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References
Colin, D., Kurring, R.G.N., Quinlan, D., Yvon, C. Managing Sloughy Pressure Sores. J Wound Care 1996; 5: 10.
This Clinical Investigation compares the performance of an amorphous hydrogel and a dextranomer paste in the management of sloughy pressure sores in the hospital environment. Specific parameters measured during the study were efficacy, safety, ease of handling and patient comfort. The clinical investigation was restricted to the debridement of sloughy non-viable tissue only. The amorphous hydrogel and dextranomer paste performed to a similar standard in terms of debridement of non-viable tissue. At day 21, however, the median reduction in wound area was 35% in the amorphous hydrogel group compared with 7% in the dextranomer paste group.
Vernon, T. IntraSite Gel and IntraSite Conformable: The Hydrogel Range. British Journal of Community Nursing 2000; 5: 10: 511-516
Wound management can be a confusing area of nursing practice. Even when an holistic patient assessment has been undertaken healthcare professionals frequently ask for guidance when faced with choosing the most appropriate wound management product. This article reviews two hydrogels from Smith & Nephew Healthcare - IntraSite Gel and IntraSite Conformable, which is the latest addition to the hydrogel range.
Punder, R. Amorphous Hydrogel Dressings in Wound Management. Journal of Community Nursing 2001; 15: 6:43-46
This is the third in a series of articles examining the role of a variety of wound care products used in clinical practice. This article will examine the use of amorphous hydrogels that are widely used in practice to debride necrotic and sloughy wounds, and discuss some of the research that has been undertaken in this area. The hydrogel dressings fulfil many of the characteristics of an ideal dressing as they provide a moist environment, are non-adherent and can be removed from the wound without causing trauma, are safe to use, free from particulate contaminants and are available in the hospital and community settings
Jones, V. Use of Hydrogels and Iodine in Diabetic Foot Lesions. The Diabetic Foot 1999; 2: 2:47-48
Although not usually the first dressing of choice for a diabetic foot ulcer, both hydrogels and iodine-based dressing materials may, on occasions, provide useful alternatives for practitioners. Improved formulations of hydrogels and advances in our knowledge of the effects of iodine have extended the application of these dressings to cover a wider range of wound problems affecting the diabetic foot.
Ratcliff, C, R. IntraSite Gel to Promote Wound Healing from Necrosis. The Cancer Bulletin 1991; 43: 1:85-86
Localised carcinomas of the cervix are usually responsive to radiotherapy. Those that are not are considered secondary to the bulk of the tumour at the beginning of radiotherapy. In an attempt to reduce the tumour volume intra-arterial chemotherapy, which delivers large concentrations of chemotherapeutic agents through the arteries supplying the malignant area, may be given prior to radiotherapy to patients with advanced localised disease. Necrosis is occasionally seen as a complication of the intra-arterial therapy or the radiotherapy and presents a challenge in terms of clinical management of the wound. The use of a hydrogel to promote healing in such a case is reviewed in this article
Fry, M, M. A Framework for Wound Management. Nursing Standard 1993; 7: 28:29-32
This article looks into four of effectively the most commonly used wound dressing products: IntraSite, Kaltostat, Lyofoam and Granuflex. Their characteristics and uses are discussed, and a simple framework for choosing the appropriate dressing for individual wounds has been complied. The author concludes that there is no 'ideal' dressing which can be used at all the stages of the wound healing process.
Bale, S., Banks, V., Harding, K,G. A Comparison of Two Amorphous Hydrogels in the Debridement of Pressure Sores. Journal of Wound Care 1998; 7: 2:65-68
This study compared the efficiency of two hydrogel dressings in the debridement of necrotic pressure sores. This randomised, controlled, assessor-blind, clinical trial involved 50 patients whose wounds were assessed weekly using computerised wound analysis for four weeks or until debrided. Debridement was identified when there was 80% red granulating tissue present and no sign of necrosis. There were no statistically significant differences in comfort, wound odour, surrounding skin condition of time to debridement between the two groups.
