Pilonidal sinus is a benign disease that involves a sinus in the natal cleft. This condition mostly affects the young and the resulting wounds can be extremely painful and debilitating. For symptomatic pilonidal disease, treatment may involve surgical intervention such as incision and drainage. The management of pilonidal wounds can be challenging, but with a systematic approach to wound care that involves patients in their own care to help prevent infection and recurrence of this painful disorder, positive results can be achieved. Treatment should not prevent patients from returning to the normal activities of daily living (both social and work-related), and nurses should aim to achieve this as quickly as possible. Psychological care is just as essential as nursing care when managing this disease. This article provides an overview of pilonidal sinuses for community nurses as well as focusing on one dressing which is designed to cope with them, in particular, the excess exudate that can be produced (Exufiber®; Mölnlycke Health Care).
With the plethora of wound contact dressings available and the demand for their use in clinical practice, clinicians need to keep abreast of what is new on the market to ensure that they provide their patients with the best treatment options, while also considering the costs involved. Preventing pain to the patient, trauma to the wound or periwound skin, and infection, are key considerations for clinicians at dressing changes (Hollinworth, 2001). With advances in wound care technology, patients should not experience pain due to adherent products causing trauma to the wound and/or ‘skin stripping’. The use of silicone dressings can help to prevent such occurrences from happening and thus promote patient wellbeing and quality of life (Upton, 2011; Yarwood-Ross, 2013). This article looks at the role of primary wound contact layers in wound management, and introduces a new silicone dressing with case reports demonstrating its positive effects in clinical practice.
Choosing the correct dressing is often key to moving a wound along the healing trajectory, with its ability to deal with problems such as pain, excess exudate production and inflammation being crucial to the healing outcome. Infection is also a serious problem in many wounds and this article looks at the basics of wound infection as well as some of the main treatments, such as topical antimicrobials. However, clinicians are faced with a huge range of wound care products, many of which have antimicrobial properties. This article considers the use of one gelling fibrous silver dressing (Durafiber® Ag; Smith and Nephew), which is specifically designed to deal with many of the problems mentioned above, particularly excess exudate production and infection. The authors also presents the results of a small, prospective multicentre case series that was carried out to assess the efficacy of Durafiber Ag in a variety of wounds.
Community nurses often have very busy caseloads and need a wide variety of knowledge to deal with the many different clinical scenarios that they face. This is particularly true of wound care, which can present a unique set of challenges, including infection, how to control exudate and making sure that any dressing they have chosen does not actually further harm the patient by, for example, damaging the skin when it is removed. This article outlines some of the most important areas that community nurses need to understand when it comes to wound care before going on to look at the solutions provided by one particular dressing (Actilite Protect®; Advancis Medical), which is designed for use on the full range of wounds, including acute skin tears, post-surgical wounds, chronic leg ulcers, pressure ulcers, diabetic ulcers and infected wounds. As well as presenting an overview of the dressing, this article also presents a series of case studies that illustrate the benefits of the dressing in practice.
Community nurses require a wide skill set to deal with the variety of clinical presentations they meet in any given day. This includes wound care, which can present nurses with a range of management challenges, i.e. how to combat infection, which kind of dressings to use to control exudate volume and how to ensure that dressings provide patient comfort and do not further damage the wound or skin on removal. It is important, therefore, that community nurses have access to a range of versatile products that can be used in a variety of clinical situations and which are also cost-effective. This article examines some of the common wound care issues that community nurses can face, as well as looking at how a versatile wound dressing (Durafiber® Ag; Smith & Nephew) — which has a variety of applications in primary care — can help with some of these issues.
Exudate management is one of the key challenges for clinicians who have to deal with wounds. The World Union of Wound Healing Societies (WUWHS, 2007) highlighted the importance of appropriate dressing selection for exudate control and removal of excess exudate. Correct dressing selection ensures that the wound bed remains moist without becoming saturated, which in turn prevents damage and pain to the surrounding skin and reduces the risk of infection from strikethrough. This article examines the role of exudate in wound healing, and the inherent challenges in its management, both for patients and carers. The role of superabsorbent dressings is discussed and the findings of an evaluation of clinicians’ requirements and expectations of superabsorbent dressings are presented.
June Jones, JJ TVE, Tissue Viability Education, Southport, Merseyside
Jo Barraud, Tamaris Communications, Hitchin, Hertfordshire
Alexandra Nielsen examines the literature surrounding the role and management of exudate from chronic wounds.
As a part of a new series looking at wound dressings, rosie Pudner discusses the advantages and use of hydrocolloids.
Rosie Pudner, BA(Hons) RGN RCNT Dip.N.Ed. Dip. App.S.S.(Open) is a Senior Lecturer - Tissue viability, faculty of Health and Social Care Sciences, Kingston University and St.George's hospital Medical School, London.
Article accepted for publication February 2001.
In her second article, Rosie Pudner, reviews the role of alginate and hydrofibre dressings in modern wound management.
Rosie Pudner discusses the use of foam, hydrocellular and hydropolymer dressings in every day clinical practice.
Rosie Pudner BA (Hons), RGN, RCNT, DipN.Ed, Dip.App.S.S. (Open) is a Senior Lecturer - Tissue Viability, Faculty of Health and Social Care Sciences, Kingston University and St George’s Hospital Medical School, London.
Article accepted for publication
August 2001.
