Supporting healthcare professionals in taking control of the infection risk with ACTICOAT Flex TAKE CONTROL. of the infection risk in chronic wound

Transcription

1 Supporting healthcare professionals in taking control of the infection risk with ACTICOAT Flex TAKE CONTROL of the infection risk in chronic wound

2 Introduction The impact of infection on patients is well recognised amongst clinicians who acknowledge the stress and anxiety that symptoms create, the altered body image and the probable need for increased clinical intervention. Fast resolution of symptoms using comfortable, conformable and fit for purpose dressings is foremost when considering patient outcomes and quality of life. The Darzi report and quality indicators are a reminder that, as clinicians, we have a responsibility to monitor the success of treatments, the quality of service provision and patient experience (Ousey and Shorney, 2009). In our experience, ACTICOAT Flex dressings has shown rapid results with a reduction in the signs and symptoms of wound infection leading to wound progression. The option to apply a 3 or 7 day variant offers better choice in the management of different wound aetiologies. Benefits include its flexibility and conformability, making dressing changes easier in awkward to dress areas and the transportation of excess exudate away from the wound bed into the secondary dressing. Cutting is also made easier as it s a single layer which can be rolled or scrunched to line the wound bed and has several application techniques offering adaptability. Through a case study approach we would like to share with you some of the real advantages in clinical practice. Sue Murray and Ann Pardoe Tissue Viability Team Outer North East London Waltham Forest Community Services Sue Murray Ann Pardoe Reference Ousey K and Shorney R. (2009) What are the quality indicators in wound care? Wounds UK; (2): 3-. Photographer: Ian Tuttle

3 The use of ACTICOAT Flex 3 dressing in the management of a hand burn Hand burn A 79-year-old male with a burn caused by the patient smoking whilst receiving oxygen therapy. The patient suffers with Chronic Obstructive Pulmonary Disease (COPD) and requires continuous oxygen therapy, is totally immobile and as a consequence is dependent on his wife. ACTICOAT Flex 3 dressing was chosen because this was an awkward area to dress and the wound was infected. Gauze, PROFORE #1 dressing and Tubifast TM were used as secondary dressings. Once ACTICOAT Flex 3 dressing was no longer required Epiderm TM, N-A TM Ultra, gauze and Tubifast were applied to the hand. Hand burn on first presentation ACTICOAT Flex 3 in situ After using ACTICOAT Flex 3 dressing for 2 weeks It is evident from the pictures that there was a huge improvement to the wound. The ability of ACTICOAT Flex dressing to be woven between the fingers and conform well around the hand ensured good wound bed contact. In just 4 weeks following the initial presentation of the burn, improvement was seen with minimal scarring

4 The use of ACTICOAT Flex 3 dressing in the management of a necrotic foot ulcer Necrotic foot ulcer An 86-year-old female with necrotic foot ulcers, which had been present for about 3 months. Past medical history included diabetes, anaemia and a triple heart bypass. The patient was discharged from secondary care to a private nursing home for palliative care following treatment with IV antibiotics. Surgery, including amputation, was unsuitable. A referral was made to Tissue Viability by an Advanced Specialist Podiatrist. The clinical aim was not wound healing but to control the symptoms in the wound including pain and extending infection as well as minimising the social impact of the wound and preventing re-admission to hospital. The patient described the malodour as the most distressing symptom which at times caused nausea and loss of appetite. ACTICOAT Flex 3 dressing was chosen to help manage the ulcers and was changed every 3 days. ALLEVYN Non-Adhesive dressing and PROFORE #1 dressing were selected as the secondary dressings. A Fentanyl TM patch was used for pain with an Oramorph TM for breakthrough pain. Wound on presentation ACTICOAT Flex 3 in situ 3 months later, there was no further deterioration in the ulcer. The pain and malodour which were caused by the wound were controlled and systemic antibiotics or admission to hospital were not needed. It is worth noting that when ACTICOAT Flex 3 dressing was stopped for a short period of time, intravenous antibiotics were needed as the signs and symptoms of infection re-occurred. The patient is able to eat and drink again, and go out into the garden with family. ACTICOAT Flex 3 dressing continues to be used to help prevent infection.

