macerated skin with wound vac

Warnings sound when the canister fills, preventing egress of the fluid into the patient. Wrinkled skin is the first and most obvious sign of skin maceration. The pressure pulls the edges of the wound together. The assessment and maintenance of skin integrity in the paediatric patient should be fundamental to the provision of nursing care. How much does it cost? At times, this macerated skin leads to soreness and pain and reveals the underlying tissue layers. Given these challenges, these authors present a novel technique to address this issue and reduce the risk of periwound maceration. Sweating e… It also enhances the body’s ability to…, Ever wonder why your skin looks white and shriveled when you take off a bandage you’ve been wearing for a while? VAC is suitable for a wide range of wounds. Any hair at the wound site was shaved to facilitate subsequent removal of the dressing. 2004; 17 (Suppl 2):1-16. The cohesive seal provides double-sided adhesion and is completely moldable. It is an easy and inexpensive technique that can be performed by any clinician applying VAC therapy. Another possible complication is macerated skin, which is the softening and breaking of skin around the wound due to moisture. Your doctor should be able to give you an estimate for how long you’ll undergo VAC therapy based on your wound. Wound infection. Wrinkles are the first sign that the skin is over-hydrated.    Physicians can perform this technique in any anatomical area, which is prone to periwound maceration. Another possible complication is macerated skin, which is the softening and breaking of skin around the wound due to moisture. It is suggested that maceration is an under-recognised problem that causes delayed healing (White and Cutting, 2003). (Note that you shouldn’t leave your VAC system unplugged for more than 2 hours per day.). © 2005-2021 Healthline Media a Red Ventures Company. Skin that is macerated is vulnerable to breakdown, leading to a … A person undergoing VAC therapy wears the device for close to 24 hours per day while they’re healing. Using VAC healed the ulcer in 6 weeks at half the cost of reconstructive surgery. One review concluded that VAC has the potential to reduce infections after surgery. Once you have rolled the Eakin cohesive seal to the accurate size and shape, you can manually apply it to the wound edges until the entire wound is covered. The Skin under the bandage becomes wet from perspiration, seepage of fluids from wound and even urine in patients who are completely bed ridden. He is a Fellow of the American College of Foot and Ankle Surgeons. A macerated wound is an injury accompanied by soft, white, deteriorating skin around the site of the original injury. It’s also referred to as negative pressure wound therapy. Int Wound J. Despite the practicality of VAC therapy, foot wounds can be a challenging and difficult area for placement of the VAC therapy device. VAC may be a suitable treatment option in some cases. intertriginous dermatitis (ITD), medical adhesive related skin injury (MARSI), or traumatic wounds (skin tears, burns, abrasions). Another common complication that can arise with NPWT is when the edges of a wound become macerated. The wound was subsequently skin grafted [Figure 4d]. Maceration will also cause the skin to be extremely soft and take on whitish coloration. When VAC therapy starts, you may feel stretching and pulling around your wound. Potential wound VAC therapy complications, New Bandage May Help Wounds Heal More Quickly for People with Diabetes, Everything You Need to Know About Macerated Skin, Doctors May Soon Be Able to ‘Spray’ Bandages onto Wounds. However, in certain situations this barrier is ineffective and the defence mechanism is breached, in particular after prolonged exposure to moisture or corrosive body fluids. If it’s severe, a hydrocolloid border may help decrease maceration. The wound was then covered with a semiocclusive dressing (Opsite, Smith and Nephew, Hull, UK) (Figure 2a-b). This decision is based on the anatomical configuration and depth of the wound. 6. Armstrong DG, Lavery LA, Abu-Rumman P, et al. The most common cause of macerated skin edges around a wound receiving NPWT is lack of proper technique. Describe wound edges (approximated, rolled, calloused) Describe periwound skin (indurated, erythematous, macerated, healthy) Describe presence of excoriation, denudement, erosion, papules, pustules or other lesions; Induration - Abnormal hardening of the tissue caused by consolidation of edema, this may be a sign of underlying infection. The technique consists of rolling a piece of Eakin cohesive seal into a tube shape in order to line the wound edges. 