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Purely by coincidence, all of the books reviewed in this month's column are about animals. This is not surprising, since books with animal characters are often favorites of children. Ranging [...]

Dressings continue to be a key part of successful wound care, however, choosing the right product for the right patient at the right time can be challenging for the clinician (Hedger, 2014). Modern foam dressings have been widely available since the mid-1970s with the aim to manage light-to-heavy exuding wounds (Hedger et al, 2014). Historically, bordered foam dressings have utilised acrylic-based adhesives; however, these have been associated with increased risk of skin sensitisation and medical adhesive-related skin injuries (MARSI; Meuleneire and Rucknagel, 2013; Hedger et al, 2014; Mestach et al, 2018; Downie and Collier, 2021). A clinical evaluation was undertaken to detail the characteristics and performance of Suprasorb® P sensitive silicone foam dressing (L&R Healthcare). The evaluation comprised a minimum of four dressing changes over at least 2 weeks. Fifty patients (51 wounds) were included in the evaluation. At the final evaluation, 57% (n=29) of the wounds were recorded as improved, 37% (n=19) were recorded as static and 6% (n=3) were recorded as having deteriorated. Of the 27% (n=14) evaluations where patients reported self caring, 71% scored Suprasorb P sensitive as above average for ease of use, suggesting the dressing may be suitable for patients who were self-caring and can apply their own dressing. Suprasorb P sensitive performed well in all the parameters evaluated and may be considered where effective exudate handling, improved patient comfort and ease of handling is required. [ABSTRACT FROM AUTHOR]

This article describes the evaluation in clinical practice of Kliniderm foam bordered and non-bordered, including the heel-shaped wound dressing on 25 patients over a twoweek period, with an average of four dressing changes and a minimum of two dressing changes. An evaluation form was completed at each dressing change, which aimed to elucidate particular aspects of the dressing's performance, considering: patient comfort on application, ease of application, conformability of the dressing, the dressing's ability to manage exudate, ability to stay in place, ease of removal and patient comfort on removal, the condition of the wound and the surrounding periwound skin. The ratings on evaluation forms were collated and an average rating was calculated for each category. [ABSTRACT FROM AUTHOR]

This article describes the evaluation in clinical practice of Kliniderm silicone wound contact layer on 21 patients over a two-week period, with an average of four dressing changes and a minimum of two dressing changes. An evaluation form was completed at each dressing change; aspects being evaluated included patient comfort on application, ease of application, conformability, exudate transfer to secondary dressing, ability to stay in place, ease of removal, patient comfort on removal, the condition of the wound and periwound skin, and the wear time of the dressing. The ratings from each evaluation form were collated and an average rating was calculated for each category. [ABSTRACT FROM AUTHOR]

Foot ulcers in diabetes and their associated consequences (including amputation) present a significant burden to both patients and the NHS. The majority of foot ulcers are preceded by callus formation, effective treatment and prevention of callus will, therefore, reduce the burden of foot ulcers in diabetes. Emollients are a commonly used topical treatment for hyperkeratosis/callus, but there is a lack of evidence regarding optimal use in diabetes foot care. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a huge effect on podiatry services, both from a clinician and patient point of view. This has resulted in changes to the way care is being delivered, some of which may result in permanent shifts -- both positive and negative. An expert group of podiatrists met online in early July 2020, to discuss the challenges of delivering podiatry services during a pandemic, how they have addressed these challenges, and how this may change delivery of care in the future. [ABSTRACT FROM AUTHOR]

Slow-healing, chronic wounds have a negative impact on patient wellbeing, are challenging for clinicians to manage and are costly to the health economy (Frykberg and Banks, 2015). Woulgan is a newly available wound care gel containing the active ingredient 2% soluble beta-glucan. Beta-glucan has immunomodulating properties and has been shown to kick-start the healing of slow-healing wounds. A working group of key opinion leaders met in January 2018 to determine the potential role of Woulgan gel in slow-healing wounds, such as diabetic foot ulcers, pressure ulcers and venous leg ulcers, and to develop a decision pathway for clinical practice to support clinicians in escalating treatment promptly to avoid unnecessary impact on patient wellbeing and costs. The group's consensus recommendations on appropriate use are presented here. [ABSTRACT FROM AUTHOR]

The management of exudate is an essential requirement in wound care. It is important that an optimal moist environment is created and the surrounding skin protected from the risk of maceration and subsequent risk of infection. Selected antimicrobial dressings for wounds aim to manage exudate levels, maintain a moist wound environment, aid progression and reduce any signs of infection. This article reports on how the ActivHeal Aquafiber Ag dressing performs on a diverse range of patients with complex infected and non-infected wounds. [ABSTRACT FROM AUTHOR]

