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Wound digest Wound digest

This digest summarises recent key papers published in the areas of pressure ulcers, skin integrity, venous leg ulcers and diabetic foot ulcers.

SELECTED PAPERS OF INTEREST 1. Dressing comparison for paediatric burn wounds 2. Venous leg ulcer treatment guidelines and the need for a consensus document 3. Pressure-relieving support surfaces: a review of the evidence 4. National diabetic foot care strategy in Scotland 5. Developing and validating a risk score for amputation

To compile the digest a Medline search was performed for the three months ending in October 2011 using the search terms ‘pressure ulcers’, ‘skin integrity,’ ‘leg ulcers’ and ‘diabetic foot ulcers’. Papers have been chosen on the basis of their potential interest to practitioners involved in day-to-day wound care. The papers were rated according to readability, applicability to daily practice, and novelty factor.

Skin integrity 1

Dressing comparison for paediatric burn wounds

Readability Relevance to daily practice Novelty factor

n This single-blind randomised controlled pilot study compared the performance of a silicone net dressing (Mepitel®, Mölnlycke Health Care) with a monofilament polyamide woven dressing (SurfaSoft®, Inn Med).

n The study group was recruited from paediatric patients (aged one–15 years) who required acute or reconstructive procedures for burn wounds and who were being treated with the epithelial cell suspension ReCell® (Avita Medical).

n All donor sites were treated with ReCell and covered with either Mepitel (n=5 — although eight people were initially recruited) or SurfaSoft (n=7). Measurements of the rate of epithelialisation and epidermal maturation, pain levels, and ease of dressing removal were recorded every two days until the wound healed.

n Results showed that there was no difference in the rate of epidermal maturation between the two groups. Less pain and force to remove the dressing was shown in the Mepitel group when compared with SurfaSoft. The rate of epithelialisation was found to be an unreliable measure.

n The authors concluded that further research was necessary and that study design could be informed by the results of this pilot study.

Campanella SD, Rapley P, Ramelet AS. A randomised controlled pilot study comparing Mepitel® and SurfaSoft® on paediatric donor sites treated with ReCell®.Burns 2011; 37: 1334–42.

Leg ulcers 2

Venous leg ulcer treatment guidelines and the need for a consensus document

Readability Relevance to daily practice Novelty factor

n This article was based on an analysis of 14 treatment guidelines for venous leg ulcers from a range of countries found using a thorough Internet search.

n The authors collected information from the recommendations under the following headings: diagnosis, treatment, compression, adjunctive measures and prevention. They also discussed areas of both concordance and disagreement.

n Ankle/brachial index and venous duplex were recommended in 100% and 64%, respectively, of the guidelines. All guidelines recommended wound 30

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