Background Wound care is the cornerstone of treatment for patients with epidermolysis bullosa (EB); however, there are currently no guidelines to help practitioners care for these patients. Objectives The objective of this study was to generate a list of recommendations that will enable practitioners to better care for patients with EB. Methods An expert panel generated a list of recommendations based on the best evidence available. The recommendations were translated into a survey, and sent to other EB experts to generate consensus using an online-based modified Delphi method. The list was refined and grouped into themes and specific recommendations. Results There were15 respondents (45% response rate), with significant experience in the EB field (>10 years [67%]). Respondents included physicians (67%), nurses (17%), and allied health professionals (7%). There was more than 85% agreement for all the proposed items. These were further refined and grouped into 5 main themes (assessment and management of factors that impair healing, patient-centered concerns, local wound care, development of an individualized care plan, and organizational support) and 17 specific recommendations. Limitations There is a paucity of scientific evidence with most recommendations based on expert opinion. Conclusions These recommendations will provide practitioners with a framework for caring for these patients. Additional scientific research including effectiveness studies for everyday practice and expert consensus, may further refine these recommendations.

PHMB foam dressing successfully reduced chronic wound pain and bacterial burden.

: After participating in this educational activity, the participant should be better able to:

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Silver alginate powder is an effective treatment option for wounds with increased bacterial burden.

The aim of the study was to evaluate a novel foam dressing with continuous low-level release of ibuprofen (Biatain-Ibu foam dressing, Coloplast A/S, Humlebaek, Denmark) in persons with leg ulcers compared to local best practice. An open comparative and prospective block-randomised study of 24 patients was conducted in a Canadian wound clinic. Twelve patients were randomised to ibuprofen-foam and 12 patients to local best practice. The study population consisted of patients with chronic, painful exudating leg ulcers. The patients rated their wound pain intensity at baseline and after the first dressing application. Pain intensity in the morning and evening was rated during a period of 1 week using a numeric box scale (NBS). A t-test compared the main differences in pain intensity and a five-point verbal rating scale measured the patients' pain relief. At the last clinical visit, pain after dressing change was assessed using an NBS. In addition, wound size, percentage of healthy granulation tissue and the presence of peri-ulcer erythema, were (all) evaluated at inclusion and the end of the study. The nurses and patients both evaluated the relative dressing performance and exudate management at the last study visit. This study demonstrates that the ibuprofen-foam dressing decreased wound pain in patients with leg ulcers compared to best practice. The ibuprofen-foam dressing was associated with: diminished chronic pain between dressing changes, reduced acute pain at dressing change, increased healthy granulation tissue, decreased peri-wound erythema and excellent exudate handling capacity. It can be concluded from the results of the study that the combination of foam with a continuous low-dose release of ibuprofen may offer a valuable new therapeutic approach to the reduction of wound pain.

A nanocrystalline silver dressing combined with 4-layer bandaging was safe and successful in promoting healing in stalled CVLUs. Healing was associated with a reduction in wound bacteria and neutrophilic inflammation with an associated persistent or high lymphocyte count, as determined by wound biopsy.