Wound cleansing Resources

Chronic wounds are complex by nature and require thorough assessment and carefully planned management. Part of that management often includes preparing the wound and periwound skin for healing, for which debridement is frequently required. While there are several methods of debridement available, often requiring specialist referral, there are some that can be used by generalist nurses and patients and carers  themselves. This article describes one of those methods, mechanical debridement,

This article describes the wound infection continuum in surgical, acute and chronic wounds. The phases are: contamination, colonisation, local infection and finally spreading and systemic infection. Clinicians need to be familiar with the signs and symptoms of local infection in order to put strategies in place to prevent a ‘full blown’ wound infection and to recognise how the signs and symptoms differ by wound type. The article looks at the
most recent guidance on wound infection management strategies, together with the identification and treatment of suspected biofilms and the two-week challenge, used in clinical practice to disrupt biofilms. Wound cleansing and the use of antimicrobial dressings
and topical antiseptics are also discussed.

Over the years, there has been a plethora of evidence-based literature on effective and ineffective wound management practices; however, some healthcare professionals continue to manage wounds using outmoded or ritualistic practices. The key areas are: frequency of dressing changes; maintenance of a moist environment to aid healing; when wounds should be cleansed; and which cleaning solutions to use. This article presents the evidence base in these key four areas and aims to dispel some of the myths and misconceptions to ensure that healthcare professionals can be confident that they are delivering upto- date, evidence-based wound care in accordance with the Code of Conduct (Nursing and Midwifery Council [NMC], 2015).

The government's policy of moving care closer to home means that not only will community nurses continue to see patients with chronic wounds such as leg ulcers, pressure ulcers and diabetic foot ulcers, they may also start to see an increase in the numbers of patients who have been discharged from hospital with surgical wounds, who might previously have stayed in secondary care for a longer period. It is imperative that community nurses tasked with visiting a range of patients in their own homes have an understanding of the fundamentals of wound development and management to provide basic evidence-based wound care. This article looks at some of those fundamentals, including debridement, dressing application and removal, wound cleansing, infection, and the effects of comorbidities on the wound.

Lynne Watret & Margaret Armitage discuss wound cleansing procedures.
Lynne Watret MN, MA, RGN is a Tissue Viability Nurse Specialist and Margaret Armitage DN Cert, RSCN, RGN is a Vascular Liaison Nurse Specialist, both are employed by the Greater Glasgow Primary Care NHS Trust.
Article accepted for publication September 2001.

Sylvie Hampton examines the evidence for wound cleansing with tap water and makes some suggestions for practice
Sylvie Hampton MA, BSc (Hons), DpSN, RGN is a Tissue Viability Consultant in Eastbourne.
Article accepted for publication: August 2004

Sally Magson-Roberts reviews the evidence surrounding the use of tap water in wound cleansing in a bid to establish what current research suggests is safe and effective, thus ensuring quality patient care, whilst delivering a cost effective and equitable service.
Sally Magson-Roberts RGN, DN, BSc, Dip HE is a District Nursing Sister, Eastbourne Downs PCT.
Article accepted for publication: January 2006