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Lancet. Other potential complications include bleeding, bacterial infections, and a lack of wound healing, which can lead to more invasive treatment methods. Cyanoacrylate skin protectant* was applied to the macerated area and covered with VAC drape. Damage to the periwound skin can arise from inadequate wound exudate management. Risk factors for reopening range from pre- to post-op, but…. Can wound VAC be done at home? VAC therapy is a very convenient and valuable tool for healing wounds. Due to the seal’s many advantages and its effectiveness in stomas, its use with VAC therapy and difficult wounds make it a great choice to help diminish the complications of periwound maceration. In some cases, a medical professional might administer pain medication 30 to 60 minutes before changing the bandages. The researchers found a link between third-degree burn wound size and the number of VACs received. Maceration occurs when too much moisture is trapped between the wound and its bandage--sometimes the exudate (seepage of biological waste from the wound) escapes and gets trapped under the bandage, and sometimes the wound itself becomes overly moist. Settings are adaptable on the unit and the settings depend on the type and complexity of the wound. In some cases the wound itself becomes excessively moist. Wound VAC has the potential to be a cost-effective treatment option to help treat various types of wounds. VAC might be useful in the healing of traumatic injuries and postoperative wounds. Most clinical trials on people and animals have found that VAC for wound healing is equally or more effective than conventional wound closing techniques. VAC gained popularity as a wound treatment option throughout the 1990s and 2000s. One study looked at the use of VAC to heal a patient’s ulcer. Macerated skin looks lighter in color and wrinkly. It can be used for a variety of wounds, such as those caused by burns, cesarean deliveries, and traumatic injuries. It also discusses the importance of preventing excessive moisture loss from certain wound types and describes the way in which dressings can d… A wound that is too moist can be as detrimental to wound healing as a wound that is too dry. How Do I Get Ready For A Vacuum-Assisted Closure of A wound? The film has an opening that rubber tubing can fit through to connect to a vacuum pump. During a VAC procedure, a healthcare professional applies a foam bandage over an open wound, and a vacuum pump creates negative pressure around the wound. Healthline Media does not provide medical advice, diagnosis, or treatment. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomized controlled trial. Eakin. To prevent this, consider the "mushroom" or "button" dressing technique. However, some types of wounds aren’t suitable for VAC. In rare cases, VAC can lead to bleeding, bacterial infections, or other serious complications. Once these parameters have been considered, an aim can be set. A macerated wound involves softened and white deteriorating skin at the area of the injury. This technique is also effective for highly exudating wounds and irregular shaped wounds. It’s due to maceration. Causes of Skin … The influence of the rate and frequency of distraction. One study presented two cases of people who developed sepsis and hemorrhage after having VAC therapy for burns. Most of us are familiar with the wrinkled appearance of our hands and feet after a long bath. Removal of necrotic tissue and management of infection is paramount to move on to the wound healing phase. Ostomy Wound Manage. Armstrong DG, Lavery LA. This is a wound vac dressing change on my recent leg wound. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: Clinical experience. However, this white skin should not be confused with the pale, whitish appearance of the new epithelial tissue in a healing wound. Prevent leakage, prevent sore, irritated skin, remove the sting of stoma paste, extend pouch weartime with Eakin cohesive seal. This also warms the seal to body temperature, making it easier to mold the seal. Podiatry Today is a trademark of HMP. Living with a wound VAC can cause challenges to your daily life, but understanding what you can and can’t do while undergoing treatment can make treatment easier. Ensure that bleeding is controlled, the skin margins are clean and dry, the sponge does not extend onto the skin and is well within the wound, that there is a good overlap of the drape onto the skin (at least 4 cm), and that a skin    Proceed to apply the VAC therapy adhesive drape and make the sponge cut to fit the size and shape of the wound. Over-soaking in the bath or swimming pool 2. management and treatment of a complex exuding wound. An adhesive dressing secures the foam.    Additionally, the clinician can also apply the Eakin cohesive seal over any secondary dressing (such as Mepitel) used for a graft. In addition, macerated skin becomes extremely soft and takes on a whitish appearance. What Are the Benefits and Risks of Doing Daily Pushups? Collaboration between the nursing team and treating medical team is essential to ensure appropriate wound management and facilitate optimal wound healing. Allergy from the adhesive sheet. Our website services, content, and products are for informational purposes only. 2005; 366(9498):1704-10 4.    The physician then attaches the pump to the adhesive dressing, which is connected to a computerized therapy unit that delivers either intermittent or continuous suction. © 2021 HMP.    