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Onze teams van Onderzoek en Ontwikkeling zijn wereldwijd werkzaam, en creëren synergieën met onze deskundigheid en verwante vakdisciplines. Wij wisselen internationaal veel van gedachten met onafhankelijke, gespecialiseerde instituten, belangrijke opinieleiders en kennisverspreiders om zo samenwerkings- en kennismanagement op het hoogste niveau te kunnen garanderen. In het kader daarvan voeren wij grote studies uit die voortdurend op congressen in de vorm van posters of lezingen van onze partners, op symposia en in workshops worden gepresenteerd, en ook in befaamde wetenschappelijke tijdschriften worden gepubliceerd. De voor het grootste deel door onafhankelijke deskundigen beoordeelde, op bewijs gebaseerde vakpublicaties stellen wij u graag in deze databank ter beschikking:

  1. Poster

    Anwendung eines antimikrobiellen Wundverbandes aus Cellulose bei infizierten Unterschenkelulcera: 2 Fallstudien

    Poster presented at DEWU 2021 (Online) 05.05.2021 Virtual Conference, Germany

    Einleitung:

    Die Behandlung von infizierten chronischen Wunden stellt im klinischen Alltag eine Herausforderung dar. Bei der antiseptischen Behandlung dieser Wunden ist Polihexanid (PHMB) das Antiseptikum der Wahl [1]. Vorgestellt werden zwei Fallstudien an infizierten chronischen Unterschenkelulcera. Die antiseptische Behandlung erfolgte mit einem PHMB haltigen antimikrobiellen Wundverband aus Cellulose.

     

    Methoden:

    Patient 1: Ein 80 Jahre alter männlicher Patient mit Ulcus cruris mixtum zirkulär am rechten Unterschenkel (Wundfläche: 450 cm², Wundtiefe: 1 cm). Bei Übernahme des Patienten bestand eine massive Infektion des gesamten Unterschenkel mit starker Exsudation und Geruchsbildung. Wundschmerz und Schmerzen am gesamten Unterschenkel von 8 auf der Visuellen Analogskala (VAS). Ödematöse Schwellung des gesamten rechten Unterschenkels sowie papulöse Verhärtungen m Bereich des rechten Vorfußes. Wundgrund mit Biofilm und stellenweise Fibrin belegt. Wundränder und Umgebungshaut gerötet. Einzelne Läsionen vorhanden. Hygiene des Patienten war mangelhaft.

     

    Patient 2: Ein 27 Jahre alter männlicher Patient mit seid 11 Monaten bestehendem infizierten Ulcus cruris venosum am rechten Unterschenkel (Wundfläche: 315 cm², Wundtiefe: 0,1 cm). Moderate Exsudation, Geruchsbildung und Wundschmerz von VAS = 7 vorhanden. Kürzlich trat eine tiefe Venenthrombose auf. Zudem leidet der Patient unter Drogensucht (intravenös), Alkoholsucht und einer psychischen Störung.

     

    Ergebnisse:

    Bei beiden Patienten konnte eine signifikante Verbesserung erreicht werden. Die Infektion wurde in beiden Fällen beseitigt. Entsprechend nahmen in beiden Fällen Wundschmerz und Geruchsbildung ab bzw. verschwanden ganz. Wundheilung wurde eingeleitet.

     

    Diskussion:

    Der antimikrobielle Wundverband erwieß sich als geeignete Wundauflage zur Behandlung von chronisch infizierten Wunden.

  2. Poster

    Treatment of hard to heal DFU with monofilament debridement lolly and hydrobalance dressing

    Poster presented at Wounds Australia National Conference 2021 04.05.2021 Virtual Conference, Australia

    Situation

    Intellectually disabled 54 year old man with diabetes, obesity and hypertension. The patient has peripheral neuropathy of feet and developed a diabetic foot ulcer. Surgical debridement was performed in OR and wound was initially treated with impregnated gauze ribbon changed twice daily and cleaned with PHMB solution.

