Use of a New Foam Dressing Technology with Unique Exudate Channels* (UEC) Under Compression to Handle Copious Thick, Viscous Exudate
Problem: Patients with lower extremity vascular disease, especially venous insufficiency, often present with ulcerations complicated by edema and high-volume thick viscous exudate. Because of the chronicity of these wounds and their exudative pattern, periwound integrity is frequently affected by maceration and inflammation.
In a pilot study, we explored whether a new wound dressing technology consisting of non-bordered conformable soft silicone foam with Unique Exudate Channels* (UEC) could assist with the transfer of thick viscous exudate away from the skin, thereby preventing skin damage and facilitating the healing of leg ulcers.
Background: To manage wounds resulting from venous insufficiency and vascular disease, initially compression wraps are used where appropriate to control the edema; however, until recently, no advanced wound care dressings on our formulary prevented the high-volume thick exudate from macerating the periwound skin.
Lower extremity ulcers had lifestyle consequences for the patients in our study:
- Ruined shoes from exudate saturation
- Clothing was constantly saturated
- Wound and exudate odor prevented social interaction and produced isolation
- Embarrassment was experienced
- Pain at 6 out of 10 was associated with dressing changes
Method: Three patients were enrolled in this pilot study on the novel UEC foam dressing.
- All patients had vascular disease and/or venous insufficiency with ulcerations and copious thick, viscous exudate
- Two patients were seen in an Outpatient Resident Clinic.
- One patient was seen in the homecare setting.
Our homecare patient initially had a honey calcium alginate applied to an ulcer with a depth > 1 cm. In order to provide antimicrobial effect this was changed to a calcium alginate with silver, and the UEC foam dressing was applied as a cover dressing.
All patients had skin cleansed with soap and water and then moisturized. UEC foam dressing was placed over ulcers and lapping onto ulcerated skin with multi-layer compression dressing applied as indicated from toes to knees
Results: All 3 patients benefitted from the use of this new technology foam dressing. The high-volume thick exudate was effectively absorbed and well-managed by the use of the new foam dressing technology with UEC, allowing the periwound skin to heal and remain intact, without evidence of maceration or inflammation.
There was no evidence of trauma to the wound bed upon UEC dressing removal, no bleeding or tearing of reepithelialization. No signs of sensitization to the new UEC dressing were observable in any of the patients’ skin. Pain on removal was reported at less than 2 on a scale of 10.
Two of the patients were morbidly obese, with 3+ edema. We used the UEC dressings for 3 weeks for these patients, then advanced to traditional compression wraps due to diminished, thinner exudate. All the patients continue to heal with a decrease in ulcer size.
Summary: In an era of increasing pressure to reduce cost and ensure care efficiency and quality, the non-bordered UEC foam dressings exceeded expectations for exudate absorption and management, preservation and healing of the periwound, long wear time in context of high exudation, excellent management of dressing-related pain, and patient experience of care.