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Aim:

Time constraints and reimbursement for managing patients with chronic lymphedema present challenges for healthcare professionals. The case series demonstrates how a debridement device and a Velcro compression wrap were used to implement self-care as a solution.

Method:

20 patients with primary and secondary lymphedema were enrolled into the study. Following assessment of the patient’s condition and ability to understand and apply the treatment, each patient was educated and trained how to:

1. Use the monofilament fibre debridement pad for skin and wound preparation.

2. Apply the Velcro compression wrap system for treatment and maintenance.

3. Perform correct application and to record clinical improvements.

Time for each treatment episode, frequency of visits and overall treatment time were measured

Results / Discussion:

The number of treatment episodes reduced from 3 to 2 per week. The time for each episode reduced on average from 1 hour to 30 minutes. Improvements in the condition of each patient showed improvement in mobility, less independency, and leads to more time left for the patients. Additionally patients were able to participate in their care, giving them control.

Conclusion:

The use of simple solutions for self-care such as those used in this study could provide solutions to benefit the patient and healthcare professionals. Reductions in treatment times and the use of patients instead of a more costly therapist could equate to cost savings for the organisation.

Aim:

At present many care professionals are under pressure for time. Therefore there is a need to avoid delays in wound treatment due to mismanagement or incorrect treatment of the wound. Correct assessment and diagnosis should be the starting point for follow on management to implement good patient care and cost efficient wound treatment. Good debridement enables visualisation and assessment.

Method:

In this centre more than 200 patients have been treated according to the same protocol, all starting with wound debridement using a monofilament fibre debridement pad for acute and chronic wounds. Most of the patients had chronic wounds of varying duration, severity and causes. The case studies follow 4 patients with ulcer to show the wound status before and immediately after debridement. Photographs were taken.

Results / Discussion:

Photographic evidence was a very easy way of documenting outcomes when the debridement pad had removed devitalised tissue and the skin and wound were revealed. In all patients the average number of pads were 2 and the average time for debridement was 2 – 4 minutes per episode. Some patients required additional treatment episodes depending on the condition. Appropriate treatment regimens were implemented as a result of good assessment.

Conclusion:

Even wounds that appear non-complex often require debridement to aid diagnosis. The use of a very easy method which can be performed by all care professionals helps to simplify wound treatment and save time.

Aim:

Traumatic implantation of pigmented particles in the skin require removal as quickly as possible to prevent deeper penetration and persisting skin tattoo. We present the case of a patient with accidental contamination during his work as a channel digger. A cushions were inflated under pressure. the cushion burst when the patient was just 1-2 metres away. Water and mud exploded within the channel and covered the face and hands of the patient. Dirt particles penetrated the skin, eyes and cornea.

Method:

The particles in the eyes and cornea were removed surgically and a systemic antibiotic therapy was started. Laboratory examination revealed a C-reactive protein of 49.3 mg/l (normal: <5 mg/l). Cheeks and periocular region showed remarkable oedema. After a rehydration of the skin with aliphatic ointments (0.4 mg/ml Polihexanid in Unguentum leniens) under semi-occlusive dressing over 4 hours, a mechanical debridement with a monofilament fibre debridement pad* was performed.

Results:

Almost all particles could be eliminated leaving superficial skin lesions - pain-free. Antiseptic ointment (Clioquinol 5 mg/g) was recommended for the further skin treatment. The systemic antibiotic therapy was also continued. A follow-up two days after the debridement showed a decrease of oedema and inflammation and a skin totally cleared from dirt particles.

Conclusion:

The immediate comparison with the use of moistened compresses showed a clear predominance of the monofilament pad in the efficiency of particle removal. Usual treatments with scalpel blade or dermabrasion are time-consuming and painful for the patients. By the use of a monofilament fibre debridement pad in an early stage of traumatic tattoo, a very satisfying cosmetic result could be achieved.

For the management of wounds with no or low levels of exudate wound contact layers may be used. When combined with an absorbent dressing these dressings are also appropriate for use in moderate to highly exuding wounds. A wound contact layer that contains hydrocolloid particles and petroleum jelly coated onto a mesh was evaluated and compared to itself in a blinded-user test. Each dressing was split into two parts and then marked with four different colour tags. Usability (packaging, application, aseptic handling of the dressing, ease of dressing removal, conformability, flexibility, possibility to cut to size, adherence to the wound bed) and user acceptance (haptic, optic, easy to use) scored very good/good. There was no difference noted between the products tested. Although the features of the dressing that were evaluated were clinically relevant, the results need to be confirmed in actual wound management.