     

    Action(s) taken/ treatment provided

    A review of treatment regime and dressings was conducted at 5 weeks post-operation due to deterioration of wound, odour and possibility of future amputation of foot. New treatment plan included cleansing and debridement with and monofilament fibre pad and use of biocellulose hydrobalance dressing dipped in PHMB solution to improve rate of healing.

     

    Outcome(s)

    After 9 days, wound was granulating with reduced level of exudate and odour. Total cost of dressings over 9 days of treatment was $114.51. Patient was able to be transferred to a rehabilitation facility and avoided amputation.

     

    Lesson(s) learned

    After 5 weeks using a wound dressing regime including gauze and time consuming twice-daily dressing changes, the wound had deteriorated, rather than progressed towards healing. The change of dressing plan resulted in granulation and wound progression in just 9 days. Dressings were cost effective and saved time as did not need to be changed so regularly.

  3. Poster

    Reusable short stretch compression for the treatment of a recurring VLU

    Poster presented at Wounds Australia National Conference 2021 04.05.2021 Virtual Conference, Australia

    Situation

    Patient is a 73 year old lady who has been suffering with venous leg ulcers since 2016. On presentation, she had leg ulcers measuring more than 50cm2 which were very painful with high levels of exudate.

     

    Action(s) taken/ treatment provided

    Compression therapy was initially commenced with a long stretch compression bandage. This was changed to a 2 layer resuable short stretch system due to ease of use and patient comfort. This was a cost effective option as patient was able to wash, re-roll and reuse the bandages throughout her treatment from September 2019 to February 2020. The bandages were skin friendly and comfortable for the patient who is prone to dermatitis. The wounds were managed with alternate combinations of ionic gel dressing for pain relief, cadexomer iodine, antimicrobial dressings and biocellulose hydrobalance dressings.

     

    Outcome(s)

    In the first 4 weeks, the ulcers had reduced in size by 50% and after 6 months of treatment the wounds had fully closed.

     

    Lesson(s) learned

    In the absence of corrective surgery, compression therapy has been found to be the most effective treatment for venous leg ulcers (VLUs)1. Achieving healing rests on patients’ adherence to treatment and in this case it was found that compression bandages which are both cost effective and comfortable for the patient are more likely to encourage patient concordance. Compression therapy alongside effective wound care resulted in full healing for this patient after 4 years of suffering with venous leg ulcers.

  4. Poster

    Just in the Nick of T.I.M.E.S.: The importance of debridement for wound assessment

    Poster presented at Wounds Australia National Conference 2021 04.05.2021 Virtual Conference, Australia

    Situation

    Patient presented with a traumatic injury to left hand sustained while sailing. The wound was 3 weeks old and covered in hardened necrotic tissue.

     

    Action(s) taken/ treatment provided

    Upon advice from clinician, patient covered wound in plastic wrap overnight to soften and visited hospital the following morning. A monofilament fibre debridement lolly was used to mechanically debride outer necrotic eschar. An ionic hydrogel dressing was then applied for further autolytic debridement and deeper wound assessment. The dressing was removed after 24 hours and mechanically debrided again with monofilament fibre debridement lolly. After full wound assessment, decision was made to intervene surgically and patient received a skin graft within 24 hours.

     

    Outcome(s)

    After 3 months, the skin graft had healed and patient regained full use and movement of his hand.

     

    Lesson(s) learned

    The combination of mechanical and autolytic debridement using two simple, easy to use, community based products allowed for full assessment of the wound bed. The treating clinician was able to assess, dress, reassess and refer, resulting in a fast decision to send the patient for surgical intervention and improved overall clinical outcome.

  5. Poster

    Compression therapy using reusable short stretch bandaging for treatment of VLU

    Poster presented at Wounds Australia National Conference 2021 04.05.2021 Virtual Conference, Australia

    Situation

    Patient presented with bi-lateral leg ulceration and was being treated daily by a GP. Wounds had been present for the past 133 weeks and compression therapy was not part of the treatment regime.

