Silflex soft silicone wound contact dressing: Case study 12

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 12

This case features an 88-year-old man who presented with varicose eczema on his lower limbs secondary to underlying venous disease and cardiac oedema. Topical steroid cream was used for one week, in conjunction with Silflex dressings (Advancis Medical) and limited compression.

First review

As can be seen in Figure 1, the eczema is widespread with various wounds and vulnerable areas of skin. Macerated epithelium is also present across wide areas and the exudate was high in volume but low in viscosity. The eczema was treated with Betnovate C, which was applied across both lower limbs, with Silflex used to dress all the wounds and abrasions. Absorbent pads were placed over the Silflex and secured using a layer of Softban (Smith and Nephew) sandwiched between two layers of toe-to-knee blue line Comfifast (Synergy Health). As the steroid cream had to be applied daily, the Silflex dressings were also changed daily for one week.

Figure 1. Bilateral varicose eczema with cardiac and chronic oedema present.

Second review

As shown in Figure 2, the maceration and eczema resolved and the oedema was reduced. The overall condition of the patient’s skin was improved and he was started on a less potent steroid therapy. The period between dressing changes was also increased.

Figure 2. Limbs after seven days of limited compression, topical steroid cream and Silflex.

Summary

In this case, the Silflex dressings were used in conjunction with limited compression and topical steroid therapy and the patient’s legs were returned to a much healthier state. The decision to include Silflex dressings in the treatment regimen was taken to reduce the risk of the absorbent pads adhering to the skin. Silfex also helped to protect the already damaged and vulnerable skin.

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.