Superabsorbent charcoal dressing versus silver foam dressing in wound area reduction: a randomised controlled trial.

AIM: This study aimed to compare the effect of a novel sterile polyacrylate wound pad with activated carbon cloth treatment with a standard non-adhesive hydrocellular foam dressing with silver in reducing wound area. METHOD: A multicentre randomised controlled open-label wound-dressing trial was conducted in two wound care outpatient clinics in western Switzerland from November 2018 to March 2020. RESULTS: A total of 77 successive patients were randomised to receive either a sterile polyacrylate wound pad with activated carbon cloth treatment (n=38) or the standard non-adhesive hydrocellular foam dressing with silver (n=39). Reduction in wound area was the primary outcome, whereas the application period of the dressing, odour, maceration and pain were the secondary outcomes. Wound area was measured at baseline and during each wound dressing change until the dressings were no longer indicated. Wound area reduced faster in the intervention group than in the control group (0.45cm2 per day vs. 0.2cm2 per day), although the application period was longer in the intervention group compared with the control group (9.5 days vs. 8.1 days). Maceration reduction was more pronounced in the intervention group (-2.07cm2) than in the control group (-0.71cm2). Odour, pain and infection were similar in both groups. CONCLUSION: Sterile polyacrylate wound pad dressings with activated carbon cloth reduced the wound area, as well as the maceration area, faster than the non-adhesive hydrocellular foam dressing with silver.

Prevalence and incidence of venous leg ulcers-a protocol for a systematic review.

BACKGROUND: Venous leg ulcers (VLUs) are chronic wounds characterized by slow healing and high recurrence. Information on prevalence and incidence is essential for ascertaining the burden of VLU on the health care system and to inform epidemiological research, priority setting, and health care planning. The objective of this protocol is to present a transparent process for how we plan to review the existing international literature on the prevalence and incidence of VLU as well as the characteristics of the population reported within these studies. METHODS: An exploratory search was performed using MEDLINE via PubMed and CINHAL via Ebsco to identify concepts, keywords, MeSH terms, and headings to identify study types looking at data of VLU prevalence and/or incidence and related patient characteristics. The findings of this exploratory search will determine the final search strategy. The titles and abstracts of the identified articles will be screened independently be two authors for relevance. Study which pass the quality assessment will be included. Data extraction will be performed independently by two authors and in accordance with a pre-designed data extraction form. If the data allows, a meta-analysis will be performed otherwise a descriptive summary of the findings will be conducted. DISCUSSION: The results of this review will contribute to the evidence base on VLU occurrence and may inform the decision making of healthcare professionals, policy-makers, and consumers. It will also inform future research in this area of VLU care. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020205855.

The lived experience of recurrence prevention in patients with venous leg ulcers: An interpretative phenomenological study.

AIM OF THE STUDY: To explore patient understanding of why they develop a venous leg ulcer and how they can prevent recurrence. METHOD: The methodological framework of the hermeneutic phenomenological approach was used. Semi-structured interviews were conducted with seventeen participants living with a venous leg ulcer from May 2017 to November 2018. Data were analysed using Smith's interpretative hermeneutic analysis. RESULTS: The results are categorised into three main themes: "Trauma due to accident" (initial venous leg ulcer) and "Prevention of ulcer recurrence" (compression); "Trauma due to compression therapy" (venous leg ulcer recurrence). The findings demonstrate active venous leg ulcers are often caused by acute incidents while carrying out an activity in people with underlying chronic venous insufficiency. After a complete healing, preventive measures, such a compression stockings are initiated by the patient or health care provider. Trauma due to adherence to compression stockings caused skin breakdown beneath compression that caused subsequent ulcer recurrence. CONCLUSION: This study contributes to understanding the lived experience of patients with venous leg ulcers who develop a venous leg ulcer and their understanding of how they can prevent recurrence. Patients with VLUs would benefit from early preventive strategies, such as such a compression stockings fitting and application, integrated into daily care plan of primary care and community settings.

Comparison of sterile polyacrylate wound dressing with activated carbon cloth and a standard non-adhesive hydrocellular foam dressing with silver: a randomised controlled trial protocol.

OBJECTIVE: Hard-to-heal wounds such as leg (LU) or diabetic foot ulcers (DFU) are slow healing, have a high recurrence rate and are associated with infection, smell and exudate. Current therapeutic approaches are multifaceted and focus on improving wound healing and preventing recurrences. Advanced wound dressings, especially super absorbent dressings are an important aspect of wound care, as hard-to-heal wounds tend to produce excessive amounts of exudate, which may contribute to maceration and excoriation, thus delaying wound healing. Additionally, excessive wound exudate is associated with malodour. Therefore, an important aspect of care is the management of exudate and odour. The use of effective advanced wound dressings is a promising strategy to achieve adequate absorption of wound exudate and malodour promoting wound healing. The aim of the current study is to determine whether there is a difference in wound size reduction between wounds dressed with either a sterile polyacrylate wound dressing with activated carbon cloth or a hydrocellular foam dressing with silver. METHOD: A randomised controlled trial with 248 participants in one wound care outpatient clinic is proposed. Randomisation will be concealed. The outcome assessor will be blinded to the group allocation of participants. CONCLUSION: This research project compares two wound dressings in an everyday care setting. Since the cost of hard-to-heal wounds to individuals, the economy and society is high, an evaluation of which wound dressing leads to a faster reduction of wound size and subsequent wound healing is an important issue/question for the individuals affected, their families, society and the health-care system.