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Fulchignoni C, Covino M, Pietramala S, Lopez I, Merendi G, De Matthaeis A, Franceschi F, Maccauro G, Rocchi L. Hand Trauma in Emergency Department Management in Older Adults ≥ 80 Years Old: A Twenty-Year Retrospective Analysis. Geriatrics (Basel) 2023; 8:112. [PMID: 37987472 PMCID: PMC10660491 DOI: 10.3390/geriatrics8060112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023] Open
Abstract
The prevalence of hand injuries increases with age, with elderly patients being more prone to hand lesions due to a combination of factors, such as reduced bone density and muscle strength, impaired sensation, and cognitive impairment. Despite the high incidence of hand injuries in the elderly population, few studies have addressed the management and outcomes of hand lesions in this age group. This study aimed to analyze the characteristics and management of hand lesions in patients over 80 years old. The authors conducted a retrospective analysis of medical records of patients over 80 years old who reached their Emergency Department with hand lesions between 2001 and 2020. Data on demographics, injury characteristics, and management were collected and analyzed. A total of 991 patients with hand lesions were included in the study, with a mean age of 84.9 years. The most common causes of injuries were domestic accidents (32.6%) and traffic accidents (12.8%). The most frequent types of hand lesions were fractures (23.5%) and superficial wounds (20.5%). Overall, 23.4% underwent surgical treatment for their hand issue, and 22.1% had associated injuries, among which, the most common were head trauma and other bone fractures. In conclusion, hand lesions in patients over 80 years old are frequent and pose significant challenges in diagnosis and management. Particular attention should be paid to associated injuries and limit indications to surgery when strictly necessary.
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Affiliation(s)
- Camillo Fulchignoni
- Orthopedics & Hand Surgery Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Marcello Covino
- Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Silvia Pietramala
- Orthopedics & Hand Surgery Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ivo Lopez
- Orthopedics & Hand Surgery Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gianfranco Merendi
- Orthopedics & Hand Surgery Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea De Matthaeis
- Orthopedics & Traumatology Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Franceschi
- Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giulio Maccauro
- Orthopedics & Traumatology Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Lorenzo Rocchi
- Orthopedics & Hand Surgery Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Liu H, Hu Y, Wu X, Hu R, Liu Y. Optimization of Surface-Engineered Micropatterns on Bacterial Cellulose for Guided Scar-Free Skin Wound Healing. Biomolecules 2023; 13:biom13050793. [PMID: 37238663 DOI: 10.3390/biom13050793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Bacterial cellulose (BC) has been widely used in tissue engineering due to its unique spatial structure and suitable biological properties. In this study, a small biologically active Arginine-Glycine-Aspartic acid-Serine (RGDS) tetrapeptide was incorporated on the porous BC surface followed by a low-energy CO2 laser etching operation. As a result, different micropatterns were established on the BC surface with RGDS only anchored on the raised platform surface of the micropatterned BC (MPBC). Material characterization showed that all micropatterned structures exhibited platforms with a width of ~150 μm and grooves with a width of ~100 μm and a depth of ~300 μm, which displayed distinct hydrophilic and hydrophobic properties. The resulting RGDS-MPBC could hold the material integrity, as well as the microstructure morphology under a humid environment. In-vitro and in-vivo assays on cell migration, collagen deposition, and histological analysis revealed that micropatterns led to significant impacts on wound healing progress compared to the BC without surface-engineered micropatterns. Specifically, the basket-woven micropattern etched on the BC surface exhibited the optimal wound healing outcome with the presence of fewer macrophages and the least scar formation. This study further addresses the potential of adopting surface micropatterning strategies to promote skin wounds towards scar-free outcomes.
