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    1. Poster

      REDUCED TISSUE FIBROSIS WITH ADDITION OF TEXTURED COMPRESSION GARMENTS TO EDEMA MANAGEMENT PROGRAM

      Poster presented at WUWHS 2022 01.03.2022 Abu Dhabi, UAE
      Downloads Citation (RIS)
      Further versions
    2. Poster

      Rapid wound debridement: Clinical outcomes and clinician satisfaction after up to 2 applications of monofilament fibre debridement technology*

      Poster presented at WUWHS 2022 01.03.2022 Abu Dhabi, UAE
      Products Debrisoft Pad
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    3. Poster

      THE USE OF NIGHT TIME GARMENTS FOR CHRONIC EDEMA MANAGEMENT IMPACTS PATIENTS' QUALITY OF LIFE AND EDEMA MANAGEMENT

      Poster presented at WUWHS 2022 01.03.2022 Abu Dhabi, UAE
      Further versions
    4. Poster

      Providing Compression Options: The Key to Better Compliance and Concordance

      Poster presented at ALA Virtual Conference 2020 28.05.2020 Hobart, Australia

      Aim:

      Compression remains the gold standard for long-term management of chronic edema. Reviews have shown that the benefits of compression diminish according to levels of non-adherence. Reasons commonly stated for nonadherence to compression include inconvenience, heat, cost, and pain. We hypothesize that offering compression options will have positive impact on patients’ compliance and concordance to compression regimens.

       

      Method:

      Observational study performed at 2 different edema management clinics. Ten patients presenting with lower extremity swelling and history of non-compliance with previous compression regiments were observed. Objective data measured included limb volume, range of motion (ROM), functional activity status using the Timed Up and Go(TUG), and assessment of quality of life (QOL) using the Lymphoedema QOL Tool (LYMQOL-LEG). Measurements were taken at four different intervals over a minimum of 3 months. Compression options were individualized to patient's physical presentation and lifestyle for long term management of their edema.

       

      Results / Discussion:

      Compression therapy had a positive impact on all outcomes measured during the intensive phase of therapy. Follow-up outside the intensive phase of therapy demonstrated further volume loss in 6/10 subjects; Volume remained constant 3/10, increased slightly 1/10. LYMQOL scores and functional performance level maintained stable during the follow-up period.

       

      Conclusion:

      Offering multiple compression options including custom and ready-to-wear flat knit stockings*, an adjustable wrap ** and nighttime compression options*** had a positive impact on patients’ adherence to compression regimens during the study period compared to single compression modalities offered previously. Individualizing the compression regimen to each patient’s lifestyle improved their adherence to chronic edema management.

      Further versions
    5. Poster

      When you have End Stage Heart Failure, 85, your legs leak and you’ve had previous ulcers…. Help!‘

      Poster presented at Wounds UK 2019 04.11.2019 Harrogate, UK
    6. Poster

      Combining different compression approaches to achieve quality of life

      Poster presented at EWMA 2018 09.05.2018 Krakow, Poland

      Aim:

      Improving Quality of life should be paramount to every patient’s care-pathway. Many quantitative tools are available but rarely capture the individuals true goal. Individual goal setting however difficult to achieve, should always be considered. A selection of compression devices available and applied in a novel way were adapted to improve one lady’s quality of life and achieve her goal.

       

      Method:

      A 48-year-old lady with unilateral lymphoedema of her left leg, secondary to surgery for endometriosis was referred for Decongestive Lymphoedema Treatment (DLT). DLT consisted of compression bandaging using a foam roll and cohesive inelastic bandages* and lymphatic drainage using a hand-held negative pressure device**, for 6 sessions over 10 days. Following DLT a class IV flat-knit compression stocking was fitted with a below-knee velcro wrap system over the top of the stocking to prevent ‘rebound’ oedema. Individual aims were set by the patient – to ride her horse again.

       

      Results / Discussion:

      Limb volumes reduced following DLT and maintained with monthly lymph drainage, compression stocking and velcro wrap system. Sub-bandage pressures were measured to indicate pressure and stiffness of combined treatment.

