In vitro and clinical experience of Cutimed Sorbact: the evidence base

Extensive Type V Aplasia Cutis Congenita Without Fetus Papyraceus or Placental Infarction: A Rare Case

Aplasia cutis congenita (ACC) is a congenital disorder characterized by the absence of epidermis, dermis, and sometimes subcutaneous tissue and bone. There are nine types of ACC based on the number and location of the lesions as well as the presence or absence of associated deformities, with type I ACC being the most common. Type V affects the trunk with a characteristic pattern resembling the "H" letter of the alphabet, generally accompanied by fetus papyraceus (death of one of the twin fetuses) or placental infarction. Type V ACC without fetus papyraceus and placental infarction is a rare case. We reported a case of type V ACC in a 3-day-old baby girl, with clinical manifestation of extensive ulcers on the scalp, back, buttocks, and both lower extremities, in an "H"-shaped pattern, with history of placenta accreta, but no fetus papyraceus or placental infarction was found. The patient received dialkyl carbamoyl chloride hydrophobic swab with hydrogel (Sorbact^® gel dressing-BSN Medical) and hydrocolloid wound dressing with good response, as indicated by the wounds becoming dried up, leaving an atrophic scar. Complete epithelialization was achieved in 72 days. The cause of type V ACC remains not completely understood. The diagnosis of ACC can be established based on clinical manifestations. Further examination is required if extracutaneous involvement is suspected. Early identification of the etiology of the lesions and appropriate investigation and treatment, including conservative wound management, are needed so that aplastic lesions can heal successfully, although cosmetic repair may be required at a later stage.

Effizienzsteigerung und Kostenreduktion durch Straffung der Wundversorgung von chronischen Wunden in einem Klinikverbund mit 16 Kliniken

Seit Jahren gilt die feuchte Wundbehandlung als Standard in der Wundversorgung. Obwohl dieser Grundsatz allgemein akzeptiert ist, ist die Evidenz schon für dieses Dogma überschaubar. Die Industrie bietet auf diesem Grundsatz eine Vielzahl von Produkten zur Wundversorgung an, deren Überlegenheit gegenüber anderen Produkten auf evidenzbasierter Grundlage oft nicht gegeben ist.

Ziel war es, in einer Klinikgruppe das Sortiment unter hauptsächlich einkaufspolitischen Kriterien zu straffen und zu häufige, unbegründete Therapiewechsel zu vermeiden. Daraus ergab sich die Aufgabe, sich nach Möglichkeit auf wenige Hersteller zu begrenzen.

Um die Akzeptanz und die Gründe für alle Anwender im Prozess transparent zu gestalten, wurden diese über eine strukturierte Abfrage für das Thema sensibilisiert und mitgenommen. Als Ergebnis ist ein kleines, sehr straffes Kontingent in der Wundversorgung mit hoher Anwenderakzeptanz entstanden. Hierdurch lassen sich im Einkauf deutliche Kosteneinsparungen realisieren.

Modern and Classic Wound Dressing Comparison in Wound Healing, Comfort and Cost

 Introduction: Wound care has also developed rapidly after the dissemination of the concept of TIME (Tissue, Infection, Moisture, and Wound Edge) in modern dressing (MD). The aim of this study was to compare modern dressings (MDs) and classic dressings (CDs) in terms of patient comfort, cost effectiveness and wound healing.Methods: A prospective study design with total of 25 participants. The sampling technique used was consecutive sampling. Patient comfort was assessed through the frequency of wound care and pain scale using the Visual Analogue Scale (VAS). Cost-effectiveness was assessed using direct and indirect costs. Wound healing was assessed using the Bates-Jensen Wound Assessment Tool (BWAT) score. The data was analyzed using the independent t and Mann-Whitney tests.Results: In terms of comfort, the mean for the number of times that wound care was performed and the pain scale in the participants using MD was (3.07 ± 0.88 times and VAS 4.59  ± 0.72, respectively), which is less compared to using CD (4.60  ±  1.84 times each and VAS 5.43  ± 0.75). Referring to the indirect and direct costs, MD (13.67  ± 6.09 and 527.63  ± 84.47, respectively) has the same cost-effectiveness as CD (14.00  ± 7.64 and 482.68 ± 98.08, respectively). In terms of healing, the mean of the BWAT score in MD (31.26  ± 1.69) was better compared to CD (33.07  ± 1.65).Conclusion: The application of MD has the same cost-effectiveness as CD with a more satisfactory outcome for the wounds in terms of comfort and healing.