A new concept in the management of complex foot wounds: Case study 4

Lead Author - Linda Rafter, Tissue Viability Nurse Consultant, Honorary Professor in Nursing, DeMontfort University, Leicester 

Introduction

The Eclypse foot is a unique super absorbent dressing which is anatomically designed to fit around the foot. Eclypse foot is designed to absorb and retain large amounts of fluid and exudate and reduce the associated odour. The dressing contains a rapid wicking layer and 12 super absorbent compartments which lock away fluid into the dressing, reducing maceration and preventing re-infection from fluid leaking back on to the skin as it spreads the load across the dressing. The backing layer is a water resistant barrier and also prevents strike through, this is combined with a high moisture vapour transfer rate that allows breathability and prolongs wear time. The pre shaped foot allows easy application, thereby reducing the nursing time for dressing change and resulting in significant financial cost.

Method

Five patients were recruited from the inpatient and outpatient clinic in a general hospital. The ages ranged from 60 – 90 years. Patients were nominated by the ward staff and then the author visited them to ask them to volunteer to take part in the trial of the Eclypse Foot Dressing. She asked them for a contact number if they were going home to enable her to follow the patient up 14 days later. If they were still an inpatient the author I visited the ward to perform the follow up of information. The opinions of 20 nursing staff were also collected on the Eclypse Foot dressing. Fourteen days’ treatment was carried out where possible on each patient to enable a thorough evaluation of the comfort for the patient and if healing had taken place.

Case Study 4

Mr B a 76 year old male is known to have heart failure and arterial disease and diabetes. Mr B still had pitting oedema to both lower legs and the author could feel pulses in both feet which were warm. However, he had dry mummification of the left second toe and medial side of the third toe. The fourth toe was very wet at the toe base. Auto amputation appeared to be starting as the toes were very loose ( see figure 7) His left heel ulcer was 5x5cms 50% and the wound bed consisted of soft yellow tissue and 50% pink tissue. He did have increased pain in his left heel on the McCaffrey 8.

Care Pathway

The care pathway advised was that the right heel and Mummified toes had only sorbsan ribbon at the base of the toes and Eclypse foot dressing every 4 - 5 days.

Fig 7

Fig 8

On review on the 3rd October 2011 Mr B still had pitting oedema to both lower legs and the author could feel pulses in both feet which were warm. However, he had dry mummification of the left second toe and medial side of the third toe. The fourth toe was very wet at the toe base. Auto amputation appeared to be starting as the toes were very loose ( see figure 8) His left heel ulcer was 5x5cms 50% and the wound bed consisted of soft yellow tissue and 50% pink tissue. He did have increased pain in his left heel on the McCaffrey 8. Mr B commented that he liked Eclypse Foot dressing as it fitted well and enabled him to wear smaller size foot wear that was not so bulky. He also found the dressing very comfortable and that. it contained odour quite well.

Results

The results of five patient case studies will be reported in full in this poster and the patient outcomes. The patients experience on how they have found Eclypse Foot dressings was it comfortable and how it conformed to the patients foot.

Discussion

The new Eclypse Foot dressing appears to provide the optimum environment for healing. .It appears that the Eclypse Foot dressing helps to prevent infection and the fluid from is wicked away into the dressing. Nurses ordinarily used an Eclypse 20x30cm dressing which is not tailored to fit the patients foot for these complex wounds. The Eclypse Foot dressing provides an increased performance to manage the exudate appears and maintains the patient dignity.

Conclusion

The new Eclypse Foot dressing is an urgonomically designed suitable alternative choice for patients that suffer from toes that are about to auto amputate , gangrene, extremely wet feet and diabetic foot. Currently there are no dressings that address the issues like Eclypse Foot dressing by providing the optimum environment for patients that do not necessarily require their wounds to heal but need there foot to be kept dry. The Eclypse Foot dressing also delivers patient dignity as it gives them reassurance that Eclypse Foot dressing will encase their foot and wick the exudate into the dressing and prevent the embarrassing smell if the exudate leaks through the dressing on to their clothing.

References

Mc Caffrey M, Beebe A (1989) Pain A Clinical Manual for Nursing Practice St Louis, MO: CV Mosby Co