Technology update Preventing post-operative wound blisters
have contributed, at least in part, to the lack of blisters. As discussed in the published literature, dressings that are flexible and able to stretch can help reduce the tension and shear forces generated between the dressing and the skin [4, 6-7,9-11,17]
. This is especially
important if bruising and soft tissue oedema develop in the post-operative period. The test dressing incorporates a clinically proven a traumatic adhesive technology [16]
.
It is this patented soft silicone adhesive that provides a greater flexibility than dressings with other wound dressing adhesives. Termed micro-adherent, the dressing conforms to the uneven skin surface creating many contact points, generating a larger effective contact area with the skin [18]
. It is considered
to be this property that helps to reduce the mechanical shear forces between the dressing and the skin [17]
. In comparison, dressings with traditional
adhesives adhere only to the top of skin pores, and so have less skin-to-dressing contact, allowing a greater propensity for movement of the dressing, so increasing the risk of friction, which can lead to shear forces and the potential for blister formation. Prior to the introduction of the test dressing, the surgical teams at Alingsas Hospital initially used dressings with traditional adhesive for the post-operative wound care following hip and knee arthroplasty. Both an absorbent island wound dressing,
and a vapour-permeable film dressing used to retain the primary absorbent dressing, utilise acrylic adhesives. It has been reported that these traditional adhesive systems have a tendency to cause allergic-type reactions and skin damage, especially upon their removal. Studies in the literature that have reported dressing-related post-operative blisters[8]
plus
studies that set out to evaluate the ability of dressings to overcome blistering describe the
use of products containing acrylic adhesives [4-5,7,9,11-13]
. In addition, this study reports that the test
dressing was easy to use. Nurses found the application and removal of the test dressing to be easy, a key term in the characteristics of an ‘ideal dressing’ [19]
. If a dressing is easy to
apply and remove, it will generally take less nursing time to perform dressing changes with that product than it would with one that is more difficult to use and so has economic implications for health care providers. But more importantly, if a dressing is difficult to remove it is likely to cause trauma to the
120
100 80 60 40 20 0
No problems reported Problems reported Figure 6: Suture-related problems .
100 80 60 40 20 0
Healthy periwound skin Figure 7: Periwound skin blister formation.
100 80 60 40 20 0
Very good Good Satisfactory Bad Figure 8: Overall assessment of Mepilex Border as a post-operative wound dressing.
www.woundsinternational.com 32 33 Very bad Periwound skin blisters
Dressing caught on sutures
Bleeding at dressing removal
Technology and product reviews
Percentage of patients
Percentage of patients Percentage of patients
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