Appropriate Use Of Dressings Research Articles

3D Porous Collagen Matrices-A Reservoir for In Vitro Simultaneous Release of Tannic Acid and Chlorhexidine.

The treatment of wounds occurring accidentally or as a result of chronic diseases most frequently requires the use of appropriate dressings, mainly to ensure tissue regeneration/healing, at the same time as treating or preventing potential bacterial infections or superinfections. Collagen type I-based scaffolds in tandem with adequate antimicrobials can successfully fulfill these requirements. In this work, starting from the corresponding hydrogels, we prepared a series of freeze-dried atelocollagen type I-based matrices loaded with tannic acid (TA) and chlorhexidine digluconate (CHDG) as active agents with a broad spectrum of antimicrobial activity and also as crosslinkers for the collagen network. The primary aim of this study was to design an original and reliable algorithm to in vitro monitor and kinetically analyze the simultaneous release of TA and CHDG from the porous matrices into an aqueous solution of phosphate-buffered saline (PBS, pH 7.4, 37 °C) containing micellar carriers of a cationic surfactant (hexadecyltrimethylammonium bromide, HTAB) as a release environment that roughly mimics human extracellular fluids in living tissues. Around this central idea, a comprehensive investigation of the lyophilized matrices (morpho-structural characterization through FT-IR spectroscopy, scanning electron microscopy, swelling behavior, resistance against the collagenolytic action of collagenase type I) was carried out. The kinetic treatment of the release data displayed a preponderance of non-Fickian-Case II diffusion behavior, which led to a general anomalous transport mechanism for both TA and CHDG, irrespective of their concentrations. This is equivalent to saying that the release regime is not governed only by the gradient concentration of the releasing components inside and outside the matrix (like in ideal Fickian diffusion), but also, to a large extent, by the relaxation phenomena of the collagen network (determined, in turn, by its crosslinking degree induced by TA and CHDG) and the dynamic capacity of the HTAB micelles to solubilize the two antimicrobials. By controlling the degree of physical crosslinking of collagen with a proper content of TA and CHDG loaded in the matrix, a tunable, sustainable release profile can be obtained.

Complete Healing of a Heel Bedsore using Argania Honey Dressing: Case Report

Background: Chronic wounds and injuries represent a significant burden for health care professionals due to the difficulties related to their management. The selection and use of appropriate dressings have become essential for successful treatment. Honey has been used for thousands of years as a biological treatment because its bioactive components contribute to the healing process. Objective: This case report aims to demonstrate the efficiency of Argania honey dressing on pressure ulcers. Case Presentation: The wound care was achieved using pure raw Argania honey with no additives, pasteurization, or manipulation. A previous mechanical debridement process was necessary before the application of honey dressings to a right heel bedsore in a 69-year-old man who suffered an ischemic stroke. Results: This case report describes for the first time the complete healing of a right heel bedsore using Argania honey dressing. Bedsore demonstrated rapid recovery and complete healing over approximately 18 weeks (124 days, between June and October 2021). Conclusion: With the rise of natural medicines and some pathologies that are resistant to conventional treatments, Argania honey can be an asset for its therapeutic effects on the skin, but more studies are needed to explain and identify the complexity of mechanisms involved to ensure this complete healing process.

Appropriate use of dressings containing nanocrystalline silver to support antimicrobial stewardship in wounds.

Antimicrobial resistance is an ever‐increasing global concern, with the era of untreatable infection becoming a reality. Wound care is no exception, with increasing issues of antibiotic‐resistant infections across different wound types and care settings. Antibiotic resistance and stewardship have been the priority for most strategic interventions so far; however, in wound care, alternative or supplementary strategies using antiseptics should be considered. Antiseptics such as silver can provide effective cidal activity across a broad range of wound pathogens, assuming they are used at the correct level for an appropriate duration. Evidence summarised in this manuscript suggests that effective antiseptics, such as nanocrystalline silver, have an increasing body of evidence in support of their use to minimise transmission of antibiotic‐resistant organisms as part of institutional infection control procedures and, in addition, through appropriate early use and stewardship on local wound infections, in conjunction with local procedures, to minimise the need for systemic antibiotic therapy. Engagement, alignment, and collaboration between wound care professionals and wider related teams and governments on antimicrobial stewardship, and the potential role of antiseptics within this, will help to generate further evidence for such interventions in the fight against antimicrobial‐resistant infections in wound care.

The benefits of using an online ordering service to improve efficiency in wound care services

ONPOS is an online non-prescription ordering service (ONPOS) provided by Coloplast that enables formulary wound dressing products to be purchased from a variety of supply routes without needing a prescription or paperwork. ONPOS has been available for over a decade and is currently used in over 30 trusts throughout the UK. This article presents the need for improved access to wound dressings in the community, and outlines the proven benefits of adopting ONPOS, including reduced dressing wastage, instantly accessible dressing stock, improved formulary compliance and more appropriate use of dressings. Using ONPOS also provides real-time data that enables tracking of product usage and spend which can then be used to inform decision-making and promote a cost-effective culture within the organisation.

Negative pressure wound therapy: improving the patient experience Part 2 of 3

Despite the clear benefits of negative pressure wound therapy (NPWT) as a treatment for wounds, it is essential that greater focus is given to the patient experience of this treatment. In particular, it is important that any unpleasant consequences, such as pain, stress, and skin trauma are minimised, so as to promote quality of life and healing. This article presents part two of three studies which aim to explore ways in which the patient experience of NPWT can be improved. In this study, the views of wound care clinicians (n=12) were investigated in greater depth through semi-structured interviews. Findings indicate a pressing need to minimise pain, particularly through ongoing assessment and collaboration with patients, and also through the use of appropriate dressings, films and other products that promote patient comfort. Additionally, it is evident that greater education is needed for both nurses and patients about NPWT, in order to promote high-quality care and patient wellbeing.

Seminar Review: Wounds and Dressings

Venous leg ulcers are the most common type of lower limb ulceration. Compression therapy combined with the use of appropriate dressings remain the gold standard for the management of venous ulcers. Although a wide range of wound dressings is available, the management of venous leg ulcers is primarily dependent on a careful assessment of the patient, the wound, and the effectiveness of the treatment.

Appropriate use of dressings.

This issue includes an audit assessing the appropriate use of dressings in clinical practice (pages 305-308). The authors define appropriate use if the dressing chosen and the technique for application are based on a combination of relevant literature, expert opinion and manufacturer's advice.