     

    Action(s) taken/treatment provided

    Upon referral to the Nurse Navigator service at Princess Alexandra Hospital, routine vascular tests were carried out and he was deemed suitable for light compression therapy in addition to a wound care treatment plan, including wound bed preparation with monofilament fibre debridement pad. Compression bandaging is the gold standard treatment for those suffering from venous ulceration. The short-stretch bandage of choice delivers safe, light compression and is washable to help reduce the costs of ongoing treatment.

     

    Outcome(s)

    Wound healing progress was slow but consistent with the use of short stretch compression and the wound care treatment plan. Patient was adherent to care and found compression bandage to be comfortable, affordable, helped to reduce pain and improve quality of life. Leg ulcers fully healed after 32 weeks of treatment.

     

    Lesson(s) learned

    The Nurse Navigator supported patient care at GP practice to enable collaboration and education of those involved in ongoing care. This ensured a holistic approach to care allowing for systems improvement, patient centred care, improving patient outcomes and most importantly creating partnership between the GP practice and hospital.

  6. Poster

    Use of monofilament fibre debridement pad for hyperkeratosis in the community

    Poster presented at Wounds Australia National Conference 2021 04.05.2021 Virtual Conference, Australia

    Situation

    44 year old man with chronic history of gout in many joints. The patient had surgical intervention on right big toe due to infection of joint, pain and bone osteomyelitis.

    At 2 week post-surgery, the patient experienced delayed healing, pain and odour from the wound. On presentation, the wound had heavy thick slough, undermining of edges and slight hypergranulation at base of wound.

     

    Action(s) taken/treatment(s) provided

    Monofilament fibre lolly was used to clean wound bed, disrupt and remove biofilm and slough. Second generation hydrogel dressing then applied to wound bed for autolytic debridement and softening of slough. Pain relief was instant and patient no longer required oral pain medication. Biocellulose hydrobalance dressing was also applied at day 4 to improve and speed up epithelialisation process.

     

    Outcome(s)

    Patient and clinician happy with progress in first 7 days. The treatment and dressings reduced pain and allowed the patient to walk and wear his own shoes. Wound was fully healed after 26 days.

     

    Lesson(s) learned

    The use of monofilament fibre lolly combined with additional autolytic debridement with second generation ionic hydrogel dressing helped to prepare the wound bed and removed slough, debris and other barriers to healing. Further treatment with hydrogel dressing and hydrobalance dressing helped to create optimal conditions for wound healing.

    Products Debrisoft Pad
  7. Poster

    Combining nursing and podiatry for successful outcomes in a community setting

    Poster presented at Wounds Australia National Conference 2021 04.05.2021 Virtual Conference, Australia

    Situation

    76 year old lady with systemic pneumococcal infection was in ICU for 6 weeks and now being treated in community nursing and podiatry care. 9 toes were affected with necrosis.

     

    Action(s) taken/ treatment provided

    Patient had black, hard necrotic toes which required debridement of tips, nail beds and removal of exposed dead bones. Toes are difficult to dress and required moisture for autolytic debridement. Patient also required a solution which will relieve pain.

    It was decided that a combined treatment of community nursing and podiatry would deliver the best outcome for this patient.

    • Podiatry: Sharp debridement, removal of nails and removal of protruding dead bony toe phalanges

    • Community nursing: Debridement with monofilament fibre pad (in combination with sharp debridement) and dressings for autolytic debridement and pain relief.

     

    Outcome(s)

    After 2 weeks of treatment on the left foot, black necrotic tissue has been softened to allow for further debridement. After 4 weeks of treatment, big toe almost healed and small amount of nail bed regrowth.

    After 2 weeks of treatment on the right foot, evidence of granulation and epithelialisation of toes and nail bed areas.

     

    Lesson(s) learned

    Working as a multi-disciplinary team alongside allied health is vital for the healing process and can help to achieve the best possible clinical and patient outcomes, particularly for complex wounds.

  8. Poster

    Treatment of post-surgical toe wound with monofilament fibre pad and second generation ionic hydrogel dressing

    Poster presented at Wounds Australia National Conference 2021 04.05.2021 Virtual Conference, Australia

    Situation

    44 year old man with chronic history of gout in many joints. The patient had surgical intervention on right big toe due to infection of joint, pain and bone osteomyelitis.

