How to guidesFlivasorb & Flivasorb Adhesive

Flivasorb & Flivasorb Adhesive

Complex wounds, Exudate Management, Products | June Jones

Tips on using Flivasorb and Flivasorb Adhesive

Indications

  • Flivasorb and Flivasorb Adhesive are indicated for moderately to highly exuding wounds.
  • Flivasorb and Flivasorb Adhesive may be used under compression.  Flivasorb Adhesive should only be used under compression bandaging if there is a specific requirement for an adhesive dressing in this situation, but can be very convenient to use under compression hosiery.
  • Flivasorb or Flivasorb Adhesive can be used on critically colonised and infected wounds as they have bacteriostatic properties (Weigand et al, 2009). Antimicrobial dressings and/or systemic antibiotic therapy may also be required and a thorough patient assessment should be carried out.


Precautions and contraindications

  • Do not use Flivasorb or Flivasorb Adhesive on patients sensitive to any of the components of the dressings.
  • If using oily ointments on a wound or surrounding skin where Flivasorb or Flivasorb Adhesive is used, this may affect the absorbency/adhesion capability of the dressing, where it is in contact with the ointment.
  • Do not use Flivasorb in wound tunnels because the dressing will expand in the tunnel and may be difficult to remove.
  • Do not use Flivasorb or Flivasorb Adhesive on lightly or non-exuding wounds.


Applying the dressing:

  • The wound should be cleansed according to local protocols and the wound edges patted dry before application of Flivasorb or Flivasorb Adhesive.
  • Antiseptic cleansing solutions can be used with Flivasorb and Flivasorb Adhesive.
  • Flivasorb should be applied with the blue side facing away from wound.
  • Flivasorb should extend beyond the wound edge by about 2-3cm.
  • Flivasorb Adhesive should extend beyond the wound edge by about 4-5cm.
  • Apply Flivasorb Adhesive without stretch to allow the dressing room to expand and prevent tension on the surrounding skin when the dressing absorbs exudate and swells.
  • Do not cut Flivasorb or Flivasorb Adhesive because the absorbent contents of the dressing will come out.
  • Flivasorb will require additional secondary fixation, but Flivasorb Adhesive does not.


Dressing change frequency
Flivasorb and Flivasorb Adhesive should be changed when the absorbent capacity of the dressing has been reached. This may be after 2-3 days, but in some cases more or less frequent changes may be necessary. (Adapted from Morris, 2009.) 

Evidence for using Flivasorb
A number of observational studies, case series and case studies that discuss the use of Flivasorb and Flivasorb Adhesive in a range of wound types have been reported. These studies support the effectiveness of Flivasorb in the management of highly exuding wounds in reducing maceration and dressing change frequency. Dowsett (2008) advised that frequent dressing changes can lead to periwound damage by stripping the skin. It is also important to remember that for many patients the removal and/or changing of a dressing is the most common trigger for pain in chronic wounds (Meaume et al, 2004).



Clinical benefits
Another study examined the use of Flivasorb for 7 days in 15 patients with highly exuding wounds. At the start of the study, seven patients had periwound maceration, but this had fallen to one patient by the end of the study. In addition, after three days, dressing change frequency was reduced from daily to twice weekly in 12 patients (Faucher et al, 2012).

An evaluation Flivasorb Adhesive in 11 patients found the product easy to apply. Patients reported comfort during wear to be good to excellent, and reported low or almost no pain during dressing changes (Mustafi et al, 2012). Further case studies have confirmed that Flivasorb is effective under compression bandaging for venous leg ulceration (Collarte and Lear, 2010) and lymphoedema (Billingham, 2009; Lewis, 2010).

Cost benefits
In a prospective four week study of 16 patients with highly exuding wounds, change of treatment to Flivasorb resulted in a reduction in dressing change frequency by 1-2 visits per week, which gave considerable cost savings. The authors calculated that by reducing daily dressing changes (at a cost of £8,736 per year - based on £24 per change) to twice weekly, a significant saving of £6,240 per year is made for each patient that does not heal within the year for dressing costs alone (Verrall et al, 2010).