5 The use of ACTICOAT Flex 3 dressing in a patient with a dehisced abdominal wound Dehisced abdominal wound A female in her 80 s who underwent a Hartmann s procedure. The patient was discharged home but 2 days later was readmitted to re-open and drain the wound. The wound was left to heal by secondary intention and the patient was discharged home with a Hydrofiber TM and a low adherent adhesive dressing on the wound. The patient was referred to the Tissue Viability team for Negative Pressure Wound Therapy (NPWT) to the lower wound as the wound had been present for 8 months. The patient complained of odour and discharge to the middle wound. ACTICOAT Flex 3 dressing was chosen with ALLEVYN Gentle Border as the secondary dressing. The wound on first presentation ACTICOAT Flex 3 dressing in situ (NPWT to lower wound) ALLEVYN Gentle Border dressing used as secondary dressing After just a few weeks, all signs and symptoms of infection had disappeared and the wound continued to follow a normal wound healing trajectory.

6 The use of ACTICOAT Flex 3 dressing with Negative Pressure Wound Therapy in a patient with a traumatic wound Traumatic wound A 6-year-old gentleman who presented to the district nursing staff with a wound to the inside of his right thigh and a swollen lower leg. The wound was sustained by dropping a motorbike whilst loading into the back of a lorry. Past medical history of Type 2 diabetes and hypertension. The patient works as a long distance lorry driver and is usually very mobile and active. The wound on first presentation The wound bed was covered in soft yellow slough. IODOFLEX dressing and ALLEVYN Gentle Border dressing were applied but 10 days later a cavity was noted to the centre of the wound bed, 2cm in depth with undermining. The patient was referred to the surgeon for exploration and debridement, and was admitted to hospital. VAC TM therapy was commenced but dressing changes needed to be done under a general anaesthetic due to adhesion. The patient was discharged home 9 days later and continued NPWT using RENASYS GO dressing and gauze filler with flat drain. The objective was to accelerate wound healing and manage copious amounts of exudate to reduce maceration to the surrounding skin. The wound was producing 700ml of exudate per week, requiring frequent dressing changes and nurse visits. The treatment protocol reduced nurse visits as dressing changes were now required twice weekly rather than twice daily. 1 days post-debridement the patient complained of malodour and gauze appeared green in colour. A wound swab was taken and antibiotic therapy commenced. ACTICOAT Flex 3 dressing was applied to the wound bed to reduce the odour associated with the wound as this was distressing to the patient. The patient was very anxious that he had a wound infection. 9 days after initial presentation ACTICOAT Flex 3 dressing in situ with NPWT being applied Dressing in situ In less than 3 weeks The patient noted that the odour had subsided after the first ACTICOAT Flex 3 dressing application. This reassured the patient as he associated the odour with infection. The patient was seen by the surgeon who had considered skin grafting, but in view of the good progression of the wound this was no longer considered necessary. The patient reported no pain from the dressing. Removal was simple and pain-free. The patient was able to return to work much sooner than initially anticipated.

7 The use of ACTICOAT Flex 3 dressing in a patient with a chronic non-healing leg ulcer Chronic non-healing leg ulcer A 22-year-old gentleman presented with an ulcer to the medial malleolus on his left leg. The patient suffered from chronic venous disease and was under hospital care for a wound biopsy and scan. The wound was scraped and debrided on alternate weeks. The hospital recommended a Hydrofiber TM and multi-component bandaging. There had been no improvement for the last 2 years with the ulcer becoming larger in size. The patient had increased pain, erythema, malodour and increased exudate levels. A referral was made to the Tissue Viability team. ACTICOAT Flex 3 dressing was used as a primary dressing to eliminate odour and PROFORE dressing multi-layer compression bandaging was applied. The leg ulcer on presentation ACTICOAT Flex 3 dressing in situ ACTICOAT Flex 3 dressing under PROFORE #1 Improvement was seen by the first dressing change and therefore the patient was discharged under the care of the Leg Ulcer clinic. Clinician I chose ACTICOAT Flex to reduce the malodour and because it was easy to apply and remove under the multi-component bandages. Also for its ability to conform to the wound bed and ability to be cut to the shape. The wound healed after 4 months of being referred to the Tissue Viability Team. ACTICOAT Flex 3 dressing under PROFORE multi-layer compression bandaging Improvement to ulceration after 3 weeks

8 Product Size S&N Code Pack ACTICOAT Flex 3 dressing cm x cm 10cm x 10cm 10cm x 10cm 10cm x 20cm 20cm x 40cm ACTICOAT Flex 7 cm x cm cm x 12.cm cm x 1cm cm x 40cm cm x 40cm cm x 60cm Smith & Nephew Croxley Green Business Park Building, Lakeside Hatters Lane, Watford Hertfordshire WD18 8YE T +44 (0) F +44 (0) Trademark of Smith & Nephew All Trademarks acknowledged August 2016 Smith & Nephew 74732