Abstract
Introduction and Objectives:
Current hand devices to delay webbing and contractures are often not tolerated. Dressings are bulky, baggy and impede hand function. To overcome these problems a disposable dressing glove and reinforced web-spacer glove, were co-designed with people with Recessive Dystrophic Epidermolysis Bullosa (RDEB). The objective of this study was to evaluate the performance of the novel gloves and analyse the costs.
Materials and methods: An N-of-1 proof of concept study was conducted to account for differences in clinical characteristics, skills and preferences regarding dressing use. Participants with RDEB (adults and children) who wore dressings on their hands or were advised to were recruited from two tertiary centres. Participants were invited to replace their conventional dressings with bespoke dressing gloves, manufactured to fit in an iterative process of measurement and adjustment. Self-reported outcome measures, co-designed and validated with patients and clinicians and uploaded to a Hand Therapy-Online (HTO) system included: experiences of wearing and changing dressings and hand skin condition (primary outcomes); and extent of finger webbing, wrist function, hand pain and hand function (secondary outcomes). Time taken for hand dressing changes, frequency and use of conventional products were also self-reported. Participants recorded contemporaneous notes.
Visual inspection of plotted outcome measures, unpaired t-tests and telephone interviews were used to assess performance. Routine clinical follow-up is being conducted in one centre within a Service Evaluation using the HTO system.
Results: Twelve participants were recruited, nine were fitted with the dressing glove and four completed the study. Eleven carers also provided data. Participants reported an improvement in their experience of wearing and changing dressings; reduced skin maceration; and improved skin appearance. Web spaces and wrist function were also mostly maintained. Participants reported a thicker viscose material could improve absorption and provide more protection. Achieving the correct fit took several iterations due to the difficulty of translating hand measurements into knitted gloves. Use of the dressing glove was cost neutral for two participants and increased for the other two because of more frequent dressing changes. All participants completing the study wanted to remain in the dressing gloves. Five additional patients adopting the gloves are self-reporting outcome measures within the Service Evaluation.
Conclusions: This study provides early proof-of-concept for the novel dressing glove for patients who could wear the gloves. Both gloves are available through the bespoke supply chain. Continual data collection supports a shared patient-clinician record, long-term evaluation and cost analysis.
Current hand devices to delay webbing and contractures are often not tolerated. Dressings are bulky, baggy and impede hand function. To overcome these problems a disposable dressing glove and reinforced web-spacer glove, were co-designed with people with Recessive Dystrophic Epidermolysis Bullosa (RDEB). The objective of this study was to evaluate the performance of the novel gloves and analyse the costs.
Materials and methods: An N-of-1 proof of concept study was conducted to account for differences in clinical characteristics, skills and preferences regarding dressing use. Participants with RDEB (adults and children) who wore dressings on their hands or were advised to were recruited from two tertiary centres. Participants were invited to replace their conventional dressings with bespoke dressing gloves, manufactured to fit in an iterative process of measurement and adjustment. Self-reported outcome measures, co-designed and validated with patients and clinicians and uploaded to a Hand Therapy-Online (HTO) system included: experiences of wearing and changing dressings and hand skin condition (primary outcomes); and extent of finger webbing, wrist function, hand pain and hand function (secondary outcomes). Time taken for hand dressing changes, frequency and use of conventional products were also self-reported. Participants recorded contemporaneous notes.
Visual inspection of plotted outcome measures, unpaired t-tests and telephone interviews were used to assess performance. Routine clinical follow-up is being conducted in one centre within a Service Evaluation using the HTO system.
Results: Twelve participants were recruited, nine were fitted with the dressing glove and four completed the study. Eleven carers also provided data. Participants reported an improvement in their experience of wearing and changing dressings; reduced skin maceration; and improved skin appearance. Web spaces and wrist function were also mostly maintained. Participants reported a thicker viscose material could improve absorption and provide more protection. Achieving the correct fit took several iterations due to the difficulty of translating hand measurements into knitted gloves. Use of the dressing glove was cost neutral for two participants and increased for the other two because of more frequent dressing changes. All participants completing the study wanted to remain in the dressing gloves. Five additional patients adopting the gloves are self-reporting outcome measures within the Service Evaluation.
Conclusions: This study provides early proof-of-concept for the novel dressing glove for patients who could wear the gloves. Both gloves are available through the bespoke supply chain. Continual data collection supports a shared patient-clinician record, long-term evaluation and cost analysis.
| Original language | English |
|---|---|
| Article number | P45 |
| Pages (from-to) | 49 |
| Number of pages | 1 |
| Journal | Acta Dermato-Venereologica |
| Volume | 100 |
| Issue number | Supplement 220 |
| DOIs | |
| Publication status | Published - Jul 2020 |