Biatain Silicone, which is available both in normal and lite versions, is a multilayered soft silicone adhesive foam dressing which can be used on a wide range of exuding wounds for moist wound healing and exudate management.
Venous leg ulceration can be a chronic problem that has a negative effect on patients’ quality of life and is very expensive in terms of healthcare resources. The scale of the problem is continually increasing due to the ageing population, however, the standard of care across the UK varies despite a clear relationship between accurate assessment of the patient and the delivery of effective compression therapy. One of the major obstacles to the delivery of effective treatment is the reluctance of some patients to concord with prescribed compression therapy and there are a variety of reasons for this, including a lack of patient understanding of the importance of compression, or clinicians’ lack of knowledge or experience leading to poor patient education. The authors suggest, however, that maintaining patient concordance with compression therapy can result in effective healing. Central to this is the development of an effective therapeutic relationship between the clinicians and the patient and their family/carers and this article provides an overview of how one team of nurses were able to achieve this.
In the current economic climate it is important that clinical quality and cost-effectiveness is maintained and community nurses must be confident that they are selecting dressings which provide multiple treatment outcomes. This can include exudate management, reducing trauma and pain at dressing change, extended wear time, and protection of the periwound area. Similarly, there has been a recent rise in the incidence of skin tears, particularly within care homes and in the elderly population, and this requires a dressing that can both protect vulnerable skin and prevent the entry of contaminants and bacteria into the wound bed. Community nurses need a dressing that can perform all of these roles and this article examines Advazorb® Border (Advancis Medical), a dressing specifically designed to manage exudate, prevent pain, trauma and skin stripping on removal, and protect the periwound skin. Crucially, in clinical practice Advazorb Border has been shown to manage skin tears appropriately while staying in place longer and the author discusses clinical evidence that shows how the dressing provides cost-effective wound management and long-term savings within clinical practice.
Repeated application/removal of adhesive dressings and tapes can cause skin stripping in and around wounds, resulting in pain, increased wound size, delayed healing, inflammation and increased risk of infection. Adhesive tapes and dressings are also used widely in many care settings to secure tubes, monitors and drains, while the more fragile skin of children and the elderly is at increased risk of epidermal stripping when adhesive dressings are removed. Here, the authors use a series of case studies to demonstrate how Appeel® Sterile Liquid Sachet and Spray applications (CliniMed Ltd), part of the Appeel Sterile Medical Adhesive Remover range, help with adhesive removal, reducing pain and trauma. This article examines how Appeel Sterile removes dressings, tapes and other medical adhesive appliances quickly and easily from both intact and broken skin, resulting in reductions in pain, trauma, use of analgesia, infection risk, cost of dressings and nursing time.
Many community nurses will have to attend patients that have a surgical wound. The desired clinical outcome for any surgical wound will be to achieve closure and skin integrity with an acceptable cosmetic result, and to avoid any complications. Patients presenting to community nurses after discharge from hospital may well have experienced postoperative complications or may be at risk of complications following suture removal. Community nurses should be aware of wound problems that may arise following surgery and how to address them appropriately.
A chronic heavily exuding wound can have a devastating impact on a patient’s quality of life, often resulting in symptoms such as increased pain, depression, anxiety and stress, as well as a loss of independence and social isolation. For community nurses, wounds with high levels of exudate can incur increasing costs, both in time and resources. It is imperative to heal these wounds as quickly as possible and the community nurse should undertake a robust and holistic assessment before implementing a clear and evidence-based management plan, potentially including wound debridement and the use of an effective absorbent dressing in combination with compression therapy, where appropriate, to manage exudate. This article examines the development of chronic wounds and the problem of excess exudate production specifically, before going onto look at the benefits of one particular superabsorbent dressing (Flivasorb®; Activa Healthcare/L&R). The author uses extensive evidence as well as clinical expertise to provide an overview of the dressing, and presents a case study to demonstrate its benefits in practice.
When trying to prevent the recurrence of leg ulcers, many community nurses find it hard to get patients to concord with compression devices and techniques, particulary over the long term.
This article looks at a new adjustable Velcro compression device, juxtalite (part of the juxta® range; medi UK), which is designed to be simple to apply. It has built-in pressure system (BPSTM) that allows the nurse to accurately monitor the level of compression being applied to the limb, ensuring a therapeutic level of compression is maintained. Here, the author relates her own expreience of using the juxta system (in particular the juxalite version) through a series of case studies that show how the system aids patient concordance with treatment over an extended period of time.
Pressure ulcers result in pain and poor quality of life for patients as well as being regarded as an indicator of poor practice for nurses and healthcare organisations. Similarly, prevention of pressure ulcers is preferable to treatment, which can be expensive. This article considers the latest guidance on the prevention of pressure ulcers and looks at some of the innovations such as pressure relieving devices and the use of dressing products, which nurses can use to provide holistic care. Finally, the author reiterates that despite the use of guidelines and innovative products, the nurse must also rely on their clinical judgement.
Community nurses often work in isolation and are not always able to attend best practice updates in venous leg ulcer treatment. As a result, they do not always possess the up-to-date knowledge and skills to manage these patients. This project reached out to local ways of delivering compression therapy; in this case an adjustable Velcro compression device, juxtacures (juxtacures®; medi UK). The juxtacures range is designed to be simple to apply with a built-in pressure system that allows the nurse to accurately monitor the level of compression being applied to the limb. This ensures a therapeutic level of compression is maintained. The authors felt and skill level in compression bandaging. The aims of the project were to reduce the amount and duration of community nursing visits to patients with venous leg ulcers while ensuring that safe, visits to patients with lower limb problems, with some patients successfully discharged to self-manage their lower limbs.
This article details a literature search that aimed to find evidence for best practice in treating heel pressure injury. The article gives some background to the aetiology and presentation of heel injury, as well as detailing some of the evidence and literature that was found in the search. The results show that more good quality studies are necessary to arrive at a definition of best practice in heel pressure ulcer treatment to guide nurses. For example, there should be clear indications about how to treat the different categories of pressure damage, the surgical intervention required to repair wounds without putting patients at risk of major amputation, and more focus on the benefits of a through vascular assessment before stating any debridement.
