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Kleiner Ruhedruck und maximaler Arbeitsdruck sind das A und O für einen tiefenwirksamen Kompressionsverband. Dafür ausschlaggebend ist die Stiffness des Kompressionsmittels. Bisher hatte der nicht nachgiebige Zinkleimverband (Fischer-Verband) schon den höchsten Stiffness-lndex. Man konnte allerdings die Steifheit durch überwickeln mit Steifgaze (von Messpunkt B =direkt oberhalb des Knöchels bis D =zwei Querfinger unter Kniekehle) bei Bedarf noch steigern.

Steifgazebinden werden leider seit Anfang 2016 nicht mehr hergestellt. Wir haben jetzt einen Ersatz gefunden, der überraschenderweise den Mehr-Komponenten- (Zinkleim, Steifgaze) Kompressionsverband in allen Bereichen übertrifft. Bei diesem neuen Mehr-Komponentenverband wird der nicht nachgiebige Zinkleim mit einer Gipsbinde (..Stiffness-Booster") von Messpunkt B bis D überwickelt und mit einer Idealbinde nach außen abgeschlossen. Zinkleim und Gipsbinde gehen eine ideale Symbiose ein mit dem Resultat eines maximalen Stiffness-lndex. Der Wirkungsgrad des neuen Verbandes ist um etwa ein Drittel höher als beim reinen Fischer-Verband. Er wird deswegen standardmäßig in meiner Ambulanz seit einem Jahr angewendet. Die Anlagetechnik und das Verbandmaterial für diesen Drei-Komponenten-Kompressionsverband werden vorgestellt.

Introduction:

Endoscopic Negative Pressure Therapy (ENPT) presents a novel treatment option for leaks in the upper gastrointestinum. We report a first use of intraluminal ENPT for intraoperative anastomotic prophylaxis in a case of high cervical tubular esophageal resection.

Material and Method of Intraluminal ENPT:

For intraluminal ENPT open-pore drainage is constructed by suturing open-pore polyurethane foam at the tip of a drainage tube. Then the drainage is placed in the esophageal lumen by endoscopic means. Negative pressure is applied with an electronic vacuum device. Esophageal lumen is occluded and drained by suction simultaneously.

Case Report:

A 46 year old woman underwent tubular resection of the upper esophagus because of a retroesophageal schwannoma. Cervical end-to-end esophago-esophagostomy anastomosis was hand sewn just below the upper esophageal sphincter. Then open-pore polyurethane foam drainage was placed intraluminal covering the whole anastomotic region and vacuum was applied.

Results:

Prophylactic ENPT ended after three days. Perfusion was excellent, no edema, ulceration or local inflammation were seen. Because of temporary left sided vocal cord paralyses artificial ventilation went on for one week postoperative. Endoscopy confirmed normal healing without stenosis in long term follow up.

Conclusion:

This first report is a single observation of the use of ENPT for intraoperative anastomotic prophylaxis. We suppose, prophylactic intraluminal ENPT might reduce the incidence of anastomotic leaks. Further studies are needed.

Introduction

• Pressure ulcers have been on the NHS agenda for over 10 years (Porter 2015) and yet pressure ulcer occurrence continues to challenge healthcare providers (Fletcher 2015)

• As part of the East Lancashire Hospitals NHS Trusts commitment to provide “Safe Personal and Effective Care” a steering group was set up to drive pressure ulcer prevention and reduce avoidable harm

• Over the financial year the 1395 electronic incident forms were completed by clinical staff to report pressure ulcers

• The challenge we set as an organisation at the end of the previous year was to look at new pressure ulcer incident reports, check accuracy and build a picture of the numbers of pressure ulcers that had occurred under our care

Conclusion

Having a clearer picture of how many pressure ulcers we are seeing has helped when looking at resources required to manage these. Knowing where these pressure ulcers are happening has helped provide focus for education and support within the Trust and has driven collaboration with the clinical commissioning groups to support work with care homes and care agencies. Staff are more engaged when they know the discussions about prevention and the extent of the problem include more accurate numbers and that the data shows progress made. The next stage is to look at the pressure ulcers we see that didn’t occur under our care and see were these are happening and what

This poster demonstrates the novel use of Debrisoft, a monofilament fibre debridement pad consisting of 18 million polyester fibres. These are a specific angle, length and density that allow them to reach uneven areas and loosen, lift and bind into the pad necrotic tissue, hyperkeratotic skin, and adherent exudate from the wound and surrounding skin. The pad is soft, flexible and comfortable which allows for non-traumatic debridement and cleansing.