Silflex soft silicone wound contact dressing: Case study 13

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 13

This case report features an 85-year-old man who presented with general varicose eczema and a large superficial area of exposed dermis on the outer aspect of his right calf. This wound was thought to have developed secondary to trauma associated with
a secondary dressing.

Review 1

At first review (Figure 1), the wound measured approximately 12 x 10cm and was superficial in nature with no evidence of infection. Large volumes of fluid were escaping from the wound due to underlying cardiac oedema and the rest of the limb was undergoing treatment for varicose eczema using Betnovate C cream.

Figure 1. At first review the wound measured approximately 12 x 10cm and was superficial in nature with no evidence of infection.

The wound was dressed using Silflex (Advancis Medical) dressings secured with absorbent pads. These dressings were held in place using toe-to-knee SoffBan® (Smith & Nephew) sandwiched between two layers of Comfifast™ (Synergy Health) blue line. These outer dressings were changed daily and the steroid cream applied to the rest of the leg. The contact layer was left in place for three days.

Review 2

After 14 days of the regimen described above, the limb was reviewed and found to be almost completely healed (Figure 2). The general skin condition of the leg had also improved.

Figure 2. After 14 days of treatment, the limb was reviewed and found to be almost completely healed.

Conclusion

In this case, a superficial wound complicated by the presence of high volumes of leakage associated with cardiac oedema was managed using a Silflex dressing. This was placed on the wound bed and left for three days with daily changes of the absorbent pad and associated dressing materials. Over 14 days, the skin integrity in that area was restored.

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.