Fear, M., Thomas, S, Dr., Mid-Glamorgan Health Authority. IntraSite Gel compared with Debrisan paste in the management of pressure sores.
Introduction
A wide range of products is currently available for the management of yellow sloughy wounds. Two of the most frequently used products are IntraSite Gel and Debrisan Paste. However these materials have not been compared previously in a controlled clinical evaluation.
Objectives
To compare clinical performance, cost effectiveness and user acceptability of two widely used desloughing/cleansing agents in the management of pressure sores. Dressings
IntraSite Gel is a sterile amorphous hydrogel, containing polymer, water and propylene glycol.
Debrisan paste is a ready-mixed paste formulation consisting of dextranomer, polyethylene glycol 600 and water. According to the instructions, gauze dressings should be used in conjunction with paste to form a 'package' which lies within the wound itself.
Both dressings were converted using a perforated plastic film, absorbent dressing and retained using tape/bandages as appropriate.
Methods
40 patients with grade 3 or grade 4 pressure sores containing significant quantities of yellow/brown slough were recruited into the study and randomised to treatment.
All wounds were cleaned with normal saline. Dressings were applied according to the manufacture's instructions.
Within the limits defined in the study protocol, frequency of dressing changes was left to the clinical judgement of the investigator.
Patients continued in the study until their wound has been fully cleansed, or for a maximum of 28 days.
Assessments were made at each dressing change.
Mehtar, S, Dr., Mayet, F. A pilot study of IntraSite Gel in the management of infected wounds
A pilot study of IntraSite Gel in the management of clinically infected wounds was carried out at the North Middlesex Hospital in London.
Five patients with a variety of clinically infected wounds were recruited to the study. One patient had 2 wounds, making a total of six wounds evaluated during the study period.
All patients were treated using systematic antibiotics. Non-occlusive secondary dressings were used, and in the majority of cases dressings were changed on a 24 hourly basis. All six wounds treated went through to a stage were the infection was said to have resolved.
The study demonstrates that clinically infected wounds can be successfully treated through a resolution of infection using IntraSite Gel, when the manufacturers guidelines for using are followed.
Westerhof, W, Dr., Mekkes J, R. IntraSite Gel under occlusion in Infected wounds
Between March and June 1991, four patients with difficult non healing wounds were treated with IntraSite Gel under occlusion. This report contains details of the wound and patient history.
In each case, IntraSite Gel removed necrotic tissues very effectively and was found to be comfortable for the patient. The debriding effect of IntraSite Gel under occlusion was considered to be better than the soaked gauze (changed three times per day).
D Krasner, Using a hydrogel foam and dressing retention sheet
A nurse may sometimes feel better able to evaluate a specific dressing if placed in the position of the patient experiencing the results first-hand. Recently an ET nurse had this opportunity when she became involved in her own wound care following abdominal surgery. The following case study chronicles the topical management of her abdominal wound and describes a diagnosis that was radically different from that suggested by the original symptoms.
Vernon,T. IntraSite Gel - Its use in the Treatment of Excoriation. EWMA conference 1999
3 case studies to illustrate how IntraSite Gel can be used in the management of excoriation caused by either urinary or faecal incontinence. The results showed improvement after several days application. More clinical investigation into the properties of IntraSite Gel for this indications needs to be conducted for healthcare professionals to base their practice on evidence based medicine.
Westerhof, W, Dr., Mekkes, J,R. Academisch Medisch Centrum: A Pilot Study comparing IntraSite Gel with saline soaked gauze for wound debridement
A pilot study comparing the performance of IntraSite Gel and saline soaked gauze as debriding agents in the management of necrotic wounds. Ten patients with venous leg ulcers were treated and evaluated during the 7 day study period. Five patients were treated using IntraSite Gel, 5 using saline soaked gauze. IntraSite Gel was changed on a daily basis, saline soaked gauze three times daily. The study demonstrates, using quantifiable measures, that IntraSite Gel is an effective debriding agent, and offers a number of perceived advantages/benefits over the centre's standard saline soaked gauze regime.
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