Objectives: A clinical evaluation was undertaken to detail the characteristics and performance of a next generation Silicone foam dressing and how it impacted skin sensitisation and medical adhesive-related skin injuries (MARSIs) Methods: The evaluation comprised a minimum of four dressing changes over at least 2 weeks. Fifty patients (51 wounds) were included in the evaluation. The evaluation was undertaken in a community setting and an acute Diabetic Foot Clinic. Each patient evaluation ran for a minimum of 2 weeks with a minimum of four contacts including the first contact and application of the Silicone foam. All patients over the age of 18 years who had a wound with low to moderate levels of exudate were invited to be involved in the evaluation. The aim was to include at least 40% of patients with friable and vulnerable skin, or who were known to have experienced MARSIs in the past. Results: At the final evaluation, 57% (n=29) of the wounds were recorded as improved, 37% (n=19) were recorded as static and 6% (n=3) were recorded as having deteriorated. Silicone foam dressing was rated highly by both clinicians and patients, in all aspects of comfort, softness, ease of removal and ability to stay in place, with no reports of skin damage from the adhesive. Conclusions: In this 51-wound evaluation, the Silicone foam dressing performed well in patient comfort and ease of handling, exudate management and where there was existing poor peri-wound skin condition. Generally, the peri-wound skin condition improved, suggesting that the dressing could be included as part of a holistic wound care plan to support effective exudate management and care of the peri-wound skin. [ABSTRACT FROM AUTHOR]

Background: The goal of this study was to assess the effect of a controlled adverse environment (CAE) challenge on subjects with both allergic conjunctivitis and dry eye. Methods: Thirty-three subjects were screened and 17 completed this institutional review board-approved study. Subjects underwent baseline ocular assessments and conjunctival allergen challenge (CAC) on days 0 and 3. Those who met the ocular redness and itching criteria were randomized to receive either the controlled adverse environment (CAE) challenge (group A, n = 9) or no challenge (group B, n = 8) at day 6. Thirty minutes after CAE/no-CAE, subjects were challenged with allergen and their signs and symptoms graded. Exploratory confocal microscopy was carried out in a subset of subjects at hourly intervals for 5 hours post-CAC on days 3 and 6. Results: Seven minutes post-CAC, subjects exposed to the CAE had significantly greater itching (difference between groups, 0.55 ± 0.25, P = 0.028), conjunctival redness (0.59 ± 0.19, P = 0.002), episcleral redness (0.56 ± 0.19, P = 0.003) and mean overall redness (mean of conjunctival, episcleral, and ciliary redness, 0.59 ± 0.14, P < 0.001). The mean score at 7, 15, and 20 minutes post-CAC for conjunctival redness (0.43 ± 0.17, P = 0.012), episcleral redness (0.49 ± 0.15, P = 0.001), mean overall redness in all regions (0.43 ± 0.15, P = 0.005), and mean chemosis (0.20 ± 0.08, P = 0.017) were also all significantly greater in CAE-treated subjects. Confocal microscopic images of conjunctival vessels after CAC showed more inflammation in CAE-treated subjects. Conclusion: In subjects with both dry eye and allergic conjunctivitis, exposure to adverse environmental conditions causes an ocular surface perturbation that can intensify allergic reactions. [ABSTRACT FROM AUTHOR]

While age-related decreases in lower extremity kinesthesis have been reported, age-related changes in upper extremity kinesthesis are minimally documented. This study compares kinesthetic acuity and kinesthetic memory in younger and older adults and establishes test-retest reliability of the testing devices. Subjects included thirty-six normal 20-29-year-olds and thirty-six normal 60-69-year-olds. Kinesthetic acuity and kinesthetic memory were assessed using a ramp and stencil device, respectively. Younger subjects exhibited significantly lower thresholds for kinesthetic acuity than older subjects (p = 0.049), and less error on the kinesthetic memory test than older subjects (p < 0.000). [ABSTRACT FROM PUBLISHER]

Purpose: To compare the clinical efficacy of Patanol® (olopatadine hydrochloride ophthalmic solution 0.1%) to Claritin® (loratadine 10 mg) tablets, in the conjunctival allergen challenge model. Methods: This was a randomized, double-masked, single center, contralateral controlled, antigen challenge model study. The concentration of allergen that elicited a positive response was determined at Visits 1 and 2 (itching ≥2 and redness ≥2 OU). At Visit 3, 29 subjects were randomized into two groups. Fifteen subjects received Claritin® tablet and Patanol® ophthalmic solution 0.1% in one eye and placebo in the contralateral eye. Fourteen subjects received placebo tablet and Patanol® in one eye and placebo in the contralateral eye. One hour after drug administration, subjects were challenged with the antigen that elicited a positive response. At 3, 7, and 10 minutes, itching was subjectively evaluated. At Visit 4, the same procedure was followed as in Visit 3, but antigen challenge occurred 8 hours after drug instillation. Results: Results were analyzed by eye. Eyes treated with Patanol® (concomitant with placebo tablet) had significantly lower ocular itching scores when compared to eyes treated with placebo (concomitant with Claritin®) at 3, 7 and 10 minutes in the onset of action evaluation (p<0.05). Eyes treated with Patanol® (concomitant with placebo tablet) had significantly lower ocular itching scores at 7 minutes and there was a statistical trend (0.05