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Supported by the NHS Lymphoedema Service Administrator, this article reports on a project undertaken by a clinical nurse specialist in Lymphoedema (CNS) and in part fulfilment of an MSc in Skin integrity skills and treatment, achieved from the University of Hertfordshire, September 2011. The need for the project was generated by the 5-day delay experienced by terminally ill patients in a hospice while waiting to receive treatment for lymphorrhoea from the community-based CNS. The training and assessment of healthcare assistants in a cost-effective treatment enabled the instigation of care within 3 hours of the development of lymphorrhoea in a patient and an evaluation of its competent delivery.

Debridement is a crucial component of wound management. Traditionally, several types of wound debridement techniques have been used in clinical practice such as autolytic, enzymatic, biodebridement, mechanical, conservative sharp and surgical. Various factors determine the method of choice for debridement for a particular wound such as suitability to the patient, the type of wound, its anatomical location and the extent of debridement required. Recently developed products are beginning to challenge traditional techniques that are currently used in wound bed preparation. The purpose of this review was to critically evaluate the current evidence behind the use of these newer techniques in clinical practice. There is some evidence to suggest that low frequency ultrasound therapy may improve healing rates in patients with venous ulcers and diabetic foot ulcers. Hydrosurgery debridement is quick and precise, but the current evidence is limited and further studies are underway. Debridement using a monofilament polyester fibre pad and plasma-mediated bipolar radiofrequency ablation are both very new techniques. The initial evidence is limited, and further studies are warranted to confirm their role in management of chronic wounds.

observe higher Ca2+-concentrations especially at the border between SG and SC. Higher Ca2+concentrations are found extracellular as well as intracellular. The increase of extra- and intracellular Ca2+-concentration is more pronounced in triple provoked murine skin compared to single provoked skin. However, even though the number of provocations shows a significant correlation with epidermal thickness and IgE-serum concentration, there is no significant correlation to Ca2+concentration, neither in the overall gradient, nor in the intracellular/extracellular concentrations in the stratum granulosum. This the first description of the alteration of extracellular and intracellular Ca2+-levels in an atopic eczema mimicking model.

observe higher Ca2+-concentrations especially at the border between SG and SC. Higher Ca2+concentrations are found extracellular as well as intracellular. The increase of extra- and intracellular Ca2+-concentration is more pronounced in triple provoked murine skin compared to single provoked skin. However, even though the number of provocations shows a significant correlation with epidermal thickness and IgE-serum concentration, there is no significant correlation to Ca2+concentration, neither in the overall gradient, nor in the intracellular/extracellular concentrations in the stratum granulosum. This the first description of the alteration of extracellular and intracellular Ca2+-levels in an atopic eczema mimicking model.

Negative-pressure wound therapy (NPWT) is an advantageous treatment option in wound management to promote healing and reduce the risk of complications. NPWT is mainly carried out using open-cell polyurethane (PU) foams that stimulate granulation tissue formation. However, growth of wound bed tissue into foam material, leading to disruption of newly formed tissue upon dressing removal, has been observed. Consequently, it would be of clinical interest to preserve the positive effects of open-cell PU foams while avoiding cellular ingrowth. The study presented analyzed effects of NPWT using large-pored PU foam, fine-pored PU foam, and the combination of large-pored foam with drainage film on human dermal fibroblasts grown in a collagen matrix. The results showed no difference between the dressings in stimulating cellular migration during NPWT. However, when NPWT was applied using a large-pored PU foam, the fibroblasts continued to migrate into the dressing. This led to significant breaches in the cell layers upon removal of the samples after vacuum treatment. In contrast, cell migration stopped at the collagen matrix edge when fine-pored PU foam was used, as well as with the combination of PU foam and drainage film. In conclusion, placing a drainage film between collagen matrix and the large-pored PU foam dressing reduced the ingrowth of cells into the foam significantly. Moreover, positive effects on cellular migration were not affected, and the effect of the foam on tissue surface roughness in vitro was also reduced.