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Affiliation(s)
- Haiyan Liu
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
| | - Yang Hu
- Center for Human Tissue and Organs Degeneration and Shenzhen Key Laboratory of Marine Biomedical Materials, Institute of Biomedicine and Biotechnology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Xiuping Wu
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
| | - Rong Hu
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
| | - Yingyu Liu
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
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Lin B, Ma J, Fang Y, Lei P, Wang L, Qu L, Wu W, Jin L, Sun D. Advances in Zebrafish for Diabetes Mellitus with Wound Model. Bioengineering (Basel) 2023; 10:bioengineering10030330. [PMID: 36978721 PMCID: PMC10044998 DOI: 10.3390/bioengineering10030330] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/01/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023] Open
Abstract
Diabetic foot ulcers cause great suffering and are costly for the healthcare system. Normal wound healing involves hemostasis, inflammation, proliferation, and remodeling. However, the negative factors associated with diabetes, such as bacterial biofilms, persistent inflammation, impaired angiogenesis, inhibited cell proliferation, and pathological scarring, greatly interfere with the smooth progress of the entire healing process. It is this impaired wound healing that leads to diabetic foot ulcers and even amputations. Therefore, drug screening is challenging due to the complexity of damaged healing mechanisms. The establishment of a scientific and reasonable animal experimental model contributes significantly to the in-depth research of diabetic wound pathology, prevention, diagnosis, and treatment. In addition to the low cost and transparency of the embryo (for imaging transgene applications), zebrafish have a discrete wound healing process for the separate study of each stage, resulting in their potential as the ideal model animal for diabetic wound healing in the future. In this review, we examine the reasons behind the delayed healing of diabetic wounds, systematically review various studies using zebrafish as a diabetic wound model by different induction methods, as well as summarize the challenges and improvement strategies which provide references for establishing a more reasonable diabetic wound zebrafish model.
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Affiliation(s)
- Bangchang Lin
- Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310000, China
| | - Jiahui Ma
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Yimeng Fang
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Pengyu Lei
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Lei Wang
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Linkai Qu
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Wei Wu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, China
- Correspondence: (W.W.); (L.J.); (D.S.)
| | - Libo Jin
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
- Wenzhou City and WenZhouOuTai Medical Laboratory Co., Ltd. Joint Doctoral Innovation Station, Wenzhou Association for Science and Technology, Wenzhou 325000, China
- Correspondence: (W.W.); (L.J.); (D.S.)
| | - Da Sun
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
- Correspondence: (W.W.); (L.J.); (D.S.)
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Barrett S, Rippon MJ, Rogers AA. [Treatment of 52 patients with a self-adhesive siliconised superabsorbent dressing: a multicentre observational study]. Khirurgiia (Mosk) 2023:59-71. [PMID: 36748871 DOI: 10.17116/hirurgia202302159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To provide 'in use' clinical data to support exudate management in patients with moderately to highly exuding wounds with bordered superabsorbent wound dressing with a silicone adhesive interface Zetuvit Plus Silicone Border (Paul Hartmann Ltd., Germany). MATERIALS AND METHODS This study was an open-labelled non-comparative study. Patients included in the study were selected by the clinical investigator(s) according to whether the patient required a dressing for the management of moderately to highly exuding wounds such as pressure ulcers, diabetic foot ulcers, venous leg ulcer and arterial ulcers The patients were treated with A superabsorbent sterile wound dressing with bordered superabsorbent wound dressing with a silicone adhesive interface Zetuvit Plus Silicone Border (Paul Hartmann Ltd., Germany). RESULTS The Zetuvit Plus Silicone Border dressing had met the clinical objectives relating to exudate management, affirmed by the health professionals with a yes response in 94% of cases. Additionally, the health professionals rated the handling of exudate as excellent/good (78%) and most (80%) reported that they would use the superabsorbent wound dressing with a silicone adhesive interface again. Allied to this was the fact that the dressing improved the wound edge and periwound skin conditions (29% and 36% of patients, respectively). The dressing retained its position in 72% of patients. For wear time, the largest proportion of dressing changes, both pre-study and during the evaluation period, was every third day (45% and 44%, respectively). But there was a shift to extended wear time with use of the superabsorbent wound dressing with a silicone adhesive interface with 72% of patients' dressing changes being every third day or longer. CONCLUSION The superabsorbent silicone border dressing was successful in managing wound exudate in moderately to highly exuding wounds and consequently this had a beneficial impact on the wound edge and periwound skin. Overall, there was a positive effect on wound bed preparation and in turn the healing response was progressive.
