Silflex soft silicone wound contact dressing: Case study 3

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 3

This case report features an 80-year-old man who was admitted to a care of the elderly ward following an extension of a cerebral vascular accident (CVA). He also had a history of Crohn’s disease and Parkinson’s disease. He was restricted to bed and had difficulty with eating and communicating.

Review 1

The patient was admitted to the ward with a small skin tear on his left arm, which had a scant covering of yellow slough. The tear measured 2 x 1.2cm (Figure 1) and was exuding very high volumes of serous exudate.

Figure 1. The patient had a skin tear on his left arm and the surrounding tissue was very oedematous.

On examination, the patient’s upper body, in particular his arms, were very oedematous and leaking from small points. Silflex (Advancis Medical) non-adherent silicone was applied in order to prevent any trauma to the wound itself or the surrounding tissue. Due to the extensive nature of the exudate, a large absorbent dressing pad was used as a secondary dressing and secured with a light non-elastic bandage. It was suggested that the pad and bandage be changed according to the level of exudate, but that the Silflex should be left in situ for 2–3 days. The ward staff carried out this plan.

Figure 2. The skin tear was healed and the oedema had resolved.

Review 2

Six days later and after three primary dressing changes, the wound had completely healed (Figure 2). The patient’s general health had also improved — he was more stable medically and the fluid that was overloading his system had reduced once he had been started on the appropriate diuretic.

Conclusion

The use of Silflex provided a primary dressing for the skin tear on this patient’s very friable tissue. Serous fluid was able to drain into the secondary dressing pad, preventing maceration of the surrounding tissue. The wound was able to heal well and quickly.

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.