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With an ageing population, it is likely that the numbers of leg ulcers requiring intervention will increase proportionately. Given that most leg ulcer care is conducted in the community, this will place an extra burden on primary care staff. Therefore, any cost-effective interventions which improve management are worth considering. The Complex Wound Clinic team (Central and North West London NHS Foundation Trust) undertook a 12-month evaluation of using octenidine-based antimicrobial wash mitts as an alternative to
bucket washing. The aim was to monitor both patient and staff reaction to the use of wash mitts instead of bucket washing, track reported incidents of staff musculoskeletal injuries, and monitor infection rates, including Pseudomonas and wound infections requiring antibiotics.

Urinary incontinence (UI) is a common consequence of radical prostatectomy for which men often feel unprepared despite the provision of information about treatment and management. The aim of this study was to explore from the patient’s perspective the nature of information and support men require to aid adjustment to daily life with UI. In a qualitative study using a convenience sample, recruited men (n=35) were aged over 18 years old and were less than 18 months post radical prostatectomy. Data were collected using interviews and a thematic analysis was performed. The study identified that men need less rather than more information, which should be succinct, and focused on management of incontinence to enable them to cope with daily activities. Effective management strategies rather than an overreliance on treatment methods, which may be ineffective, were also key to enabling successful adjustment. Men need clarity about care pathways, including access to appropriate contact information. Finally, men describe the confusion experienced when choosing containment products and require clear, concise information. 

The term ‘wound’ can cover everything from relatively minor wounds, such as a small surgical scar, to major wounds, such as chronic leg ulcers. Typically, the cause and type of wound determines how quickly and effectively it heals (Thomas and Bishop, 2007). The presence of complications such as infection can dramatically increase the time it takes for a wound to heal. In a 2015 research study, conducted by gathering data from The Health Improvement Network (THIN) database, the cost burden of wound care in the NHS was estimated. After adjusting for comorbidities, the estimated cost to the NHS was between £4.5 billion and £5 billion. Furthermore, the study found that nutritional deficiency and diabetes were independent risk factors for wounds not healing (Guest et al, 2015). Nutritional factors, such as protein-energy malnutrition, dehydration, and deficiency in certain micronutrients, have all been identified as important for some stages in the process of wound healing. Being able to identify those who are malnourished or at risk of becoming so, and those who have micronutrient deficiencies, is key to successful wound healing outcomes.

Claire Campbell, chair of the National Nurses Nutrition Group (NNNG) and nutrition support nurse specialist, Frimley Health NHS Foundation Trust, looks at how community nurses can help to tackle malnutrition and identify those most at risk.

In this article, Maria Hughes discusses her unique nursing role working alongside the North Wales Police.