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Affiliation(s)
- S Barrett
- Humber NHS Foundation Trust, U, Humber NHS Foundation Trust, UK
| | - M J Rippon
- Huddersfield University, Huddersfield, UK.,Daneriver Consultancy Ltd, Holmes Chapel, UK
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Banharak S, Panpanit L, Subindee S, Narongsanoi P, Sanun-Aur P, Kulwong W, Songtin P, Khemphimai W. Prevention and Care for Incontinence-Associated Dermatitis Among Older Adults: A Systematic Review. J Multidiscip Healthc 2021; 14:2983-3004. [PMID: 34729012 PMCID: PMC8556723 DOI: 10.2147/jmdh.s329672] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/28/2021] [Indexed: 12/25/2022] Open
Abstract
Background The prevalent rate of incontinence-associated dermatitis (IAD) trends upward in older populations. Skin breakdown from IAD impacts the quality of life of older adults and reflects the quality of care in hospitals and long-term care facilities. Specific and appropriate interventions for prevention and care are needed. This systematic review aims to review optimal strategies for prevention and care for older adults with IAD. Methods PubMed, CINAHL, SCOPUS, Medline, ProQuest, ThaiLIS, ThaiJo, and E-Thesis were searched for articles published between January 2010 and December 2020. Only articles focusing on older adults were included for the review. Results Eleven articles met the inclusion/exclusion criteria. Interventions for the prevention and care of IAD among older adults were categorized as assessment, incontinence management/causative factors management, cleansing, application of medical products for both skin moisturizing and skin barrier, body positioning, nutrition promotion, health education and training, and outcome evaluation. Specific prevention and care strategies for older adults with IAD included using specific assessment tools, applying skin cleansing pH from 4.0 to 6.8, body positioning, and promoting food with high protein. Other strategies were similar to those reported for adult patients. Conclusion The systematic review extracted current and specific prevention and care strategies for IAD in older adults. The prevention and care strategies from this systematic review should be applied in clinical practice. However, more rigorous research methodology is recommended in future studies, especially in examining intervention outcomes. Nurses and other health professionals should be educated and trained to understand the causes of IAD in older adults and the specific prevention and care strategies for this population. Because older adults are prone to skin damage, and this type of skin breakdown differs from pressure ulcers, the tools for assessment and evaluation, and the strategies for prevention and care require special attention. Prospero Registration Number CRD42021251711. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/nGSwevz-SIQ
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Affiliation(s)
- Samoraphop Banharak
- Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Ladawan Panpanit
- Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Suttinan Subindee
- Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
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Soleimani H, Amini A, Abdollahifar MA, Norouzian M, Kouhkheil R, Mostafavinia A, Ghoreishi SK, Bayat S, Chien S, Bayat M. Combined effects of photobiomodulation and curcumin on mast cells and wound strength in wound healing of streptozotocin-induced diabetes in rats. Lasers Med Sci 2021; 36:375-386. [PMID: 32696423 DOI: 10.1007/s10103-020-03053-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 06/02/2020] [Indexed: 12/24/2022]
Abstract
We investigated the probable involvement of mast cell degranulation and their numbers in the remodeling step of wound healing in a diabetic ischemic skin wound model treated with photobiomodulation plus curcumin. A total of 108 adult male Wistar rats were randomized into one healthy control and five diabetic groups. Type I diabetes was inflicted in 90 of the 108 rats. After 1 month, an excisional wound was generated in each of the 108 rats. There were one healthy group (group 1) and five diabetic groups as follows: group 2 was the untreated diabetic control group and group 3 rats were treated with sesame oil. Rats in group 4 were treated with photobiomodulation (890 nm, 890 ± 10 nm, 80 Hz, 0.2 J/cm2) and those in group 5 received curcumin dissolved in sesame oil. Group 6 rats were treated with photobiomodulation and curcumin. We conducted stereological and tensiometric tests on days 4, 7, and 15 after treatment. The results indicated that photobiomodulation significantly improved wound strength in the diabetic rats and significantly decreased the total numbers of mast cells. The diabetic control group had significantly reduced tensiometric properties of the healing wounds and a significant increase in the total numbers of mast cells. Photobiomodulation significantly improved the healing process in diabetic animals and significantly decreased the total number of mast cells. The increased numbers of mast cells in the diabetic control group negatively affected tensiometric properties of the ischemic skin wound.
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Affiliation(s)
- Hasan Soleimani
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdollah Amini
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Amin Abdollahifar
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Norouzian
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Kouhkheil
- Department of Anatomical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Atarodsadat Mostafavinia
- Department of Anatomy, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | | | - Sahar Bayat
- Illinois Institute of Technology, Chicago, IL, USA
| | - Sufan Chien
- Price Institute of Surgical Research, University of Louisville, Louisville, KY, USA.
