In some chronic wounds, excessive exudate can inhibit wound healing. Clinicians must manage the wound, ensure cost and clinical effectiveness and a positive patient experience as mismanagement may lead to non-concordance. This article discusses the evaluation of absorbent products within a community provider organisation, and includes patient feedback and opinions of the clinicians delivering the care.
Lorraine Grothier, Clinical Nurse Specialist, Tissue Viability and Lymphoedema Manager Central Essex Community Services, Essex.
Article accepted for publication: March 2013
An estimated 23 million adults in the UK have some sort of scar. Normal scars are preceded by injury, immediate in onset, flat and asymptomatic. These are the most common type of scar and are a result of the body’s natural healing process. Hypertrophic and keloid scars occur when the healing process is deranged.
This article, abridged and amended from an article previously published in JCN, outlines the differences between these latter types.
To view original article please visit: http://www.jcn.co.uk/journal/03-2011/wound-management/1416-scar-therapies/?s=scarring
This article explores how effective exudate control and debridement can promote wound bed preparation and presents a 10-patient case series where Drawtex®, an advanced hydroconductive wound dressing with LevaFiber™ technology, improved the lives of patients with chronic wounds.
Sue Johnson, RN, MA, ANP, NMP, Lead Nurse Wound Care, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster
Pam Spruce, BSc (Hons) Nursing Studies, DN, DN Cert, RGN, Clinical Director, TVRE Consulting, Stoke-on-Trent
Kathleen Leak, DPSN, RGN, Wound Care Sister, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster
Denise Ridsdale, RGN, Nurse Practitioner, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster
Article accepted for publication: April 2013
For the patient, wound infection can lead to poor healing outcomes and has the potential to result in life-threatening sepsis. For healthcare services, additional expense can be incurred due to the need for remedial treatment and extra clinician time. Poor wound infection rates malso attract negative publicity and damage the public’s perception of care standards. This article examines the essential roles played by prevention of infection, early diagnosis and the initiation of effective management strategies.
Martyn Butcher, Independent Tissue Viability and Wound Care Consultant, Devon
The UK has an expanding elderly population, which means that in the future nurses and clinicians who work in community-based units, such as nursing homes and hospices, will increasingly encounter age-related conditions such as palliative oedema and mixed aetiology ulceration. This article looks at duomed soft®, (medi UK, Hereford) a new hosiery solution, which is not only easy to apply, making patient self-care more likely, but also provides consistent mild compression in a format that is more cosmetically acceptable to patients.
Helen Butterfield, Leg Ulcer/Dermatology Specialist Nurse, Oxford
Exudate management is one of the key challenges for clinicians who have to deal with wounds. The World Union of Wound Healing Societies (WUWHS, 2007) highlighted the importance of appropriate dressing selection for exudate control and removal of excess exudate. Correct dressing selection ensures that the wound bed remains moist without becoming saturated, which in turn prevents damage and pain to the surrounding skin and reduces the risk of infection from strikethrough. This article examines the role of exudate in wound healing, and the inherent challenges in its management, both for patients and carers. The role of superabsorbent dressings is discussed and the findings of an evaluation of clinicians’ requirements and expectations of superabsorbent dressings are presented.
June Jones, JJ TVE, Tissue Viability Education, Southport, Merseyside
Jo Barraud, Tamaris Communications, Hitchin, Hertfordshire
With more and more advanced wound dressings becoming available, clinicians need to be selective when choosing the most appropriate treatment for patients with wounds in the community. Dressings are no longer tasked simply with protecting wounds and offering some level of absorbency, but need to be able to address both the physical and psychological aspects of having a wound to ensure patient-centred care. The sorbion range of dressings are developed to offer clinical solutions and provide cost-effective care.
Lisa Sutherland, Tissue Viability Lead, West Suffolk Hospital, Bury St Edmunds, Suffolk
Pressure ulcers are a significant problem in both the acute sector and the community, where nurses can spend a great deal of their time dealing with what is a painful and debilitating condition. As government policy encourages more care to be delivered in patients’ homes, finding solutions to pressure damage that aid healing and improve patients’ quality of life, as well as being cost-effective, is paramount. This article examines the background to pressure damage, as well as looking at its effect on community nurses’ workload. In particular, it focuses on the heel as a common site of pressure damage.
Lorraine Grothier, Clinical Nurse Specialist (Tissue Viability), Tissue Viability Service, Provide, delivering NHS and local authority services
The NHS spends the majority of its budget on labour costs and it could be argued that frontline staff such as community nurses are the organisation’s most valuable resource. However, optimal wound care is dependent upon effective patient engagement, the application of clinical expertise and access to wound management products. The tension between increasing demands for services and the number of nurses is already causing problems in care provision as staff cuts and excessive workload inevitably endanger patient care. Enhancing efficiency through the use of innovative products will become essential in the future if nurses are to continue to provide expert care against a backdrop of cost-savings. This article details the appraisal process undertaken within Worcestershire Health and Care NHS Trust to investigate the in-practice clinical performance of a silicone foam dressing (Allevyn™ Life Smith & Nephew, Hull).
Declaration of interest: Richard Searle and Alistair Bielby are employees of Smith & Nephew. This project was supported by an unrestricted grant from Smith & Nephew.
Jackie Stephen-Haynes, Professor and Nurse Consultant, Practice Development Unit, Birmingham City University and Worcestershire, Health and Care Trust
Alistair Bielby, Clinical Team Manager, Smith & Nephew Healthcare Ltd
Richard Searle, Health Economics Manager, Smith & Nephew Medical Ltd
This article outlines a survey that was undertaken in the community to find out how often patients with venous disease who are wearing compression hosiery have their ankle brachial pressure index (ABPI) monitored. It also asked clinical nurse specialists (CNSs) their opinion on the desired frequency of ABPI follow-up, and which patient groups they considered to be most at-risk. The survey findings highlight the lack of consensus and consistency in follow-up care. The majority of CNSs identified potential high-risk patient groups, the majority of which have their ABPI monitored every three months. However, there were inconsistencies in time interval for follow-up in patients with similar risk factors.
Winnie Furlong, Lead Clinical Nurse Specialist, Princess Alexandra Hospital and West Essex Leg Ulcer Service
