Going to hospital is depressing enough without the conditions that can appear during the stay. Among the worst of these are pressure ulcers, the dark blotches that form after patients spend too long in hospital beds or wheelchairs. But despite being a challenge to treat, a team from Smith and Nephew seems to finally have made a breakthrough.
This has been a long time coming. After all, the very "fragility" of patients makes pressure ulcers frustratingly difficult to fight, says Dr Cristiana Forni, head of nursing research at the Istituto Ortopedico Rizzoli in Bologna. "The causes of pressure incidents are linked to the intrinsic characteristics of the patients - pressure is sometimes unavoidable - and to the care [they receive]," she says. "The main reasons are related to the phenomena are prolonged pressure, slipping and friction on the cutaneous planes."
Though Forni emphasises that working to prevent ulcers is "the most important nursing challenge", elderly patients' fragility means "preventive care is often done in vain". This is especially true in her hospital, she adds. "We decided to deal with this problem because in an orthopaedic hospital, elderly patients with fractures are the very people at risk of [developing] pressure ulcers. All the preventive actions we [undertook] were not enough to [stop] the patient from developing injuries."
Things got so bad that Forni and her team decided to investigate. "As clinical nurses, we wanted to find real solutions for our elderly patients. We wanted to find new preventive strategies to add to [our] standard prevention care, which was often not enough," she explains.
After careful research, Forni and her team settled on ALLEVYN LIFE, developed by Smith and Nephew. It is easy to understand why. Unlike traditional silicone dressings, ALLEVYN LIFE uses a unique quadrilobe shape, with a wide border that fits the shape of the human body more securely. This allows patients to shower while wearing the dressing and makes it an ideal preventive tool; patients can comfortably wear ALLEVYN LIFE dressings before pressure ulcers appear.
Similarly, the dressings can be lifted and repositioned, a vital quality if hospital staff want to check a patient's condition. "The addition of a silicone wound-contact layer lends itself to continuous skin inspection as per [hospital] protocols, all without losing dressing adherence," Forni says.
Not that this subtle design sacrifices other considerations. Thanks to its hyper-absorbent core, ALLEVYN LIFE provides outstanding fluid-locking under pressure and comfortably absorbs common wound odours. According to Smith and Nephew tests, ALLEVYN LIFE lasts twice as long as other dressings. It is no wonder that Forni is thrilled with the dressings, emphasising that her team has seen "positive results in elderly patients with hip fractures" since using them.
At the same time, using ALLEVYN LIFE as a preventive tool makes financial sense. "It saves money in terms of the number of dressings that need to be used, and the necessary materials and drugs, and [it saves] nursing time," Forni says.
It helps that Smith and Nephew's product stays in place longer than the alternatives."ALLEVYN LIFE is also convenient, thanks to its high adhesiveness, which allows doctors to keep [dressings] in situ for many days, compared with other dressings on the market," Forni adds.
Though Forni and her colleagues now swear by ALLEVYN LIFE, she admits that more work needs to be done before preventive pressure-ulcer dressings enter the mainstream. "I only know of a Cochrane systematic review that suggests dressings as part of a prevention protocol," she says. "The review [advocates] for more rigorous studies before entering them permanently into prevention [use]."
Nonetheless, Forni is confident that ALLEVYN LIFE will eventually become a standard preventative tool wherever pressure ulcers are common. "A few years ago, we published a trial in which ALLEVYN LIFE was inserted into plaster casts to reduce the incidence of plaster-pressure ulcers," she explains. "The results were excellent." This is unsurprising: with its careful design and reusability, ALLEVYN LIFE seems destined to help doctors - and their wallets - far into the future.