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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