Silflex soft silicone wound contact dressing: Case study 14
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 14
This case report features a 54-year-old woman with a dehisced abdominal post surgical wound. Her past medical history included Crohn’s disease, which had been diagnosed 15 years earlier and been well-managed. The patient had been admitted as an emergency with abdominal pain. Examination under anaesthetic, uncovered the presence of necrotising fasciitis with multiple bowel fistulas. This presented a dressing and exudate challenge.
One month into this patient’s treatment (Figure 1), the wound was lined with Silflex dressing (Figure 2) and AMD® Gauze (Covidien) and negative pressure wound therapy (NPWT) was applied. The fistulas were isolated using stoma paste and a wound manager was applied to contain the bowel content.
Figure 1. The wound after one month of treatment.
Figure 2. The wound is lined with Silflex dressing.
Conclusion
The use of Silflex as a non-adherent interface has its place in wound management. In major abdominal surgery necessitating bowel management, Silflex can be used as an effective interface in conjunction with NPWT. This combination can be used to protect the bowel and prevent further fistula formation, as well as acting as an effective non-adherent interface.
Within the field of wound care, all wounds go through a spectrum of change before arriving at the healing stage. Having Silflex as a dressing choice will aid clinicians at some point throughout this process and in this case it played its part in an ultimately successful treatment plan.
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.