Hard-to-heal wounds Resources

In order to instil confidence in your patients, you yourself need to feel confident in the care you’re providing — including the products you use.

This is why we’re publishing the results of a recent randomised controlled trial (RCT) comparing the efficacy of Exufiber® with the market leading gelling fibre dressing, in exuding venous and mixed aetiology leg ulcers.

IF YOU FEEL CONFIDENT, YOUR PATIENTS FEEL CONFIDENT
In order to instil confidence in your patients, you yourself need to feel confident in the care you’re providing — including the products you use.

Debridement is the removal of non-viable tissue from the wound bed and surrounding skin and is an important part of wound healing and wound bed preparation. Devitalised tissue, such as necrosis, slough and hyperkeratosis, interfere with the process of wound
healing. When a wound fails to progress, there is a need to assess the wound bed and surrounding tissue and promote an optimum environment that encourages the formation of healthy granulation tissue (Young, 2014). Recent advances in debridement techniques
using monofilament fibre technology can be practised by nonspecialist nurses and used safely and effectively in a patient’s home. In a recent audit, a dataset of 486 patients who had been newly prescribed a monofilament fibre debridement pad was obtained to
validate clinical effectiveness and cost efficiency. The total cost of wound care prescribing fell by 14% or £101,723 in the six months after the intervention compared with the six months before. The average monthly expenditure per patient fell from £244 before the intervention to £209 after (Burnett et al, 2021). This evidence reinforces the National Institute for Health and Care Excellence (NICE) recommendations for use of monofilament fibre debridement in the community, based on evidence of its effectiveness and estimated cost savings (NICE, 2019).

The problem of delayed wound healing has been highlighted in several publications which has stimulated debate on variance and the need for updated care pathways. This paper demonstrates how adjunctive therapy can be added to the ‘standard care’ model, described in the National Wound Care Strategy Programme’s recommendations for lower limb wounds, to enhance outcomes for patients with ‘hard-to-heal’ lower limb wounds (NWCSP, 2020). A decision-making pathway based on published literature is described,  which uses wound assessment and observed response to treatment to allow the effective and targeted introduction of adjunctive therapies for ‘hard-to-heal’ wounds. This approach will allow the cost-effective introduction of new and evolving therapies, such as WoundExpress™(Huntleigh Healthcare), which addresses the underlying problems associated with resistant lower limb oedema and compromised venous function. The pathway also indicates how other adjunctive or innovative topical wound-based treatments can be integrated to optimise outcomes while providing cost-effective care.

It can be a bit daunting when you are faced with a complex, chronic wound that is failing to progress. What makes a chronic wound hardto- heal and where do you start with its management? It can also be challenging for patients because the wound may be affecting their quality of life, often causing a high volume of exudate, increased pain or discomfort and malodour (Atkins et al, 2019). This article describes what can make a wound become hard-to-heal and offers guidance on assessment and management and how the use of a collagen wound dressing, Cutimed® Epiona (Essity), can help promote wound healing.

This case series evaluation assessed the efficacy of WoundExpress™ (Huntleigh Healthcare), a novel IPC device, which applies compression to the thigh of the afflicted leg for the management of hard-to-heal leg ulcers. Eleven wound treatment centres or wound care specialists undertook WoundExpress evaluations. Eligible and willing patients (n=61), with a ‘hard-to heal’ leg ulcer used the WoundExpress device for two hours a day, in addition to continuing to receive their standard wound care for a 16-week period. Fifty-three participants completed the evaluations. Thirty-three percent (n=19) of all ulcers healed within the 16-week study period; the mean time to healing was 10 weeks. A further 60% of ulcers (n=35) progressed towards healing within the 16-week period, with a mean surface area reduction of 56% (23cm2). The evaluation concluded that thigh-administered IPC is an effective adjunctive treatment, that aids healing and reduces pain, for patients with hard to heal leg ulcers.