Evaluation of Skin Tear healing outcomes utilising two differing wound dressing types.

This study assessed Skin Tear healing trends with the use of two differing wound dressing products which were used as part of standard practice to ascertain which product provided the best outcomes. These two dressings were Mepilex Border (adhesive silicone foam dressing) and Mepitel (meshed silicone interface dressing). Both products are manufactured by the same company and fall into the generic category of soft silicone dressings and utilise what is called ‘Safetac Soft Silicone Technology’ (SSST). While they share the same SSST, they are completely different in terms of appearance, application, and usage. Mepilex Border is a self-adhesive waterproof dressing with foamlike like properties that absorb exudate and evaporate excess exudate (wound ooze) through the top of the dressing via moisture vapour permeability. The dressing contact layer (which sits on the skin) contains the SSST. When placed onto a skin tear this layer anchors the skin flap preventing movement. The absorptive pad absorbs the exudate preventing maceration of the flap and periwound area. Mepitel is a wound contact layer not unlike traditional tulle gras (paraffin coated open weave gauze) in appearance; however unlike this traditional dressing, Mepitel is wholly constructed with the SSST. This dressing is placed on a skin tear and the surrounding skin, the SSST anchors the skin flap to the surrounding skin and allows exudate to pass through the dressing. This dressing requires a secondary covering to be placed on top to absorb the exudate, for example a combine pad (cotton wool) and then a bandage to hold the dressing in place. Patients were randomised into two treatment arms with their Skin Tears dressed either with the adhesive silicone foam dressing or the meshed silicone interface dressing. Apart from the two different products used, the total care procedure was the same for both. The Research Nurse/Assistant (RA) collected baseline data when the skin tear was first assessed, with follow-up data collected at 7 days, 14 days, and 21 days. The RA was responsible for undertaking the dressing (which includes removal of the old dressing, wound cleansing and dressing reapplication - in accordance with the Hospital Wound Management Procedure) as per the random allocation at each data collection time. As per the manufactures guidelines and the protocol, both these dressings were to remain in place for the 7 days between the RA visits. A wound management/treatment form with the dressing plan (as per the random allocation) was included within the patient’s ward clinical documents. If the dressing required changing before the RA visit, the ward nursing staff would change the dressing as per the plan and document this on the wound management/treatment form (in accordance with the Hospital Wound Management Procedure). They had an additional step to call and advice the Research Team of this dressing change. Both the recording on the wound management/treatment form and call to the Research Team were used as strategies to assess adherence to the dressing plan.