Use of a Novel Silicone-Acrylic Drape With Negative Pressure Wound Therapy in Four Patients With Periwound Skin Breakdown

Emily Greenstein, APRN, CNP; Nancy Moore, MSN, RN, CWON

Disclosures

Wounds. 2021;33(11):304-307. 

In This Article

Abstract and Introduction

Abstract

Introduction: Negative pressure wound therapy (NPWT) is applied using a foam dressing and an adhesive acrylic drape to create a seal. Removal of this drape can be painful and may play a role in periwound skin breakdown during dressing changes. A novel silicone-acrylic hybrid drape (HA-drape) has been developed for use with NPWT to allow for repositioning after initial placement and easier removal.

Objective: This retrospective case series reports on the use of HA-drape in 4 patients who experienced periwound skin breakdown. The goal was to minimize skin breakdown while maintaining a seal on the dressing.

Materials and Methods: Four patients with mild to moderate periwound skin breakdown were selected to receive NPWT with HA-drape. Negative pressure wound therapy was applied using a reticulated open cell foam dressing followed by placement of HA-drape to create a seal. Negative pressure wound therapy was initiated at -125 mm Hg with dressing changes occurring every 2 days. Wound healing, periwound healing, and patient-reported pain were assessed at dressing changes.

Results: All 4 patients showed significant periwound skin improvement after the first dressing change. All patients reported a decrease in pain with dressing removal.

Conclusions: In these 4 patients' wounds, use of NPWT with HA-drape resulted in intact periwound with improved periwound skin healing and reduction in patient-reported pain associated with dressing changes.

Introduction

The use of medical adhesives in patient care has increased; however, their effect on the periwound skin is often overlooked.[1] The application and removal of medical adhesives can result in medical adhesive-related skin injury (MARSI) that is frequently worsened with adhesive and dressing removal and reapplication.[2]

Negative pressure wound therapy (NPWT), commonly used in wound care, is applied with a foam dressing and a polyurethane drape with an acrylic adhesive to create a negative pressure seal.[3,4] Removal of this drape can be painful and may play a role in periwound skin breakdown during dressing changes. A novel silicone-acrylic hybrid drape (HA-drape) consisting of a polyurethane film with acrylic adhesive and a silicone perforated layer has been developed for use with NPWT to allow for drape repositioning following initial placement and easier drape removal. In a recently published study, periwound skin in patients treated with NPWT and HA-drape showed no skin irritation or other complications, indicating that HA-drape can be used with minimal complications.[5] The present case series reports on the use of HA-drape in 4 patients in whom periwound skin breakdown developed, with the goal of minimizing periwound skin breakdown during NPWT while maintaining a negative pressure seal on the dressing.

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