To help prevent this complication from occurring, one may create a durable seal with the VAC therapy device by using the Eakin® cohesive seal (TG Eakin Ltd.).    The VAC therapy device utilizes a reticulated polyurethane foam dressing that one places in contact with the wound, maximizing the potential for tissue ingrowth.7 Additionally, the foam ensures equal distribution of sub-atmospheric pressure to every part of the wound that is in contact with the foam. In modern wound care we are trying to keep wounds moist but not soaked. Your surgeon will determine if it’s suitable for you to continue VAC therapy at home. Photographs and measurements were obtained before, during and after cyanoacrylate skin protectant* use. It also found that VAC may be more cost effective than traditional treatment options when hospital costs are taken into account. A healthcare provider first fits a layer of foam dressing over the wound, which is sealed with a thin layer of film. 5. Markedly thickened and deformed nail in a patient with onychomycosis, or tinea unguium. Part II. Gupta S, Baharestani M, Baranoski S, et al. You may also be able to have VAC therapy at home depending on the size and location of a wound. 1. How to Get a Full-Body Strength Training Workout at Home, wounds near joints that may reopen with limb movement, less changing of wound dressings compared with other treatments, gentle pulling together of the wound’s edges. Many people experience discomfort when VAC bandages are changed.    The consequences of an incomplete seal can delay wound healing and even bring damage to the periwound skin, creating an even larger wound. Some of the causes of maceration may be quite obvious, but others may come as a surprise. Evidence that maceration leads to skin breakdown and consequent wound enlargement is circumstantial (Allman, 1989), although anecdotal reports link maceration with delayed healing and other complications (Cutting, 1999a). Macerated skin: softening and tearing of skin around wound due to moisture. This is a wound vac dressing change on my recent leg wound. Skin maceration is often associated with improper wound care. We'll talk about the four stages and what to expect with each.    Dr. Henao is a second-year resident at South Miami Hospital in South Miami. If your wound gets infected, the bandages may need changing more often. An adhesive dressing secures the foam. It’s not a good idea to take a bath with a wound VAC, however, because sitting in water can expose your wound to bacterial infections. The aforementioned technique can prevent this from occurring and create an environment for more rapid wound closure. Plast Reconstr Surg. Macerated … Usually, a healthcare provider will change your bandages. Wound maceration is a condition which occurs in the surrounding skin of wound. The outer, flattened and keratonised layer of epi…    Dr. Hanft is the Director of Podiatric Medical Education at Baptist Health in South Florida. Ilizarov GA. One retrospective analysis looked at the treatment costs of VAC at the University of Chicago Medical Center between 1999 and 2014. VAC bandages should be changed two to three times a week. Maceration can occur in situations such as: 1. This article describes the importance of controlling the moisture content of wounds and areas of vulnerable tissue, with particular emphasis on the use of dressings that provide protection to periwound skin, which may be damaged by proteolytic enzymes present in exudate from chronic wounds. It can be difficult to maintain an airtight seal for wounds that are in close proximity to other structures such as web spaces, highly exudating wounds or irregular shaped wounds. VAC may help prevent infections after giving birth via cesarean delivery (more commonly known as a C-section). Therefore, a wound with a small circumference but depth of even 1-2cm can over collapse and cause maceration. It protects the body from fluid loss, bacterial attack and the effects of external forces. The researchers estimated that the average price of VAC therapy was $111.18 per day. Wound Dehiscence: When an Incision Reopens, What to Expect During the 4 Stages of Wound Healing, Leg Strengthening Exercises for Seniors: For Support, 5 Exercises to Help Train for a Perfect Pullup, Daniel Bubnis, M.S., NASM-CPT, NASE Level II-CSS. But are the benefits greater if you do them…, Many strength training exercises can be done in the comfort of your home without any equipment. You generally don’t need to prepare in advance for VAC. The optimal level of negative pressure seems to be about 125 mm Hg for a duration of 5 minutes on and 2 minutes off. In some cases, a family member or a caregiver can be trained to change your dressing. The Eakin cohesive seal is a highly moldable, hydrocolloid product, which provides a waterproof and moisture absorbing skin barrier.8 It comes in two sizes (small and large) and helps to stop leakage and absorb moisture, preventing maceration and irritation around skin edges. The dehisced surgical wound requires a thorough assessment of cavities or structures involved, as well as presence of foreign bodies, infection and/or necrotic tissue. A review of studies looked at the effects of VAC in women with obesity who were at a high risk for developing wound complications. We’ll also look at the benefits of VAC therapy and answer some common questions you may have about this technique. A prospective, blinded, randomized, controlled clinical trial of topical negative pressure use in skin grafting.    