Introduction Superabsorbent foam (SAF) and superabsorbent polymer (SAP) dressings are compared on their abilities to handle moisture exuding from an artificial wound and to affect the microclimate beneath the dressings by measuring: the amount of moisture absorbed; the amount of moisture evaporated through the outer layer; the humidity, both beneath and outside the dressing and the difference between the two; and the temperature, both beneath and outside the dressing and the difference between the two.
Method A thermodynamic indenter was used in a laboratory setting to deliver a steady flow of moisture vapour across a standard wound size to each dressing under the weight of the indenter. Sensors recorded the humidity and temperature inside and outside each dressing over 3 hours and 16 minutes with a 45-second complete unweighting of the dressing at the 3- hour mark to simulate a patient weight shift. Dressings were weighed at test end to determine moisture absorbed and moisture evaporated.
Results There were no significant differences between the SAF and the SAP dressing groups in moisture absorption nor evaporation, nor in humidity nor temperature inside versus outside the dressings.
Conclusion It can therefore be determined that SAF and SAP dressings appear to be equally competent in maintaining a warm and moist microclimate in the wound bed. It should also be noted that these dressings do not dry the wound bed as the term superabsorbent may imply.
Introduction Venous ulcers are a serious clinical consequence of chronic venous insufficiency (CVI). The basis for successful management is compression therapy such as compression bandages, compression stockings and/or elastic tubular compression devices.
Aim The purpose of this study is to undertake a retrospective review on the effectiveness of compression therapies in a wound care nurse clinic in Hong Kong.
Method Patients in the clinic who presented with lower limb ulcers which showed either the signs and symptoms of CVI with an ankle brachial index >0.8 or where CVI was confirmed by Duplex scan were included in this study (Figure 1). The search period was from the start of treatment (Week 0) up to 24 weeks.
Results Time to heal was compared by using the log-rank test; 152 wounds healed within 24 weeks, with an overall healing rate of 93.3%. A total of 90.2% of wounds healed with compression bandages, 93.5% of wounds healed with compression stockings, and 98% of wounds healed with elastic tubular compression devices. The mean healing time was 10 weeks, 8 weeks and 9 weeks respectively.
Discussion In view of the various wound sizes between the three groups, there was relatively less difference in the overall wound healing rate among the three groups – relative risk (RR)<1. For ulcers sized >4cm2 to ≤12cm2, the difference in the wound healing rate between using compression bandages rather than compression stockings was found to be only 0.8% (RR=1.08).
Conclusion Taking into account the result from our study and considering both economic factors and patients’ convenience, elastic tubular compression devices may be more suitable for our group of patients.
Introduction Diabetes is a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the body. Due to these factors, diabetes can cause several complications that include heart disease, stroke, high blood pressure, eye complications, kidney disease, skin complications, vascular disease, nerve damage and foot problems.
Aim The primary objective of the project was to educate patients who had been diagnosed with diabetes or were being followed up for diabetes management by other departments with regard to their own responsibility in maintaining preventative foot self-care. Educating patients with diabetes to take an active part in their own self-care is the cornerstone of establishing effective diabetes self-management. Diabetes education allows patients to explore effective interventions into living their life with diabetes and incorporate the necessary changes to improve their lifestyle.
Method Ten patients completed a validated educational foot care knowledge assessment pre-test to determine their existing knowledge about their own foot care after a thorough foot assessment. Preventative diabetic foot self-care education was conducted through a lecture, visual aids and a return demonstration. Patients were then subjected to a post-test questionnaire with the same content as the aforementioned pre-test to determine their uptake of the educational content.
Results Correct cutting of toenails was the most identified educational need. It was a limitation in the pre-test (30%) and it remained the lowest scoring item on the post-test (70%). Walking barefoot was thought not to be dangerous by 60% of participants pre-test but, with remedial education, all participants identified this as a dangerous activity post-test. The importance of having corns and calluses looked after by a health professional rather than self-care was also understood to be of high importance.
Conclusion Effective communication with patients by healthcare providers who can mould educational content to the identified patient needs by teaching much needed skills is a key driver in rendering safe, quality-related healthcare educational interventions.
The use of a comprehensive wound assessment tool and appropriate selection of dressing products can aid clinicians in the management of complex wounds. This paper describes the care of two patients presenting with head wounds. The first case is a patient who suffered from a right temporalis flap failure and exposed periosteum after wide excision. The second case explores the management of a sternocleidomastoid abscess that developed during radiotherapy for head and neck cancer. The paper outlines how the choice of healing by secondary intention can prevent patients from undergoing additional surgeries where outcomes may not be favourable.