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A comprehensive skincare regimen involves cleansing, moisturising, and using skin barrier protectants. Cyanoacrylate-based protectants safeguard vulnerable skin from damage caused by moisture, friction, and shear. This research involved two ex vivo and two clinical studies comparing the wear duration and wash-off resistance of a 100% cyanoacrylate and a solvent-cyanoacrylate mixture. Effectiveness was assessed using an ex vivo porcine skin model simulating urinary incontinence, evaluated with Lucifer yellow dye penetration and Corneometry, and a clinical model using Corneometry. Two single-blind clinical studies measured skin surface electrical capacitance in healthy volunteers. Study 1 (n = 42) evaluated the wear duration over 8 days, while Study 2 (n = 52) examined wash-off resistance after nine washes with various cleansers. Ex vivo results showed that both products were effective under repeated moisture and abrasion conditions, with the 100% cyanoacrylate outperforming the solvent-cyanoacrylate mixture. In clinical studies, both products maintained barrier protection throughout Study 1 (p < 0.007) and none of the cleansers significantly degraded either product in Study 2. In conclusion, the 100% cyanoacrylate provided superior protection compared to the solvent-cyanoacrylate mixture. Both products demonstrated comparable wear duration and wash-off resistance in clinical studies, but the 100% cyanoacrylate was more effective in ex vivo testing under harsh conditions.
The healthcare landscape in South Africa is challenging with a complex patient population and a stressed healthcare system. Negative pressure therapy-based systems such as negative pressure wound therapy with instillation and dwell (NPWTi-d) and closed incision negative pressure therapy (ciNPT) can help manage wounds or incisions. However, guidelines for South Africa-specific use are limited. An in-person meeting was held with 10 experts to develop South Africa-specific therapy use recommendations for NPWTi-d and ciNPT. Panel members recommended NPWTi-d use for wounds in need of cleansing. Normal saline and a 10-min dwell time were recommended with the caveat that the instillation solutions and dwell times can be changed based on the wound bed condition and the features of the instillation solution. A negative pressure cycle of 2–3 h and a negative pressure of −125 mmHg were also recommended for NPWTi-d. In patients, incisions, and surgical procedures at high risk of developing surgical site complications, ciNPT use was recommended. These general recommendations serve as a framework for NPWTi-d and/or ciNPT use in South Africa and should be updated as more region-specific evidence becomes available.
Complex reconstructions are often required after head and neck tumour resections, particularly in irradiated fields and areas with exposed bone. Fish skin grafts (FSG) have recently emerged as a potential adjunct in difficult wound healing. This case report series evaluates the effectiveness of FSG in combination with octenidine-based antiseptics, which have already shown beneficial results in split-thickness skin transplantation in high-risk patients, focusing on the time period for granulation and wound closure. Five patients with seven defects of different aetiology in the head and neck region received FSG applications. Defect sizes ranged from 2 × 4 cm (occipital) to 7 × 6 cm (temporal). Granulation was determined, with irradiated and non-irradiated wounds analysed separately. In three consecutive cases, octenilin gel (octenidine-based hydrogel) was implemented in the treatment regimen. Three patients achieved complete granulation, while two reached 66%–80% granulation. Non-irradiated wounds demonstrated faster granulation (mean 16.5 days) compared to irradiated wounds (mean 48.8 days). Although there was no statistical significance, a trend toward delayed healing in irradiated tissue was observed. Patients treated with octenilin gel showed favourable healing outcomes, including shorter granulation times. Despite the poor prognosis for uncomplicated healing in this cohort, both treatment protocols—octenisept with Flaminal forte and octenisept with octenilin gel—achieved satisfactory outcomes when combined with FSG transplantation. This approach appears promising for reconstruction in challenging head and neck wounds and warrants further evaluation in prospective clinical studies.
Chronic wounds pose a public health challenge, with community pharmacists increasingly recognised for their potential role in wound care. Since all chronic wounds originate from acute wounds, pharmacists can play a proactive role in preventing chronicity. Assessing pharmacy staff's wound care knowledge is essential as initiatives to enhance their involvement are underway in Australia. This study aimed to assess wound care knowledge among pharmacists and non-pharmacist staff in Australian community pharmacies. A national cross-sectional electronic survey was conducted between January and August 2022. Developed with multidisciplinary experts, it assessed understanding of wound healing, referral protocols, wound identification, management, and dressing selection. Descriptive and content analyses were performed, and multivariate linear regression identified predictors of knowledge scores. Of 120 responses, 70% were pharmacists, 14% non-pharmacist staff, and 16% unspecified. The median knowledge score was 27 out of 37 (IQR = 21, 30; range = 5–37). Profession, experience, and prior training were significant predictors of higher scores (p < 0.001, R 2 = 0.347). Dressing knowledge was weakest, with only 10 out of 103 respondents (9.7%) correctly identifying all types and applications. Critical knowledge gaps underscore the need for targeted educational interventions for pharmacy staff.
The opioid crisis has been exacerbated by xylazine, a veterinary sedative increasingly present in illicit drugs. Xylazine causes severe skin wounds that increase the risk of morbidity. Current wound classification systems fail to address the unique features of this injury, creating a need for a tailored assessment and treatment approach. We developed the HEAL-X classification system to standardise evaluation and treatment of xylazine-associated wounds. The system grades wounds using five criteria: History, Extent, Appearance, Location, and Xylazine-specific features. Grades range from 0 (normal skin) to 5 (underlying structure involvement). HEAL-X integrates principles from existing classifications while focusing on xylazine-specific pathology. This novel system was developed by an inter-disciplinary panel and requires empirical validation through clinical application and further research. HEAL-X provides a framework for grading xylazine-associated wounds, guiding treatment from lower-grade wounds to severe cases. This system aligns with the unique characteristics of xylazine wounds, offering a more tailored approach than any existing models individually. HEAL-X addresses a critical gap in managing xylazine-associated wounds. It offers a standardised tool to evaluate wound severity, guide treatment, and improve patient outcomes. As xylazine use rises and further research refines prognostic indicators and treatment outcomes, HEAL-X provides a framework on which to build.
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