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Case Study 1 Case Study 2 Case Study 3 · Case Study 1 Case Study 2 Case Study 3 Conclusions...

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Case-Series - Use of a Foam Adhesive Dressing* on Chronic Wounds Marie 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 Summary Background: 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 cm 2 to 111.6 cm 2 with a mean of 10.92 cm 2 (median 3.9 cm 2 ); At last visit the mean area was 6.4 cm 2 (median 0.17 cm 2 ) with a mean area reduction of 70.8% (median 93.2%) and a mean absolute area reduction of 4.5 cm2 (median 2.08 cm 2 ). 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 improved 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 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 Acknowledgements Poster design by Lutz Consulting LLC is study was supported by 3M Health Care Dressing Footnotes: *3M™ Tegaderm™ High Performance Foam Dressing **Mölnlycke Mepilex® Ag Foam Dressing †† Mölnlycke Mepilex® Boarder Dressing ‡‡ Smith & Nephew Allevyn™ Gentle Border Dressing §§ Smith & Nephew Allevyn™ Adhesive Dressing 70-2010-8387-3
Transcript
Page 1: Case Study 1 Case Study 2 Case Study 3 · Case Study 1 Case Study 2 Case Study 3 Conclusions Acknowledgements Poster design by Lutz Consulting LLC This study was supported by …

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 **Mölnlycke Mepilex® Ag Foam Dressing ††Mölnlycke Mepilex® Boarder Dressing ‡‡Smith & Nephew Allevyn™ Gentle Border Dressing §§Smith & Nephew Allevyn™ Adhesive Dressing 70-2010-8387-3

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