Journal of Community Nursing - page 68

68 JCN
2013,Vol 27, No 4
Dressing absorption
When considering the fluid-handling
capacity of the superabsorbent
dressing, six clinicians stated that
200mls of exudate was acceptable
before the dressing was changed,
while 13 clinicians said they would
not want the capacity to go beyond
100mls (
Figure 3
).
Reason for changing a
dressing before it has reached
absorption capacity
The main reasons cited for changing
the dressing before reaching capacity
were that the dressing would become
too heavy (n=11), to check the
condition of the wound (n=9), and for
patient comfort (n=8). One clinician
mentioned strikethrough to the outer
bandage as a reason for changing the
dressing (
Figure 4
).
Concerns or issues related to
wet wounds
The most common concerns
experienced when a patient has a
very wet wound were:
Underlying cause of exudate
production (n=20)
Maceration (n=13)
Excoriation and increase in
wound dimensions (n=9)
Odour (n=10).
Infection (n=6) and patient
comfort (n=6) were also mentioned,
as well as body image (n=3) and
patient wellbeing (n=3) (
Figure 5
).
The general consensus among the
clinicians was that very wet wounds
should be seen daily.
Most common reasons for high
exudate volumes
Clinicians cited infection (n=18),
chronic oedema (n=9), and heart
problems (n=7) as the most common
reasons for high exudate volumes.
Venous disease (n=3), lymphoedema
(n=4) and concurrent health problems
(n=4) were also mentioned as causing
excess exudate.
DISCUSSION
In the authors’ opinion, managing
exudate is one of the most
challenging aspects of a specialist
nurse’s role, as the underlying cause
must also be addressed to ensure
a positive outcome. For example,
WOUND CARE
Table 2:
Superabsorbent requirements
Question
(Questions 1–4 please circle the appropriate response)
Answer
1. Using the samples as a guide, in general, how much fluid would a
10x22cm dressing absorb before you feel it should be changed?
A: 10ml
B: 50ml
C: 100ml
D: 200ml
2. What is the most common reason for changing a dressing before it
reaches full capacity?
A: Patient comfort
B: Dressing becomes too heavy
C: To check on condition
of wound
D: Other reason
3. When patients have very wet wounds, what are your main concerns?
A: Dehydration due to
fluid loss
B: Underlying cause of
excess exudate
C: Concurrent medical issue
4. When patients have very wet wounds, how often should they be seen
for observation?
A: More than once a day
B: Daily
C: Twice per week
D: Weekly
5. What is the average size of the wet wounds you are treating?
6. What are the most common reasons for high volumes of exudate?
7. What other issues do wet wounds present, e.g. odour?
Table 1:
Comparison of the most commonly used superabsorbent dressings*
Dressing Manufacturer
Cost for
10cm x
10cm†
Absorption capacity (g/g)‡
Fluid loss from
saturated dressing
(adult sitting on
dressing for 5
minutes)‡
Cutisorb
®
Ultra
BSN Medical
£2.08
Data not available
Data not available
DryMax
®
Extra
Aspen Medical
£1.84
23g
23%
Flivasorb
®
Activa Healthcare
£2.20
17.5g
22%
KerraMax
Care
®
Crawford Healthcare £1.26
23g
17%
sorbion
®
S h&r Healthcare
£2.25
30g
31%
sorbion
®
S h&r Healthcare
£2.25
30g
31%
*Data presented for 10x10cm dressings
†Drug Tariff, February 2013
‡Data on file. Crawford Healthcare (2013)
changing a dressing before
capacity of the dressing is reached
Concerns or issues related to
wet wounds
Average size of wounds currently
being treated with superabsorbent
dressings
Most common reasons given for
high exudate volumes.
RESULTS
Twenty-one experienced and
specialist clinicians, including tissue
viability nurses, vascular/leg ulcer
nurse specialists, diabetic podiatrists
and nurse specialists in plastics
completed the short questionnaire.
The clinicians in this evaluation
were managing wounds of varying
dimensions, including wounds
more than 20cms in length as well
as circumferential wounds and skin
loss on the whole of the back or
trunk (specialist plastics nurses), with
varying levels of exudate.
1...,58,59,60,61,62,63,64,65,66,67 69,70,71,72,73,74,75,76,77,78,...116