Healthy eating is a topic covered widely in the media, and is particularly relevant to healthcare, with diet and nutrition vital to the management and prevention of many conditions. Wound healing is a complex process that relies on the coordination and internal regulation of activities such as the removal of devitalised tissue and growth of fresh blood vessels. This article examines the phases of wound healing and discusses how nutrients can affect and enhance this process. Understanding the role of nutrients in wound care enables nurses to offer advice to patients whose wounds are not progressing in the expected manner. Nutrition should form part of holistic wound assessment, with any malnourished patient being referred to a dietician. It is a misconception that only underweight individuals can be malnourished and the use of a robust assessment tool will assist nurses in deciding which patients require onward referral. There appears to be a significant link between poor nutrition and delayed wound healing, with a higher risk of complications such as infection identified in malnourished patients
When trying to prevent the recurrence of leg ulcers, many community nurses find it hard to get patients to concord with compression devices and techniques, particulary over the long term.
This article looks at a new adjustable Velcro compression device, juxtalite (part of the juxta® range; medi UK), which is designed to be simple to apply. It has built-in pressure system (BPSTM) that allows the nurse to accurately monitor the level of compression being applied to the limb, ensuring a therapeutic level of compression is maintained. Here, the author relates her own expreience of using the juxta system (in particular the juxalite version) through a series of case studies that show how the system aids patient concordance with treatment over an extended period of time.
The use of compression bandaging in venous leg ulcers has been acknowledged as ‘best practice’ for some time now, but these wounds remain a serious management problem in many patients with pain, excess exudate, limb swelling and poor mobility all affecting their quality of life. Wound care in general, and leg ulcer management specifically, are two of the most common reasons for referral to community nursing services and recent government policy aimed at managing more patients in primary care and in their own homes has also meant that nurses are now seeing more patients than ever before. All of this means that they need compression systems that are easy to apply and can deliver safe and consistent pressures to minimise risk and safeguard patients. This article presents the findings of a 40-patient multi-centre evaluation of a new inelastic compression bandage system (HERO H-2®; H&R Healthcare) designed to provide optimal compression levels, reduce odour and moisturise the skin. The evaluation demonstrated that the bandage system had a positive effect on a number of parameters including wound size, healing rates, patient comfort and mobility.
Rosemary Pudner discusses the impact that changes in the delivery of wound care have had on nurses working in the community.
Rosie Pudner discusses the impact of smoking on healing.
NB: This literature review was undertaken as an assignment for the award of PostGraduate Diploma/MSc in Wound Healing and Tissue Repair, University of Wales College of Medicine.
Rosie Pudner BA (Hons), RGN, RCNT, DipN.Ed, RNT is a Senior Lecturer at Kingston University, London.
Article accepted for publication June 2002.