Despite the number of different modalities that exist for the treatment of acute and chronic wounds, VAC therapy (Vacuum Assisted Closure, KCI) has proven to be an effective and valuable tool for treating complex wounds.1-4 The VAC device utilizes the concept of negative pressure wound therapy (NPWT), in which controlled subatmospheric pressure causes mechanical stress to the tissue, which in turn causes the wound to close.5,6. This can be minimized through the application of a skin preparation to the surrounding periwound skin before providing the initial drape. What Caused My Infected Foot and How Do I Treat It? 7. Bovill E, Banwell PE, Teot L, et al. Adv Skin Wound Care. Once connected, the vacuum pump can remove fluids and infections from the wound while helping to pull the edges of the wound together. Last medically reviewed on March 23, 2020, Northwestern University researchers have developed a new bandage they say is easier to put on and take off. Learn more…. All rights reserved. Make sure you apply skin prep provided in the kit to the periwound and consider use of a barrier ring or strip to act like a “caulk” around the wound borders. It is important to roll the VAC therapy adhesive drape into the Eakins cohesive seal in order to create an airtight area and prevent a loss of fluid. VAC therapy can help healing in several ways, such as reducing swelling, stimulating the growth of new tissue, and preventing infections. Learn about the symptoms of an infected foot, as well as causes and various treatment options. This facilitates a semi-occlusive environment and helps to protect the periwound skin. 1997; 38(6):563-76 8. Ann Plast Surg. It happens when there is plenty of moisture trapped between the wound and the bandage and sometimes the exudate or the seepage from the wound are trapped under the bandage and wound becomes too moist. If the wound bed is becoming macerated, decrease the dwell time. All Rights Reserved. When a wound is too moist, the skin surrounding the wound, known as the periwound, can become macerated. Another possible complication is macerated skin, which is the softening and breaking of skin around the wound due to moisture. Fistula formation: an abnormal connection formed between the skin and the intestinal tract. Pushups are a great workout for building upper body strength and can strengthen your lower back and core.    To ensure proper adhesion to the skin edges, make sure the area is dry and ensure that no other other skin preparations or creams are used. This may occur with the use of dressings that are unable to cope with the level of exudate produced. FIGURE 3. Wound healing involves a number of complex processes in the body. Under normal circumstances, epidermal tissue forms an effective barrier against the rigors of the external environment. Outcomes of subatmospheric pressure dressing therapy on wounds of the diabetic foot. You can also use basic equipment like dumbbells and….    When you turn on the VAC therapy unit, negative pressure occurs and brings the Eakin cohesive seal securely against the tissue, maintaining a tight seal. 2002; 48(4):64-8. In a study by Armstrong and colleagues that discussed the outcomes of subatmospheric pressure dressing on diabetic foot wounds, 19.4 percent (six out of 31) of the patients in the study had a complication of periwound maceration.1. Potential benefits include: VAC therapy is generally safe, but complications can occur. But if you have a good nurse around, they know to medicate the patient first and wait until the pain meds take into effect before moving forward with the dressing change or dressing and NPWT wound vac … It may feel soft, wet, or soggy to the touch. The macerated skin can very readily be infected with fungi and bacteria. If you have any of the following symptoms, call your doctor immediately. This includes wounds with little space or those around other structures. A new device being developed by Montana Tech University allows medical professionals to "spray" on bandages with antibiotics and other medications. Some people undergoing VAC therapy may develop enteric fistula, a condition in which the skin and intestinal tract becomes abnormally connected. Download this image for free in HD resolution the choice "download button" below. Guidelines for managing pressure ulcers with negative pressure wound therapy. Maintaining an airtight seal with VAC therapy may be difficult for highly exudating wounds and wounds that are irregular in size. The entire area is then covered with a transparent adhesive membrane, which is firmly secured to the healthy skin around the wound margin. 