    At 2 week post-surgery, the patient experienced delayed healing, pain and odour from the wound. On presentation, the wound had heavy thick slough, undermining of edges and slight hypergranulation at base of wound.

     

    Action(s) taken/treatment(s) provided

    Monofilament fibre lolly was used to clean wound bed, disrupt and remove biofilm and slough. Second generation hydrogel dressing then applied to wound bed for autolytic debridement and softening of slough. Pain relief was instant and patient no longer required oral pain medication. Biocellulose hydrobalance dressing was also applied at day 4 to improve and speed up epithelialisation process.

     

    Outcome(s)

    Patient and clinician happy with progress in first 7 days. The treatment and dressings reduced pain and allowed the patient to walk and wear his own shoes. Wound was fully healed after 26 days.

     

    Lesson(s) learned

    The use of monofilament fibre lolly combined with additional autolytic debridement with second generation ionic hydrogel dressing helped to prepare the wound bed and removed slough, debris and other barriers to healing. Further treatment with hydrogel dressing and hydrobalance dressing helped to create optimal conditions for wound healing.

  9. Poster

    First experience with new second generation ionic gel dressing: A spider bite gone wrong

    Poster presented at Wounds Australia National Conference 2021 04.05.2021 Virtual Conference, Australia

    Situation

    Patient presented to Hospital in the Home with large wound on the right leg which was suspected to have been caused by a spider bite. The patient was suffering from extreme pain, swelling and blistering.

     

    Action(s) taken/ treatment provided

    Wound needed debridement in the clinic to remove necrotic tissue and hardened slough. Due to the wound size and complexity, a combination of debridement methods were chosen, including mechanical with monofilament fibre pad, sharp and autolytic with ionic gel dressing. After full debridement was achieved, the wound bed was able to be thoroughly assessed and wound care plan put in place. Dressing regime included ongoing use of monofilament fibre pad for mechanical debridement and wound bed preparation and gel dressing for pain relief and dynamic fluid management.

     

    Outcome(s)

    The dressings were well tolerated and comfortable for the patient. Over the 4 months of treatment, the wound progressed towards healing and no surgical/specialist intervention or lengthy hospital stay was required.

     

    Lesson(s) learned

    Wounds with this level of complexity are often not expected to be treated in community settings. With introduction of new products onto the hospital formulary due to a new contract, new technologies were able to be used by the community nurse with successful patient outcomes. The products selected were cost effective, easy to use and reduced the need for antimicrobial dressings. Moving forward, products such as the new second generation ionic gel dressing can be used effectively in the community, reducing the need for specialist intervention.

  10. Journal article

    Effect of Negative Pressure Therapy on Open Abdomen Treatments. Prospective Randomized Study With Two Commercial Negative Pressure Systems

    Frontiers in Surgary 2021 7 596056

    The use of negative pressure dressings for open abdominal therapy has made a great impact on strategies for open abdominal treatment. Observed intestinal damage and developement of fistula formation raises questions about safety of commonly used systems (AB-Thera). The most common used system uses foils for shielding intestines directly from negative pressure. As an alternative a system with open pore dressing in double layer film was introduced (Suprasorb CNP) and proved to safe in animal studies. We compared the effects of this two systems on patients requiring open abdominal treatment.Materials and methods: Patients with secondary peritonitis in at least two abdominal quadrants were included in this randomized study. Inclusion criteria were secondary peritonitis (ACS), abdominal compartment syndrome, and abdominal trauma combined with ACS and/or contaminated abdomen. Patients with active bleeding and pancreatitis were not included. We examined Mannheim peritonitis Index (MPI), bloodcount, PCT, amount of fluid collected, and morphological changes on the bowel. Data were collected on day 2, 4, 7, 14, 21, and 28. Primary end point was fascial closure. Examination was terminated in case of death and damage to the abdominal organs. Groups were compared using Mann Whitney U-test and chi square test. Trend evaluation was evaluated using an one way repeated measure analysis of variance. P-values below 0.05 was

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