Silflex soft silicone wound contact dressing: Case study 10

Pam Cooper, David Gray, Fiona Russell and Sandra String fellow are Clinical Nurse Specialists; Melvyn Bertram, Kristine Duguid and Gail Pirie are Tissue Viability Nurses at the Department of Tissue Viability, NHS Grampian, Aberdeen

Case report 10

This case features an 86-year-old woman with a history of heart disease and hypertension. She presented to the clinical team with an infected pretibial wound, which had been debrided. She had also experienced some lower limb cellulitis, which had been successfully treated. After four weeks (Figure 1), the wound remained open and after treatment with a honey tulle dressing the clinical team decided that it would benefit from a skin replacement. The skin replacement was held in place using Silflex dressings (Advancis Medical) covered with an absorbent pad and secured with a toe-to-knee blue line Comfifast™ dressing (Synergy Health) (Figure 2).

Figure 1. Pre-tibial wound prior to application of skin substitute.

Figure 2. Skin substitute held in place by Silflex.

First review

At the first review (before treatment with Silflex) the wound exhibited 100% granulation and measured 8.5x4.5cm. Exudate levels were low in both viscosity and volume.

Second review

The wound was reviewed after 14 days of treatment (Figure 3). It can be seen that the wound bed still exhibited 100% granulation with epithelium at the margins and no infection. Exudate levels were still low in both viscosity and volume. The wound had reduced in surface area by 53% and the skin replacement had remained in position.

Figure 3. Pre-tibial wound after 14 days of treatment.

Summary

In this case the silicone dressing Silflex was used to hold a skin replacement in place over a wound to support its uptake. Over 14 days, the regimen resulted in a 53% reduction in the surface area of the wound.

CONCLUSION

These case reports illustrate the clinical benefits of using Silflex soft silicone wound contact layer. The majority of patients were elderly, a factor which not only impacts on healing, but often means that the skin is fragile. Being soft and conformable with a high tensile strength, Silflex can be inserted into wounds which do not have uniform dimensions, and the clinician can be sure of retrieving the dressing in tact.

In three cases, Silflex was used in conjunction with negative pressure wound therapy (NPWT), and prevented adherence to underlying tissue while promoting healing.

The dressing was also used successfully in heavily exuding wounds, allowing the passage of exudate into the secondary dressing, while remaining in situ and allowing the secondary dressing to be changed without causing trauma to the wound bed.

The dressing performed well in all of these cases, and the patients were positive about the product in terms of reducing pain at dressing change.

Many of the patients had particularly friable skin and, again, Silflex played a key role in protecting the skin from further damage.

As we are presented with more and more complex chronic wounds, dressings such as Silflex will become more necessary to prevent secondary damage to the wound bed and surrounding skin, and to reduce trauma and pain during dressing removal.