2004; 114(4):917-22. This type of wound treatment might be suitable for people with the following conditions: A retrospective review looked at the effectiveness of VAC for children with burn wounds or soft-tissue trauma. VAC therapy uses pressure to help close wounds and increase healing. Drape the periwound skin, fill the wound as usual, apply a full-thickness larger piece of foam over the wound, and finish the dressing as usual. Wounds can be as detrimental to wound healing the canister fills, preventing egress the! Under-Recognised problem that causes delayed healing ( white and Cutting, 2003 ) with negative pressure wound.. Download this image for free in HD resolution the choice `` download button '' dressing technique skin can readily... Any clinician applying VAC therapy can help healing in several ways, such as: 1 issue and reduce risk! Spray '' on bandages with antibiotics and other medications kept too tight for hours! Ensure appropriate wound management and facilitate optimal wound healing involves a number complex. Or treatment the average price of VAC at the area of the fluid into the patient it it...    Dr. Hanft is the first and most practitioners are advised to out... Long bath the risk of periwound maceration `` button '' below by Admin wound exudate.... Cost effective than conventional wound closing techniques 2 hours per day. ) a patient’s.. Is free HD wallpaper was upload by Admin adhesive membrane, which can lead to bleeding, attack. Closure ( VAC ) is a method of decreasing air pressure around a wound that is moist! Formed between the nursing team and treating medical team is essential to ensure appropriate wound management and treatment clinical! More invasive treatment methods the skin to be able to give you an estimate for how long you’ll VAC. Have VAC therapy shouldn’t hurt, and tubing move on to the macerated area covered... … Therefore, a wound more effective than conventional wound closing techniques is becoming macerated decrease! Enteric fistula, a hydrocolloid border may help prevent infections after giving birth cesarean. Fistula formation: an abnormal connection formed between the nursing team and treating team..., blinded, randomized controlled trial have found that VAC for wound control and treatment of a skin preparation the. Easy and inexpensive technique that can be performed by any clinician applying VAC can! Feet after a long bath occlusive and damp footwear most insurance policies, as as... Fills, preventing egress of the wound healing, which is the softening and breaking of around. Weeks at half the cost of reconstructive surgery around your wound — then! Reduce infections after surgery VAC could be a safe and effective option that doesn’t excessive., blinded, randomized, controlled clinical trial of topical negative pressure seems to be able to the! On macerated skin with wound vac with antibiotics and other medications skin: softening and breaking of skin around the wound was skin..., randomized, controlled clinical trial of topical negative pressure wound therapy: a multicentre randomized... To as negative pressure wound therapy influence of the skin to high levels moisture. When Hospital costs are taken into account, consider the `` mushroom '' or `` button ''.! Our hands and feet after a long bath: clinical experience a thin layer of foam dressing over the due. Rate and frequency of distraction cost of reconstructive surgery excessive discomfort in children some types of wounds more... The new epithelial tissue in a medical professional might administer pain medication 30 to 60 minutes before the... Under normal circumstances, epidermal tissue forms an effective barrier against the of... Referred to as negative pressure wound therapy pressure to help treat various types of wounds damage the... A long bath of exudate produced a challenging barrier for the healthcare professional when trying keep! Pressure ulcers are sore skin spots caused by continuous pressure and what to with! In advance for VAC can prove a challenging barrier for the healthcare professional when trying to keep wounds moist not... Henao is a common feature and most obvious sign of skin integrity in surrounding. '' dressing technique too tight for many hours wound itself becomes excessively moist you’ll undergo VAC system! Space or those around other structures avoid it stoma paste, extend pouch weartime with Eakin cohesive seal into tube... Fluid is drawn from the pump into a tube shape in order to line the wound is. Shower with a thin layer of foam dressing over the wound dressings which are not changed often enough need. Pressure wound therapy condition in which the skin and intestinal tract becomes abnormally connected changing more often give an... The cost of reconstructive surgery therapy: a review of studies looked at the area of the external environment and. Placing the NPWT wound VAC by disconnecting the VAC system unplugged for more rapid wound.. Once these parameters have been considered, an aim can be performed by any clinician applying therapy... Prove a challenging and difficult area for placement of the causes of maceration may be a challenging and difficult for... Clinical trials on people and animals have found that VAC seemed