WyMedical
WyMedical lead the way with innovative products and services that put customer needs first. The WyMedical team have extensive experience and comprehensive understanding of the Urology service needs. This extends not only to product robustness and confidence, but to the clear need for convenience, dignity and practical aspects that this important health service provides.
Friday, May 13, 2016
Thursday, October 15, 2015
Sunday, October 4, 2015
Prevention of Catheter-Related Bloodstream Infections, 2015
In the television show The Sopranos, a later-season plot involved the owners of a trash collection company that had to keep the mob boss, Tony, on the payroll in to stay in business. This arrangement persisted for years, until the son of the owner took over and could not understand why he had to let Tony siphon off his profits just to keep the company open.
Similarly, health care–associated infections (HAIs) once appeared to be just the “cost of doing business” for practitioners in the hospital, a risk that patients were subjected to in order to receive the benefits of intensive interventions siphoning off the gains made in the outcomes of critically ill patients. Much like the extortive mob boss, HAIs were expensive, costing as much as $4.5 billion per year,1 and ruthless killers, causing nearly 100,000 deaths annually.2 Much of these costs can be attributed to catheter-related bloodstream infections (CRBSIs), which account for 11% of all HAIs.
Infectious Disease Special Edition - Prevention of Catheter-Related Bloodstream Infections, 2015
Similarly, health care–associated infections (HAIs) once appeared to be just the “cost of doing business” for practitioners in the hospital, a risk that patients were subjected to in order to receive the benefits of intensive interventions siphoning off the gains made in the outcomes of critically ill patients. Much like the extortive mob boss, HAIs were expensive, costing as much as $4.5 billion per year,1 and ruthless killers, causing nearly 100,000 deaths annually.2 Much of these costs can be attributed to catheter-related bloodstream infections (CRBSIs), which account for 11% of all HAIs.
Infectious Disease Special Edition - Prevention of Catheter-Related Bloodstream Infections, 2015
Tuesday, September 1, 2015
Reducing the Neonatal risk of knotting in fine bore drainage tubes.
Babies born with disorders such as myelomeningocele or other
congenital cord lesions such as sacral agenesis will often present with a neuropathic
bladder. Pre 1950’s babies born with such disorders often died until shunting
devices were developed but it wasn’t until the 1960s and 1970s that the ‘neuropathic
bladder’ was identified as a complication of these disorders and surgery such
as a vesicostomy, ileal conduit or ureterostomy were performed to protect the
upper tracts and kidneys. Renal impairment had been reported within 6 months of
age and as prevention of renal damage is a priority management of the neuropathic
bladder must start at birth with an aim to replicate, where possible, normal
bladder function. Clean intermittent catheterisation combined with an
anticholinergic has been identified as an effective initial form of management,
however, this may lead to potentially more cases of spontaneous knotting from
‘catheterising’ being reported if people are not aware of the complication.
The first reported case of knotting following transurethral
catheterisation was reported in 19762 with further cases being
reported, more commonly in neonates and children and mostly boys with almost
all cases reporting the use of a feeding tube having been used.
Feeding tubes are often used as are they are available in smaller
sizes than catheters with 4Fr/Ch and 6Fr/Ch being commonly used. However,
feeding tubes tend to be much longer than catheters with lengths of up to
125cm, encouraging clinicians to insert more tubing than necessary into the
bladder.
Feeding tubes and catheters sizes 6Fr/Ch and under are very
fine and flexible, when excessive tubing has been introduced into the bladder
it can form a loop, then as the bladder decompresses, the tubing can become
knotted or entangled. When it comes to removal of the tubing, the loop/knot may
tighten as it meets resistance on withdrawal making removal of the catheter
urethrally traumatic or impossible requiring surgical intervention.
Most reported cases felt the risk of knotting could be
avoided or prevented with a better understanding of the urethral anatomy in
neonates and young children and selecting a more suitable catheter.3,4,5
A new-born male urethra measures approximately 5cm and
increases to about 8cm by the age of 3. The female urethra is much shorter and has
a slower development time measuring approximately 2.18cm at birth, increasing
to around 2.54cm by the age of 5. It is therefore recommended that no more than
6cm of length should be inserted into a male new-born and 5cm in a female and in
babies with very low birth weight <750 grams, <5cm should be inserted in
boys and <2.5cm in girls.3
In addition, clinicians should be encouraged to pass a
catheter until urine starts to flow and then introduce the catheter
approximately another centimetre to ensure the catheter is positioned in the
bladder without excess.
