (47%). CONCLUSION: The SAP dressing was well tolerated and shown to be effective in the management of moderate-to-high exudate. Consequently, the dressing supported improved healing, and reduced damage to periwound skin, leading to lower pain levels. Overall, both the patients and clinicians rated the SAP highly.

An audit of chronic oedema within the care home setting.

This articles outlines the important issue of chronic oedema, its definition and the physiology of the three main categories. The care delivered in the care home (nursing) sector was the subject of a printed questionnaire and the results are presented here. They are discussed and the implications for practice and an evidenced-based approach to care delivery are considered. Several conclusions can be drawn from this study but would be strengthened by a larger study. Care for patients with chronic oedema could be enhanced and this would improve clinical outcomes; significantly fewer patients would need to be referred for GP management if an appropriate and timely first-line treatment was agreed and provided by nursing staff. An educational resource should be developed, including: a resource folder; e-learning, patient information, and a patient leg exercise regime; a crib sheet and myth buster information; and clinical competencies. A further study would be required to confirm whether fewer patients experienced falls or presented with chronic oedema when lower leg swelling was managed.

Evaluating the performance of a new carboxymethyl cellulose dressing in the community setting.

This article describes a single-centre, non-comparative evaluation set out to assess the clinical performance and patient acceptability of a new carboxymethyl cellulose (CMC) wound dressing. Twenty patients in a community setting, aged between 34-97 years, were recruited. The progression of various types of wounds with different levels of exudate was documented over 4 weeks. No adherence to the wound bed or painful removal was reported in 18 patients, and the peri-wound skin was the same or had improved in all patients. When compared with the previous CMC dressing used by the authors, the new CMC dressing reported a longer wear time. These findings show a positive clinical performance and suggest a potential financial advantage when using the new dressing.

A 100 patient clinical evaluation of an alternating pressure replacement mattress in a home-based setting.

BACKGROUND: alternating pressure air mattresses (APAMs) support the prevention and management of pressure ulcers. A health and care NHS trust was seeking an APAM that would improve clinical outcomes in relation to pressure ulcers while considering financial cost. An APAM existed that could meet the trust's needs but there was a lack of evidence over its use in a community/home setting. This study examined the effect of using the Dual Professional (IQ Medical) APAM for patients at a high risk of pressure ulceration. It also determined patient and family satisfaction, and the views of clinicians in relation to clinical outcomes. Additionally, infection prevention and control, servicing, maintenance and electrical biomechanical engineer input were considered. METHOD: a prospective observational study was undertaken of 100 patients in their own homes following a pilot study of 10 patients. The period of the evaluation was from one day up to 295 days, with a mean average of 83 days, and a total of 5809 bed days. RESULTS: with a regimen of regular repositioning of patients and a good diet, the APAM was effective in preventing pressure ulceration in the 100 patients who were at a high or very high risk of skin breakdown and pressure ulceration. CONCLUSION: selection of pressure redistributing surfaces should be based on holistic patient assessment, including risk assessment, mobility levels, grade of pressure damage and clinical judgment.

Assessing an adherent silicone foam dressing: a clinical evaluation across five NHS trusts.

The wound contact layer of UrgoTul Absorb Border (Urgo Medical) foam dressing contains a Technology Lipido Colloid (TLC) Healing Matrix, which includes hydrocolloid and lipophilic substances designed to stimulate fibroblast proliferation and thus promote granulation tissue formation. A multicentre, noncomparative, clinical evaluation of UrgoTul Absorb Border investigated whether use of the dressing promoted granulation tissue formation and the management of wound exudate. Other parameters evaluated included: pain-free dressing changes, protection and improvement of surrounding tissue, ease of application, conformability, ability to remain in place, wear time, effect on peri-wound skin, durability, ease of removal, and patient comfort. There were 43 patients recruited into the evaluation. Results show that 8 wounds (19%) achieved full epithelialisation and 34 (81%) improved. All participating clinicians rated the dressing's overall performance, including its ability to manage exudate, as excellent, very good, or good.

Zinc-impregnated and odour-control two-layer compression.

This article presents the results of 40 patients using two versions of a new two-layer compression system in a large primary care organisation. The evaluation was undertaken to explore the following areas formulary inclusion consideration: ease of use, clinical acceptability, clinical outcome and additional patient benefits of an alternative new low-profile bandage system containing zinc (n=30) and odour-control properties (n=10).

Prevention and management of pressure ulcers: support surfaces.

Pressure ulcers are a common and debilitating problem in health care, impacting negatively on health-related quality of life and compounding challenges in achieving patient safety targets. Pressure ulcer prevention is a multidisciplinary team effort, involving a myriad of interventions, such as nutrition, skin care and repositioning. This article discusses the factors influencing pressure ulcer development, and then elaborates on the principles of prevention. This is followed by a focused discussion on the use of redistribution devices and the importance of the cover of such equipment in contributing to achieving good standards in prevention.

The assessment and management of skin tears in care homes.

This article discusses a project conducted in Worcestershire nursing homes to review current practices in the management of skin tears and the subsequent development and implementation of guidelines resulting in a standardised client care package. An initial audit in five care homes was followed by an in-depth audit in 52 homes over a 12-week period. This led to the development of resources and the 'STAR box' to assist with implementation of timely and appropriate care delivery.