EWMA Council

More documents

Recommendations

Info

COPA Ultra-soft foam wound dressing • Super absorbency • Ultra Softness and superior feel • Maximum protection 1.5 1.25 1 0.75 0.5 0.25 0 Fluid capacity (cc/cm 2 ) 1.24 0.74 COPA Allevyn ® Polymem ® www.copadressing.com 0.43 COPA’s fluid capacity outperforms the leading competition Tyco Healthcare UK Limited - 154 Fareham Road - GOSPORT - HAMPSHIRE UK - PO13 0AS - Tel: +44 (0) 1329 224 411 - Fax: +44 (0) 1329 224 390 Allevyn is a trademark of Smith & Nephew. Polymem is a trademark of Fleming Medical Limited. Trademark of Tyco Healthcare Group LP or its affiliate © 2006 Tyco Healthcare Group LP. All rights reserved. P-WC-A-Copa/GB
Selection criteria: Randomised controlled trials comparing any antiseptic preparation used for preoperative full-body bathing or showering with non-antiseptic preparations in patients undergoing surgery. Data collection and analysis: Two authors independently assessed studies for selection, trial quality and extracted data. Study authors were contacted for additional information. Main results: Six trials involving a total of 10,007 participants were included. Three of the included trials had three comparison groups. The antiseptic used in all trials was 4% chlorhexidine gluconate (Hibiscrub). Three trials involving 7691 participants compared chlorhexidine with a placebo. Bathing with chlorhexidine compared with a placebo did not result in a statistically significant reduction in SSIs; the relative risk of SSI (RR) was 0.91 (95% confidence interval (CI) 0.80 to 1.04). When only trials of high quality were included in this comparison, the RR of SSI was 0.95 (95%CI 0.82 to 1.10). Three trials of 1443 participants compared bar soap with chlorhexidine; when combined there was no difference in the risk of SSIs (RR 1.02, 95% CI 0.57 to 1.84). Two trials of 1092 patients compared bathing with chlorhexidine with no washing, one large study found a statistically significant difference in favour of bathing with chlorhexidine (RR 0.36, 95%CI 0.17 to 0.79). The second smaller study found no difference between patients who washed with chlorhexidine and those who did not wash preoperatively. Authors’ conclusions: This review provides no clear evidence of benefit for preoperative showering or bathing with chlorhexidine over other wash products, to reduce surgical site infection. Efforts to reduce the incidence of nosocomial surgical site infection should focus on interventions where effect has been demonstrated. Synopsis It is unclear whether using chlorhexidine for preoperative bathing or showering prevents surgical site infection. Surgical site infection is a serious complication of surgery and may be associated with increased length of hospital stay for the patient and higher hospital costs. The use of an antiseptic solution for pre-operative bathing or showering is widely practiced in the belief that it will help to prevent surgical site infection. However, the review found six trials that included over 10,000 patients that did not show clear evidence of benefit for the use of chlorhexidine solution over other wash products. Skin grafting for venous leg ulcers [Review] Jones JE, Nelson EA The Cochrane Database of Systematic Reviews Copyright © 2005 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.2007 Issue2. ABSTRACT Background: Venous leg ulceration is a recurrent, chronic, disabling condition. It affects up to one in 100 adults at some time. Standard treatments are simple dressings and compression bandages or stockings. Sometimes, despite treatment, ulcers remain open for months or years. Sometimes skin grafts are used to stimulate healing. These may be taken, or grown into a dressing, from the patient’s own uninjured skin (autografts), or 6 EBWM applied as a sheet of bioengineered skin grown from donor cells (allograft). Preserved skin from other animals, such as pigs, has also been used (xenografts). Objectives: To assess the effect of skin grafts for treating venous leg ulcers. Search strategy: We searched the Cochrane Wounds Group Specialised Register (February 2006) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2006). Selection criteria: Randomised controlled trials (RCTs) of skin grafts in the treatment of venous leg ulcers. Data collection and analysis: Two reviewers independently undertook data extraction and assessment of study quality. Main results We identified 15 trials – generally of poor methodological quality – involving 768 participants. In 11 trials participants also received compression bandaging. One trial (31 participants) compared a dressing with an autograft. Three trials (74 participants) compared frozen allografts with dressings, and three trials (47 participants) compared fresh allografts with dressings. Two trials (345 participants) compared tissue-engineered skin (bilayer artificial skin) with a dressing. In two trials (71 participants) a single-layer dermal replacement was compared with standard care. Four trials compared skin grafting techniques: one trial (92 participants) compared autografts with frozen allograft, a second (51 participants) compared a pinch graft (autograft) with a porcine dermis (xenograft), the third (seven participants, 12 ulcers) compared tissue-engineered skin with a split-thickness graft, the fourth (10 participants) compared a fresh allograft with a frozen allograft. The trials comparing bilayer artificial skin with a dressing reported a significantly higher proportion of ulcers healing with artificial skin. There was not enough evidence from the other trials to determine whether other types of skin grafting increased the healing of venous ulcers. Authors’ conclusions: Bilayer artificial skin, used in conjunction with compression bandaging, increases the chance of healing a venous ulcer compared with compression and a simple dressing. Further research is needed to assess whether other forms of skin grafts increase ulcer healing. Synopsis Applying bilayered tissue-engineered skin under compression improves healing of venous leg ulcers compared with simple dressings and compression, but the effect of other types of graft is not clear. Approximately 1% of people in industrialised countries have a leg ulcer at some time, mainly caused by poor blood flow back from the legs towards the heart. Skin grafts, either using the patient’s own skin or donor skin/cells, have been evaluated to see whether they improve the healing of ulcers. The review of trials found evidence that tissue-engineered skin composed of two layers increases the chance of healing. There was not enough evidence to recommend any other type of graft, and further research is required. <strong>EWMA</strong> Journal 2007 vol 7 no 2
Page 1 and 2: The EWMA Journal ISSN number: 1609-
Page 3 and 4: international recognition as refere
Page 5 and 6: Less trauma. Less pain. TM Safetac
Page 7 and 8: MATERIALS AND METHODS Samples From
Page 9 and 10: Scientific Article Table 1. Microbi
Page 11 and 12: Scientific Article bacterial specie
Page 13 and 14: Making the Choice Clear AQUACEL ®
Page 15 and 16: Scientific Article cluding home car
Page 17 and 18: 17 TH CONFERENCE OF THE EUROPEAN WO
Page 19 and 20: Listen - Participate - Debate - Act
Page 21 and 22: Scientific Article views regarding
Page 23 and 24: Scientific Article Table 1-Distribu
Page 25 and 26: NOW AVAILABLE ON PRESCRIPTION IN OP
Page 27 and 28: We call it QuadraFoam ® because
Page 29 and 30: Scientific Article them to the spec
Page 31 and 32: LESS IS EXPECT THE MOST The innovat
Page 33 and 34: Contreet / Biatain - Ag Sustained s
Page 35 and 36: Background Article Fig 2. Screendis
Page 37 and 38: SILVERCEL* dressing uses new hydro-
Page 39 and 40: Background Article Figure 1. Lord L
Page 41 and 42: Background Article Alcoholic hand r
Page 43: EBWM Sally Bell-Syer, MSc Review Gr
Page 48 and 49: Figure 2. Patient and wound specifi
Page 50 and 51: Spanish English English Helcos 2007
Page 52 and 53: Ferris Mfg. Corp. 16W300 83rd Stree
Page 54 and 55: FWCS Finnish Wound Care Society Sal
Page 56 and 57: WMAS Slovenian Wound Management Ass
Page 58 and 59: LWMS Lithuanian Wound Management So

EWMA Council

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?