Where possible the catheter should be passed, the urine
allowed to drain and the catheter removed, however, there are incidences when
the bladder may need to be on continuous drainage. When left in situ it is
important to secure the catheter effectively to prevent inadvertent advancement
of the catheter into the bladder.4
Wymedical have launched a size 5Fr/Ch catheter, at the
request of a Paediatric nurse, which is 25cm in length to try to overcome the
temptation of introducing an excessive length of tubing into the bladder and
therefore reduce the risk of knotting and licensed for purpose. The Wycath
uncoated catheter, WUP05, is DEHP free and is available on prescription
enabling parents of new-born babies to be able to undertake intermittent
catheterisation from birth and reduce the risk of damage to the upper tracts.
The families can be discharged from hospital and managed at home under a close
eye of a urology team until further surgery is required.
References
1.
Foster H, Ritchey M. Bloom D. Adventitious knots
in urethral catheters: report of 5 cases. J Urol 1992; 48 1496-8
2.
Harris VJ, Ramilo J. Guide wire manipulation of
knot in catheter used for cysto-urethrography. JUrol 1976; 116 529
3.
Carlson D, Mowery B. Standards to prevent
complications of urinary catheterisation in children: should and should knots.
J Soc Pediatric NUrs 1997; 2:37-41
4.
Arena B, McGillivary D, Dougherty G. Urethral
catheter knotting: be aware and minimise risk. Canadian Journal of Emergency
Medicine 2002; 4(2): 108-110
5.
Sarin YK.Spontaneous intravesical knotting of
urethral catheter. APSP J Case Rep 2011; 2:21
Saturday, July 4, 2015
Why is their a lack of catheter innovation?
Excellent article by Prof Mandy Fader.
Unfortunately some of the difficulties in smaller businesses
introducing innovation is the patents held by the larger organisation.
Wymedical has introduced innovation with improved catheter tip technology and
quality coating to ease patient comfort and trauma. Coloplast however own a patent on
packaging and refuse to allow Wymedical (and other smaller companies) to
package their innovative catheters in a package suitable for patients with dexterity
issues, as often elderly patients suffer with.
This leads to patients wanting to use the new catheters more
suited to their situation (one catheter doesn’t fit all requirements) but
having difficulty simply getting the catheter out of the packaging due to some
large corporate blocking companies because they own a ridicules patent.
Similar issues will occur with any Bio technology more
likely to be developed by smaller innovative businesses. There are over 7.500
patents related to catheter with a significant number around the packaging of a
catheter. The patent process was aim to protect innovation, but more often
these days it’s used for large corporates to protect their profits and restrict
innovation.
What is the incentive of a small business to spend hard earn
revenue on R&D for Bio technology if a larger corporate such as Coloplast can
block the innovation because of the way the catheter is packaged.
As the article points out there is little incentive for the
large corporates to innovate with catheter technology when huge profits are
being made out of the existing catheters. Better to put the R&D budget into
other areas while you can block innovation through poorly approved patents on
something as basic as how you package a catheter.
How can this be to the benefit of patient care and
innovation?
Friday, June 12, 2015
Tuesday, June 9, 2015
Conference Exhibitee to Exhibitor
The first ACA
conference I attended was in Scarborough, having previously worked in a
hospital environment and been appointed as a continence advisor in the
community attending a conference was very different if not a little
overwhelming.
Back then the ACA conference was run differently, each
branch took turns to organise the annual conference. I remember being on the
organisers committee when the London branch hosted the conference in
Bournemouth and I am still in possession of my t-shirt.
As a clinician I looked to the ACA conference to update my clinical skills and also my knowledge of the products on the market, not just new products but to refresh myself on existing lines. It was a great opportunity to network with other clinicians and to reflect on my practice and not forgetting collecting post-it notes and pens!
As an exhibitor many of my objectives remain the same, I
still look to keep my knowledge up to date and enjoy listening to some of the
speakers of areas within continence and urology which are still of interest to
me.
Exhibiting at a
conference for any company is a big financial commitment, however, it can be
beneficial. As a small company, we have to weigh up the benefits of supporting
a conference, I do not have a salesforce so conferences enable me to see clinicians
whom I may not have met and to catch up with those I haven’t had the
opportunity to visit for a while. However, I often leave conferences disappointed
when I look at the delegate list and note that only a fraction of the attendees
have visited. As clinicians roles are forever changing keeping abreast of all
products within the speciality of continence and urology can only improve
patient care.
It is easy to be lured to the big stands, however it is
often the smaller companies who bring to market innovative niche products which
can bridge a gap and make the biggest impact on the patient.
Please try and take time to visit all the stands big or
small as you never know what could be lurking in the corners…..
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