Choosing Foot Dressings

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Choosing Foot Dressings
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Learning Outcomes

• Ability to choose an appropriate dressing for a
  foot problem
• Practical solutions to dressing foot and toe
  wounds
• Basic chiropody felt padding techniques

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Making Dressing Choices

• No Dressing
• Non adherent
• Absorbent
• Anti-microbial
• Iodine based gauzes or pastes
• Silver added to alginates,
• hydrocolloids and foams

• Alginates
• Hydrocolloid
• Hydrogels
• Foams
• Pressure relieving

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Examples What would you use on this wound?
First visit
5
A Hydrogel and Foam was chosen, but Inadine was
used instead of hydrogel at any sign of infection
Nine weeks Now what dressing?
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Again Inadine as necessary plus Foam dressing
30 weeks Healed
17 weeks
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Dressing?
First presentation Posterior Heel
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Moist wound healing with hydrogels as circulation
was good but increases risk of infection
2-2-06 20 weeks later and after several courses
of antibiotic therapy
9
Application of silver nitrate stick on
hypergranulation tissue
22 weeks
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Signs of Infection
27 weeks and signs of erythema, heat pain and
swelling
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Inadine and Foam dressings
39 weeks What other dressings may have speeded
healing?
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Still plodding on with Foams
49 weeks Cleaner with healthy granulation tissue
except for very centre
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Are Hydrogels or Moist wound healing techniques
sometimes inappropriate in necrotic wounds?
Patient with long term IDDM Plus Renal
complications Severe Ischaemia presents with dry
necrotic ulcer
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Risks of Infection outweigh benefits if
circulation is very poor
3 weeks later after Hydrogel and adhesive border
hydrocolloid was applied led to immediate
admission and AKA
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What dressing for this toe?
First presentation Sole of sandal cut into toe
apex
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Inadine plus Biatain oval in cavity of a Felt
Bonnet pad

• Demonstration of Bonnet pad and replaceable felt
  prop
• Then Tubegauze applications and tape
  demonstration
• Now everyone has a go on each other

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Big toe healed new ulcer on 2nd toe
Hallux ulcer healed within a month but 6 months
later presents with ulcer on 2nd toe and felt
props used in addition to dressings
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Use of felt in ulcer dressings

• Show DVD from Cuxson Gerrard

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Contraindications/Side effects

• Inadine
• Allergy
• Being treated for kidney problems
• Before and after use of radio-iodine
• Pregnant and breast feeding women
• Sorbsan/Aquacel
• Exudate too low to form fibres into gel
• Adhesive Tape causing traumatic injury during
  dressing changes

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Comments

• This presentation is used by Andrew Neve
  Specialist Podiatrist for Dorset PCT and Dorset
  County Hospital Foundation NHS Trust for lectures
  
• Consequently some references in the previous
  slides leads to verbal discussion and I hope this
  downloadable Powerpoint presentation does the
  same.