Maximising patient quality of life
In the community setting where dressing changes are generally forward planned, patients need to know that the dressing selected will stay in place for the duration of time between dressing changes. Anxiety levels can be raised if patients have to contact the district nurses between planned dressing changes as they often assume that something must have gone wrong. They also need to be confident that the dressing will contain the exudate ensuring that they are not left either feeling self-conscious because there is strikethrough, with the potential risk of malodour, or with extra washing because the wound has leaked onto the bedclothes (Jones et al, 2008). Patient comfort and acceptability are important factors when determining success or otherwise of a treatment regimen.

References

  • Adderley U (2008) Wound exudate: what it is and how to manage it. Wound Essentials 3: 8-13
  • Benbow M, Stevens J (2010) Exudate, infection and patient quality of life. Br J Nurs 2010; 19(20): S20, S32-6
  • Billingham R (2009) The management of lymphorrhoea with Flivasorb and Actico. Poster at: Wounds UK conference, Harrogate (UK)
  • Collarte A, Lear Z (2010) Use of superabsorbent and antimicrobial dressings under compression. Poster at: Wounds UK Conference, Harrogate (UK)
  • Davies P (2012) Exudate assessment and management. Wound Care S18-24
  • Dowsett C (2008) Exudate management: a patient-centred approach. J Wound Care 17(6): 249-52
  • Faucher N, Safar H, Baret M, et al (2012) Superabsorbent dressings for copiously exuding wounds. Br J Nurs 21(12): S22-28
  • Gardner S (2012) Managing high exudate wounds - how to guide. Wound Essentials 7(1). Available at:  http://www.wounds-uk.com/pdf/content_10474.pdf.
  • Jones JE, Robinson J, Barr W (2008) Impact of exudate and odour from chronic venous ulceration. Nurs Standard 22(45): 53-4,56,58
  • Lewis M (2010) Chronic oedema - a patient's perpetual journey for treatment. Poster at: European Wound Management Association (EWMA), Geneva (Switzerland)
  • Meaume S, Telom L, Lazareth I, et al (2004) The importance of pain reduction through dressing selection in routine wound management: the MAPP study. J Wound Care 13: 409-13
  • Menon J (2012) Managing exudate associated with venous leg ulceration. Wound Care S6-16
  • Morris C (2009) Flivasorb® and the management of exudate. Wounds UK 5(2): 63-66
  • Mustafi N, Hampton S, Krähenbühl S, et al (2012) First evaluation of an adhesive superabsorber dressing on 11 patients with wounds of different aetiologies and exudate levels. Poster at: 22nd Conference of the European Wound Management Association (EWMA), Vienna (Austria)
  • Stephen-Haynes J (2011) Managing exudate and the key requirements of absorbent dressings. Br J Community Nurs 16(3 Suppl): S44-49.
  • Tadej M (2009) The use of Flivasorb in highly exuding wounds. Br J Nurs 18(5): S38-42
  • Verrall D, Coulbourn A, Bree-Aslan C (2010) Evaluating a super-absorbent dressing (Flivasorb) in highly exuding wounds. Br J Nurs 19(7); 449-53
  • Wiegand C, Abel M, Ruth P, Hipler U-C (2009a) Antibacterial and antifungal effect of polyacrylate superabsorbers. Poster at: Wounds UK Conference,Harrogate (UK)
  • Wiegand C, Abel M, Ruth P, Hipler U-C (2009b). A polyacrylate-superabsorber inhibits the formation of ROS/RNS in vitro. Poster at: Wounds UKConference, Harrogate (UK)
  • Wiegand C, Abel M, Ruth P, Hipler U-C (2009c). Polyacrylate-superabsorber binds inflammatory proteases in vitro. Poster at: Wounds UK Conference,Harrogate (UK)
  • World Union of Wound Healing Societies (WUWHS) (2007) Principles of best practice: Wound exudate and the role of dressings. A consensus document. London: MEP Ltd. Available at: www.woundsinternational.com


Contributor: June Jones, Independent Nurse Consultant, Associate
Tutor, Edge Hill University, Ormskirk, Lancashire 

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