Comparing test methods for moisture-vapor transmission rate (MVTR) for vascular access transparent semipermeable dressings.

BACKGROUND: Catheter insertion sites are commonly covered by transparent film dressings, offering protection of the insertion site from external contaminants and securement of the catheter while allowing site observation through a clear window. Currently, there is considerable focus on creating IV film dressings with ever-increasing moisture vapor transmission rates (MVTR) to prevent the accumulation of moisture under the film and reduce the risk of infection. These increasingly high MVTR IV dressings are often promoted as superior to IV dressings with lesser MVTR values. METHODS: Since there are different methods to determine MVTR, we chose to test a series of commercially available dressings with two standard methods to compare the results and better understand the information provided by this measurement. We used European Standard EN 13726 to test the MVTR of seven different IV dressings with two different methods (upright and inverted). RESULTS: We measured a range of MVTR values from 773 to 2838 g/m2/day for the upright method and from 845 to 30,530 g/m2/day for the inverted method for the seven IV dressings tested. Three dressings showed statistically different MVTR values with the two test methods. CONCLUSIONS: The MVTR test method (upright or inverted) used and considered for IV dressing product selection matters because the results obtained can be very different. We suggest that the upright method is better suited for IV dressings because they are not in constant contact with fluid. We conclude that the inverted method alone is not adequate to compare IV dressings.

Management of incontinence-associated dermatitis patients using a skin protectant in acute care: a case series.

OBJECTIVE: Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis. It is categorised by persistent erythema and can be associated with denudation and/or colonisation and infection. IAD is challenging to treat and affects 3.4-50% of patients. This case series evaluates a novel, elastomeric, advanced skin protectant (3M Cavilon Advanced Skin Protectant) in a UK acute health-care setting, for the management of IAD in patients suffering from moisture-associated skin damage (MASD) in the sacral/genital area. METHOD: The patient's skin was assessed by clinicians using the GLOBIAD classification tool at the point of recruitment and to monitor progress throughout the study period. The product was applied as a single layer in accordance with the instructions for use. Patients, when able, were asked to assess their own pain level using the Wong-Baker FACES pain scale. Photographs were taken as part of the ongoing assessment. RESULTS: The skin protectant was used on average every 2.28 days. Of the 18 IAD patients recruited, 79% (n=11) were classified as IAD-free, based on the GLOBIAD categorisation tool, by the end of the evaluation period. Skin deterioration during the evaluation period was seen in one patient (6%), and of the patients able to complete pain assessments, 55% (n=6) reported a reduction in pain. CONCLUSION: These results suggest that the elastomeric skin protectant, applied every three days, plays a role in the improvement of IAD. The skin protectant adheres to wet and weeping partial-thickness wounds and may aid IAD management. Reducing application to every third day supports a change in practice which may offer benefits to patients and caregivers.

Why don't patients adhere to compression therapy?

This article explores the psychological influences on patients and their choices over adopting (or not) the advice of health-care professionals (HCPs) with regard to their own health. The article will examine some key theories by reviewing studies as well as examining how the patient-HCP relationship has evolved over time to try and improve patient adherence. Although specifically focusing on the area of venous leg ulcers and compression therapy, the theories relate to many health conditions. Despite health advice and compression treatments being the cornerstone of ulcer prevention and recurrence when adhered to, patient adherence levels are often persistently poor, both anecdotally and via clinical study. This article attempts to explain what influences a patient's adherence.