The fourth and final article in this four-part series about understanding compression therapy explores the options available to clinicians and patients when the need for compression bandaging therapy has been established through holistic assessment. This paper presents an overview of both inelastic and elastic bandage systems. In addition, the indications for appropriate use of each of these systems and their limitations are discussed. The cost of compression bandaging to the health service budget in terms of sustainability, equipment and clinician time is also explored. Gait is a fundamental area of leg ulcer care that needs assessment as part of lower limb management. Discussion regarding the implications of compression bandaging therapy itself, as well as the presence of leg ulcers and pain on gait are provided. Finally, a review of fundamental skin care principles to protect the skin is offered.
Evidence suggests that biofilm is present in at least 78% of nonhealing wounds, and it is widely accepted that its presence may be a cause for delayed healing in some patients. As the majority of chronic wounds are managed in a community setting, it is important that clinicians have an understanding of what biofilm is, how to identify its presence in the wound, and how to carry out biofilm-based wound care (BBWC). AQUACEL® Ag+ Extra™ is a unique dressing that has been specifically designed to manage biofilm. It combines antimicrobial and anti-biofilm components, which work in synergy to successfully disrupt biofilm, expose microorganisms to the broadspectrum antimicrobial activity of ionic silver in chronic wounds and to help prevent biofilm re-formation, thus making it worthy of inclusion in the biofilm care pathway.
Almost one adult in 20 in the UK has a wound, while the NHS cares for 2.2 million people with wounds annually. Most of the people in the UK with a wound are managed in primary care by nurses (Guest et al, 2015). Some wounds, such as minor burns, cuts, abrasions and surgical wounds, heal quickly and with minimal intervention. However, over half of all wounds go on to become chronic, with approximately 39% of these failing to heal after 12 months (Vowden and Vowden, 2009). One of the basic tenets of evidence-based wound care is choosing the correct dressing. This article discusses the management of chronic wounds in the community and provides guidance for community nurses on choosing appropriate dressings.
