Here - EWMA 2013

POSTER: LEG ULCER
Poster: Leg Ulcer
P 319
Prevention and Management of Hyperkeratosis
Helen Crook 1 , Evelyn Frowen 1 , Kirsty Mahoney 1 , Trudy Young 2
1 Cardiff and Vale UHB (Cardiff, United Kingdom);
2 Aneurin Bevan Health Board (Newport, United Kingdom).
Aim: Hyperkeratosis is an increased thickening of the stratum corneum resulting in
thickened, scaly skin. The dry skin can be itchy, painful and produce a generalised
feeling of discomfort. Hyperkeratosis can have an accompanying distinct odour, due to
the bacterial colonisation within the scaling skin (Day and Hayes 2008, Jakeman 2012).
This condition is often associated with chronic leg ulceration. Hyperkeratosis can
become severe making treatment difficult. If not managed appropriately it can have a
significant impact on individual’s well-being.
Methods: There are no specific national guidelines for the management of
Hyperkeratosis and it is not included in the National Guidance for the prevention and
management of venous leg ulcers (Scottish Intercollegiate Guideline Network 2010).
Consequently a survey by a National Group of Tissue Viability Nurses was undertaken
to identify the current practice in the management of patients with hyperkeratosis
relating to leg ulceration.
Results: The survey identified a wide variation in practice e.g. length of time for
treatment varied enormously ranging from 10-30mins. General comments from the
survey reflected a lack of satisfaction with current practice and concluded there was no
standardization across the country. Consequently the group produced a Best Practice
Statement to provide appropriate knowledge in order to prevent the development of
hyperkeratosis and to facilitate appropriate treatment. Thus resulting in standardisation
of clinical practice across the country.
Conclusions: The guidance provided by this document is based on expert consensus,
which along with audit has been suggested as a positive method of directing care.
P 320
EFFECTIVENESS OF A HIGH TOLERABILITY MULTILAYER BANDAGE
Poster: Leg Ulcer
AnnaMaria Ippolito 1 , Roberto Cassino 1 , Alessandro Corsi 1
1 Vulnera – Italian Vulnological Center (Turin, Italy).
Aim: Compression is a necessary procedure in venous leg ulcers. Often the problem is
the low compliance of the patient that don’t tolerate multilayer compression. Very often
the problem is the materials of the bandage that can create allergies / intolerances. Aim
of the work is to evaluate effectiveness and tolerability of a multilayer bandage that we
can define «high compliance bandage».
Methods: In this observational study, we considered a multilayer compression system
evaluating effectiveness and tolerability. We recruited 15 patients with venous ulcers that
showed problems such as irritation or intolerance or allergy to commonly used multilayer
bandages. We evaluated the evolution of the lesion and the days that the patients
tolerated the bandage on the basis of their subjective tolerance. Observation time was
two dressing changes (maximum 3 weeks).
Results: The treatment effectiveness has been largely confirmed, with a healing rate
slightly higher than the one stated in the literature. There were no allergies or
intolerances. The feeling of excessive heat has been reported by three patients (20%),
but only after the fifth day of stay in place of the bandage. The itching was reported by
the same three patients. All the patients maintained the bandage for 7 days. No one
used analgesics or antihistaminic drugs.
Conclusions: The work showed that the improvement of the multilayer compression
bandages technology allows a therapeutic choice that causes less problems to patients.
The lack of adverse effects to the skin improves the compliance of those patients that
often become intolerant to the bandages.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
189