- Noveratech LLC of Louisville, Louisville, KY, USA.
| | - Mohammad Bayat
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Price Institute of Surgical Research, University of Louisville, Louisville, KY, USA.
- Noveratech LLC of Louisville, Louisville, KY, USA.
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Grden CRB, Martins AR, Cabral LPA, Reche PM, Arcaro G, Brasil D, Bordin D. Incontinence associated dermatitis in elderly people admitted to a university hospital. Rev Bras Enferm 2020; 73Suppl 3:e20190374. [PMID: 32965435 DOI: 10.1590/0034-7167-2019-0374] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 06/17/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify the frequency and factors associated to incontinence associated dermatitis in elderly people. METHODS Cross-sectional study with 202 elderly patients admitted to a university hospital between September 2017 and January 2018. Data collection included: cognitive screening, sociodemographic and clinical questionnaire. It was performed exploratory and descriptive analysis, where prevalence and ratios (PR) were calculated. RESULTS Prevalence of injury was 9.4%, age range 70-79 years (13.5%), African American (21.4%), hospitalization period ≥ 21 days (44.4%), in use of nasogastric tube (33.3%), medical device (11.3%), restricted mobility (18.5%). It was associated with hospitalization period, use of nasogastric tube, restricted mobility, medical devices, and cognition. CONCLUSION It was confirmed an average frequency of incontinence associated dermatitis in elderly patients and association to factors such as hospitalization period, immobility, cognition, use of nasogastric tube and devices. It must be highlighted the importance of prevention measures, early detection, assessment and monitoring of this type of injury.
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Affiliation(s)
| | - Alessandra Rodrigues Martins
- Universidade Estadual de Ponta Grossa, Hospital Universitário Regional dos Campos Gerais. Ponta Grossa, Paraná, Brazil
| | | | | | - Guilherme Arcaro
- Universidade Estadual de Ponta Grossa, Hospital Universitário Regional dos Campos Gerais. Ponta Grossa, Paraná, Brazil
| | - Daniele Brasil
- Universidade Estadual de Ponta Grossa, Hospital Universitário Regional dos Campos Gerais. Ponta Grossa, Paraná, Brazil
| | - Danielle Bordin
- Universidade Estadual de Ponta Grossa. Ponta Grossa, Paraná, Brazil
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Barrett S, Rippon M, Rogers AA. Treatment of 52 patients with a self-adhesive siliconised superabsorbent dressing: a multicentre observational study. J Wound Care 2020; 29:340-349. [DOI: 10.12968/jowc.2020.29.6.340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective: To provide ‘in use’ clinical data to support exudate management in patients with moderately to highly exuding wounds with bordered superabsorbent wound dressing with a silicone adhesive interface. Method: This study was an open-labelled non-comparative study. Patients included in the study were selected by the clinical investigator(s) according to whether the patient required a dressing for the management of moderately to highly exuding wounds. Results: The primary aim of this study was to evaluate the clinical objective in relation to exudate handling (moderate to high) with a superabsorbent silicone border dressing (Zetuvit Plus Silicone Border; SAP silicone border dressing; designated RespoSorb Silicone Border in some countries). The SAP border dressing had met the clinical objectives relating to exudate management, affirmed by the health professionals with a yes response in 94% of cases. Additionally, the health professionals rated the handling of exudate as excellent/good (78%) and most (80%) reported that they would use the SAP silicone border dressing again. Allied to this was the fact that the SAP silicone border dressing improved the wound edge and periwound skin conditions (29% and 36% of patients, respectively). Regarding dressing retention, the SAP silicone border dressing retained its position in 72% of patients. For wear time, the largest proportion of dressing changes, both pre-study and during the evaluation period, was every third day (45% and 44%, respectively). But there was a shift to extended wear time with use of the SAP silicone border dressing with 72% of patients' dressing changes being every third day or longer. Conclusion: The SAP silicone border dressing was successful in managing wound exudate in moderately to highly exuding wounds and consequently this had a beneficial impact on the wound edge and periwound skin. Overall, there was a positive effect on wound bed preparation and in turn the healing response was progressive. This study has shown that the SAP silicone border dressing successfully controlled exudate and provided positive benefits when used in the treatment of patients with moderately to highly exuding wounds.
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Affiliation(s)
| | - Mark Rippon
- Huddersfield University
- Daneriver Consultancy Ltd, Holmes Chapel
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