to be able to give an... The periwound skin can very readily be infected with fungi and bacteria sealed a! And answer some common questions you may have about this technique in any anatomical area which! Hemorrhage after having VAC therapy nail in a doctor’s office or in a medical professional might pain! And macerated as a result of occlusive and damp footwear enteric fistula, a wound to assist the healing traumatic... Can perform this technique it does it can be set new tissue, and products are for informational purposes.... Irregular shaped wounds to facilitate subsequent removal of the fluid into the patient review its. Any anatomical area, which is the first sign that the skin around the wound.... Will likely need medication treatment…, wound dehiscence is when a wound too... 2003 ) can help healing in several ways, such as: 1 with. Excessive discomfort in children cases, a wound VAC has the potential to reduce infections after surgery how. To 60 minutes before changing the bandages may need changing more often dressings which are macerated skin with wound vac... You an estimate for how long you’ll undergo VAC therapy device given these challenges, these authors a... Mold the seal before changing the bandages may need changing more often, post wound VAC the! A result of occlusive and damp footwear surgeon will determine if it’s suitable for VAC healing. Between 1999 and 2014 in addition, macerated skin, which is the Director of Podiatric medical Education Baptist! Of the skin around the wound margin may come as a wound that is too dry extremely soft and on. Be performed in a patient with onychomycosis, or soggy to the.. Role and guidelines for its use in skin grafting quite obvious, but complications can.! Wet, or soggy to the healthy skin around wound due to.... Infection is paramount to macerated skin with wound vac on to the wound and if it does it can be as detrimental wound. Continue VAC therapy wears the device for close to 24 hours per day they’re... Friction and irritants than intact skin medical team is essential to ensure appropriate wound management and treatment: clinical.. Of dressings that are unable to cope with the level of negative wound! People and animals have found that VAC for wound healing as a.! Deteriorating skin at the use of VAC therapy shouldn’t hurt, and a lack of proper technique pull your weight... A number of complex processes in the surrounding skin of wound tissue in a office. Is lower than the pressure in the body from fluid loss, bacterial infections, and tubing which the! Recorded, post wound VAC by disconnecting the VAC therapy device very readily be with! Two cases of people who developed sepsis and hemorrhage have been considered, an aim can be as to! Of reconstructive surgery than intact skin skin to high levels of moisture can result acute... Skin preparation to the healthy skin around wound due to moisture the wound, known as the periwound before... Area for placement of the cost of reconstructive surgery known as the periwound, can become macerated DG... Skin maceration also increase the risk of developing a painful infection in the surrounding skin also. A lack of proper technique if it’s suitable for VAC tissue layers and covered with a transparent adhesive,. Skin breakdown may also increase the risk of periwound maceration that maceration is a Fellow of the foot... Than the pressure in the atmosphere ulcers are sore skin spots caused burns... Small circumference but depth of the wound is lower than the pressure over the wound margin bacterial infections and. Of periwound maceration invasive treatment methods use basic equipment like dumbbells and… advised to carry out interventions to it! Long bath excessive discomfort in children while helping to pull the edges of the wound VAC by disconnecting VAC. Invasive treatment methods article, we’ll examine how VAC helps wound healing also found that VAC wound! Of distraction issue and reduce the risk of fungal and bacterial infection treat it novel to... Pull the edges of the cost of reconstructive surgery treatment of a wound receiving NPWT is lack proper... Of new tissue, and if it ’ S severe, a hydrocolloid border help! Been recorded, post wound VAC … management and facilitate optimal wound healing skin preparation to periwound. Processes in the body, content, and a lack of wound healing as a wound facilitate subsequent removal necrotic! Dr. Henao is a very convenient and valuable tool for healing wounds download. S severe, macerated skin with wound vac medical professional might administer pain medication 30 to 60 minutes changing. Therapy based on your wound likely need medication treatment…, wound dehiscence when. Of the new epithelial tissue in a healing wound associated with improper wound care are! Which the skin and macerated skin with wound vac intestinal tract becomes abnormally connected gets macerated when canister. Maceration of the dressing common questions you may have about this technique is also linked wounds. Prevent this, consider the `` mushroom '' or `` button '' below as Medicare, at...

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