       

      Conclusion:

      Combining existing products available on the market to achieve known pressures from scientific research has resulted in preventing rebound oedema post DLT. Most importantly the patient’s individual goals were achieved and she can ride her horse again. This is possible by understanding the tissue density, material properties and the combined prescription of compression used, without causing physical and functional restriction.

    7. Poster

      Pain · Anxiety · Inflammation · Non-healing

      Poster presented at SAWC Spring 2018 25.04.2018 Charlotte, USA
    8. Poster

      MEASURING THE IMPACT OF EDEMA MANAGEMENT - MORE THAN JUST A VOLUME REDUCTION

      Poster presented at EWMA 2018 09.05.2018 Krakow, Poland

      Aim:

      Chronic edema of the lower leg has a negative impact on functional performance. Chronic edema impairs foot wear use and normal gait patterns, impairs calf muscle pump and most importantly limits the patient’s ability to interact with his/her environment. This negative spiral of progressive edema and progressive decline in functional status can be

      reversed simply by addressing the edema.

       

      Method:

      Observational study performed at 2 separate outpatient edema management clinics. Eight patients were referred for lower extremity edema management to a physical therapist. Objective data measured including limb volume, ankle range of motion (ROM), functional activity status utilizing the Timed Up and Go (TUG) and the 4 meter walk test (4MWT), and assessment of quality of life (QOL) via the Lymphoedema QOL tool (LYMQOLLeg). Measurements were taken at initial evaluation, upon completion of treatment, and 2 weeks post treatment. Patients received compression therapies* and instruction in home exercise program only. Gait training was performed during the sessions for safety with assistive device when appropriate.

       

      Results / Discussion:

      Reduction of swelling had a direct positive impact on all outcomes measured. LYMQOL-Leg scores and functional performance scores (TUG and 4MWT) improved by 15% and 0.1m/sec respectively. Functional performance continued to improve after active therapy had been discontinued with further increased TUG scores at the 2-week follow-up assessment. The reduced edema allowed for normal footwear use, normalized gait patterns which increased mobility and enhanced QOL.

       

      Conclusion:

      Management of lower extremity edema has a positive impact on both patient’s functional status and QOL.

    9. Poster

      Supporting self-management of fragile elderly patients with oedema and a venous leg ulcer using a short-strech wrap-on compression device

      Poster presented at EWMA 2018 09.05.2018 Krakow, Poland

      Aim:

      In The Netherlands health-insurance companies aim to reduce costs for complex wound and oedema treatment. For this purpose an adjustable short-stretch compression device (ACD) may be used [1,2]. Some of the available long-stretch systems have caused skin damage [1]. The objective of this care series was to stimulate self-management of fragile elderly patients with oedema and/or a venous leg ulcer using an easy and safe to apply short-stretch wrap-on compression1 device, which was selected for patients in our region [1,2].

       

      Method:

      Twenty out-patients with oedema and a venous leg ulcer received the ACD1 and were followed during the treatment and maintenance phase. Scabs and sloughy tissue were removed using a monofilament debridement pad2 after which the ulcer was covered with a superabsorbent pad3. Those with fragile skin conditions, prone to skin lesions received a “silk”stocking4 applied under the ACD1 which provided an additional 10 mmHg and skin protection.

       

      Results:

      Many patients requiring compression treatment are elderly and fragile. Self-management is often not an option. When using traditional compression bandages correct application and an optimal pressure level is not always achieved. The 20 patients treated with ACD1 achieved ulcer closure and oedema reduction in a comfortable fashion, stimulating self-management. Within 2 weeks often more than 3 cm ankle circumference reduction was achieved. It was easy to select the correct size and colour coding enabled a correct overlap upon application. From 2015 onwards, since education on compression was put in place for physicians and nurses throughout the care-chain in our region, the number of adverse events has reduced and quality of care has improved.

       

      Conclusion:

      It is important to select a suitable and effective compression system for especially frail elderly patients. Although the general practitioners (GP) take time to getting used to ACD1, collaboration with leg measurement sites and training GPs may enable choosing and applying suitable compression. The tested ACD1 enabled effective and safe compression. Complete ulcer closure was achieved in a comfortable fashion that suited the individual needs of the patients.

    10. Poster

      Guidelines, assessment, appropriate referrals and treatment can improve patient outcome

      Poster presented at EWMA 2018 09.05.2018 Krakow, Poland