Background: Ideally, a good skin graft substitute should be readily available, cost-effective, have a low disease transmission risk, reduce infection and scarring, and aid wound healing. Fish skin grafts (FSG) are an accessible option to most populations.

Aim: This literature review explores the use of FSG, as a xenograft, to aid in wound healing and the potential benefits or harms of using this intervention.

Methods: A literature search using the PICO method was conducted on MEDLINE, CINAHL Plus, Cochrane Library, Web of Science and Embase, and hand searched on the Cardiff University Library.

Results: FSG aided faster healing of burn wounds and reduced scarring. However, there was a lack of studies that examined the patient’s experience and the long-term effects of FSG.

Conclusions: FSG has multiple biological, economical and logistical benefits. It should be considered as an alternative graft option and has been shown to be useful in low resource environments. However, more robust research on the harms and benefits of FSG use is required.

KEY WORDS

Burns

Fish skin graft

Skin graft

Traumatic wounds

Wound healing

VENNESSA C. LEE BN, RN Tissue Viability Nurse, HCA UK

Skin tears are a significant problem for frail older patients, especially in a mental health setting. Furthermore, they go largely unreported. Frail older adults are vulnerable to dry, thin and fragile skin, which may lead to skin tears. Skin tears can cause unnecessary pain, discomfort and anxiety, as well as stress to patients, carers, and their families. They can also lead to prolonged hospitalisation. In a mental health setting, skin tears are often associated with friction, shear and skin trauma due to self-harm, aggression, psychotropic medications, poor nutrition, depression, a poor lifestyle and a lack of motivation. This paper reviews evidence related to the use of moisturisation as a preventive measure to reduce skin tears among frail older adults in mental health settings. It is evident that moisturising twice daily helps to prevent the incidence of skin tears in frail older adults. However, there is limited research for skin tears in the area of mental health.

KEY WORDS

Emollients

Frail older adult

Mental health

Prevention

Skin tears

Wounds

AYODELE AYENI

Tissue Viability Nurse Specialist, Hertfordshire Partnership University NHS Foundation Trust

ABSTRACT: Here we discuss the case of a patient with treatment-resistant pyoderma gangrenosum. We explore the difficulties in managing this condition and reveal the approaches tested in order to bring about clinical improvements.

KEY WORDS

Hyperbaric oxygen therapy

Maggot debridement therapy

Novel treatment

Pyoderma gangrenosum

Wound care

DANIEL LYONS

MB, BCh, BAO, MRCPI, Beaumont Hospital, Beaumont, Dublin 9, Ireland

SARAH FLEMING MB, BCh, BAO, MRCPI, Beaumont Hospital, Beaumont, Dublin 9, Ireland

MARIE DENHAM BSc, Beaumont Hospital, Beaumont, Dublin 9, Ireland

KAREN EUSTACE MB, BCh, BAO, MRCPI, Beaumont Hospital, Beaumont, Dublin 9, Ireland

ABSTRACT: His Majesty’s Prison and Probation Service uses age 50 to describe ‘old age’ in prisons, with the average age of people dying in prison being 56 compared with 81 in the general population. Patients in custody are a uniquely vulnerable population with a disproportionately high burden of disease and an increased mortality rate compared with the wider UK population. Prison nurses manage a diverse and complex range of wound presentations, from acute trauma, self-harm wounds, complex burns, and chronic disease, requiring a range of wound care interventions, with one of the most challenging wound types being leg ulceration. A wound care strategy was developed to provide overarching support, to improve access to training, while developing the knowledge and skills to ensure safe practice. Furthermore we wanted to develop a cohort of passionate nurses with a specific interest in tissue viability who would maintain the wounds agenda, transform wound management, and more importantly, enhance timely wound healing for this vulnerable patient population.

KEY WORDS

Assessment

Education

Leg ulcer management

Prisons

Secure settings

UrgoKTwo

SARAH LAVER, RGN, Professional Nurse Advocate, Regional Primary Care Lead: Thames Valley and South Central, Practice Plus Healthcare Group