Case Study 1 Case Study 2 Case Study...

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  • Case-Series - Use of a Foam Adhesive Dressing* on Chronic WoundsMarie Brown-Etris, RN, CWOCN, Cathy Milne, MSN, APRN, BC, CWOCN, Darlene Saucier, APRN, FNP-BC, Lisa Van Watermulen, FNP, CWOCN William Lindroos,|| Shelley-Ann Walters, MS||

    Etris Associates, Inc., Philadelphia, PA, USA, Connecticut Clinical Nursing Associates, Bristol, CT, USA, Mankato Clinic, Mankato, MN, USA, ||3M Health Care, St. Paul, MN, USA

    Case Series SummaryBackground: Case series studies are an important element in understanding the clinical use of dressings on a variety of wounds to which they are normally exposed. In this study an adhesive foam dressing with a demonstrated high in vitro MVTR and a high in vivo fluid handling capacity was studied on a variety of wound types and in a variety of clinical settings.

    Methods: The wounds selected were low to high exuding, partial and full thickness dermal wounds that were currently being treated with a foam dressing and were expected to use the study foam dressing for four weeks. Weekly dressing changes were recommended if possible, but more frequent changes were not restricted. A total of 24 patients were enrolled into the study.

    Baseline Demographics: Facility: 29% Home Care, 33% Long-Term Care, 38% Wound

    Clinic Gender: 54% Female, 46% Male Mean age = 68.2 (19-91) Years Mean weight = 212.1 (102-596) lbs. Wound Type: 50% Pressure, 17% Venous, 29% Surgical, 4%

    Trauma Wound Location: 38% Sacrum/Coccyx/Buttock, 21% Foot/Heel,

    17% Abdomen, 17% Lower Leg/Knee, 8% Other (Flank/Spine) Wide range of wound age and pre-study foam use

    Overall Dressing Assessments: 72% of the 140 dressing applications were rated as having good or

    very good Ease of Application Of the 116 dressing changes, 76% were rated as having good or

    very good Ease of Removal 73% rated the dressing as very comfortable or comfortable 66% rated the dressing as maintaining a moist wound environment 89% of dressing changes were due to routine care, 3% due to

    leakage, 3% due to soiled dressing Wear Time: Mean (SD) = 4.8 (2.4) days (n=115 dressing

    applications) with the investigators stating that 51% of the dressings could have remained on longer, and at the end of the study they indicated that for all 24 subjects the dressing met their wear time expectations

    Baseline Wound Area and Change: Nine out of the 24 (38%) subjects had their wounds heal during the

    study Baseline wound area ranged from 0.29 cm2 to 111.6 cm2 with a

    mean of 10.92 cm2 (median 3.9 cm2); At last visit the mean area was 6.4 cm2 (median 0.17 cm2) with a mean area reduction of 70.8% (median 93.2%) and a mean absolute area reduction of 4.5 cm2 (median 2.08 cm2). The last visit occurred between 5 and 35 days of the first dressing application (mean of 22.4 days and median 23 days of test dressing use

    Patient History: 75 year old female Venous ulcer (right medial

    malleolus). Wound duration: 12-13 weeks. Prior treatment included a

    silver/foam dressing (~4 weeks),** a foam dressing (~2 weeks), and then gentle adhesive foam dressing until study enrollment (about ~5 weeks). Two-layer compression maintained throughout the pre-study and study period.

    Punch biopsy 4 weeks pre-study suggestive of stasis dermatitis.

    Patient Outcome With Test Dressing:* Wound assessed healed after 4 weeks with use of the test

    dressing* and continued compression therapy. Mild maceration at baseline but none after switching to the test

    dressing.* Mild erythema at baseline and at week 2, decreasing to none at

    week 3 and 4. Moderate exudate (serous) at baseline, decreasing to mild at weeks

    1, 2, & 3, with none present at week 4 (healed). No adverse events reported during treatment period.

    Case Study Summary:Results of this case study demonstrate utility of the test dressing* on a longstanding venous ulcer undergoing compression therapy. After switching to the test dressing,* the wound healed rapidly within 4 weeks of treatment. The clinicians involved assessed that the test dressing was better able to handle the amount of exudate produced by the wound and thus promoted better healing than the prior dressings in use. Wear time for the test dressing* averaged 7 days with no unscheduled dressing changes needed.

    Patient History: 63 year old female. Abdominal surgical wound

    with hypergranulation tissue. Wound duration: > 3 months. Treated for >4 weeks in

    nursing home. Previous foam dressing

    changed daily due to dressing edge lift.

    Patient Outcome With Test Dressing:*

    Wound improved significantly and was nearly closed after 4 weeks with use of the test dressing.*

    Mild maceration at baseline but none after switching to the test dressing.*

    Mild erythema at baseline and mild/no erythema with the test dressing.*

    Exudate (serous) rated as mild at baseline and continuing throughout the study. Exudate contained some liquefied necrotic tissue at week 1 due to silver nitrate treatment of hypergranulation tissue.

    No adverse events reported during treatment period

    Case Study Summary:Results of this case study demonstrate utility of the test dressing* on slow healing dehisced surgical wound with hypergranulation tissue. Clinicians found it difficult to keep the previous foam dressing on for more than one day due to the challenging location and exudate present. After switching to the test dressing,* the wound improvedrapidly within 4 weeks of treatment. The clinicians involved assessed that the test dressing was better able to handle the amount of exudate produced by the wound and thus promoted better healing than the prior dressings in use. Wear time for the test dressing* averaged 5.6 days which included one non-dressing related unscheduled dressing change.

    Patient History: 19 year old male. Stage III pressure ulcer

    on heel. Wound duration: > 1 year. Treated for >4 weeks in

    Home Care. Previous foam dressing

    changed daily due to dressing edge lift.

    Patient Outcome With Test Dressing:*

    Wound assessed healed after 2 weeks with use of the test dressing.*

    No periwound maceration or erythema present at anytime during the study.

    Exudate (serosanguinous) rated as mild at baseline and non present at week 2.

    No adverse events reported during treatment period.

    Case Study Summary:Results of this case study demonstrate utility of the test dressing* on a longstanding pressure ulcer. Clinicians found it difficult to keep the previous foam dressing** on for more than one day due to the challenging location of the wound. After switching to the test dressing,* the wound healed rapidly within 4 weeks of treatment. Wear time for the test dressing* averaged 7 days with no unscheduled dressing changes needed.

    Clinicians involved in this study found the test dressing* to be easy to apply and remove, highly conformable and comfortable for the patient, and able to maintain a moist wound healing environment. Mean (SD) wear time was 4.8 (2.4) days and in all cases met clinician wear time expectations. Results of this study corroborate in vitro MVTR and in vivo fluid handling studies, showing this uniquely designed dressing to have exceptional clinical performance.

    Case Study 1 Case Study 2 Case Study 3

    Conclusions

    AcknowledgementsPoster design by Lutz Consulting LLC

    This study was supported by 3M Health CareDressing Footnotes:*3M Tegaderm High Performance Foam Dressing **Mlnlycke Mepilex Ag Foam Dressing Mlnlycke Mepilex Boarder Dressing Smith & Nephew Allevyn Gentle Border Dressing Smith & Nephew Allevyn Adhesive Dressing 70-2010-8387-3