lucas.conrado – Page 13 – Wounds International

Wound healing using negative pressure wound therapy with instillation: case studies

Local infections are commonly associated with chronic pressure ulcers and necrotising fasciitis. The main objective in such wounds is to treat the infection either by maximising the host response systematically and/or by applying topical wound solutions locally. Negative pressure wound therapy (NPWT) with instillation was used with the following patient cases: three cases of sacral […]

Introducing HydroClean® plus for wound-bed preparation: a case series

Maintaining adequate moisture at the wound bed is important in facilitating the removal of slough and necrosis. In clinical practice, this is addressed through cleansing and one of a number of debridement techniques. Autolytic debridement is recognised as the most frequently used technique, but is criticised for being slower than other methods. The results of […]

Wounds digest 7(1)

In this section, a brief synopsis is presented of a range of recently published articles that may be of interest to health professionals working in the wound care setting. The aim of this round-up is to provide an overview, rather than a detailed summary and critique, of the research papers selected. Full references are provided […]

International Best Practice Statement: Optimising patient involvement in wound management

Living with a wound can lead to loss of independence or control; all individuals should have the chance to understand their condition, be involved in decisions about treatment and take responsibility for managing their wound where they are able to do so. For this reason, an international group of wound care experts met in May […]

Using INADINE for minor traumatic wounds case studies

This document contains a series of case reports describing the use of INADINETM in patients with a range of acute wounds (minor traumatic injuries). INADINE was used on minor traumatic wounds where infection was suspected or confirmed; for example, minor trauma, post-surgical wounds, or minor burns. Supported by KCI – An Acelity Company

Using Askina® Calgitrol® Paste for the treatment of diabetic foot infection: case studies

This document contains a series of case reports describing the use of Askina® Calgitrol® Paste (B Braun), a novel formulation of an established topical antimicrobial, in patients with infected diabetic foot wounds. All patients were treated for a minimum of two weeks and the decision to continue treatment was based on assessment and the ‘two-week […]

Using Actisorb®: Case studies

This document contains a series of case reports describing the use of ACTISORB® (Systagenix) in patients with a range of wound types. All patients were treated for a minimum of 2–4 weeks and the decision to continue with ACTISORB® was based on continual assessment. A formal assessment was performed weekly, although in some cases dressing […]

Using Silvercel® Non-Adherent

This document contains a series of case reports describing the use of SILVERCEL® NON-ADHERENT (Systagenix) in patients with a range of wound types. All patients were treated for a minimum of four weeks and the decision to continue with SILVERCEL® NON-ADHERENT was based on continual assessment. A formal assessment was performed weekly, although in some […]

The benefits of undisturbed healing using ALLEVYN LifeTM

Selecting an appropriate dressing that supports undisturbed healing can benefit clinical practice and patient wellbeing and healing. Promoting undisturbed healing practices, and thus reducing dressing change frequency, can also have beneficial effects on financial and human resources. Case studies using ALLEVYN LifeTM (Smith & Nephew) demonstrate the benefits of selecting a dressing that is pain-free […]

The use of a point-of-care test for bacterial protease activity in chronic wounds

Most wounds contain micro-organisms, but heal successfully. However, in some wounds the presence of bacteria may cause delayed healing and local and/or systemic infection, which may reduce quality of life by increasing morbidity, mortality, hospitalisation and socioeconomic burden. It can be difficult to recognise when bacterial burden is affecting healing and requires intervention, particularly in […]

Providencia rettgeri: an unexpected case of Gram-negative cellulitis

Providencia (P.) rettgeri is a rare facultative anaerobic Gram-negative organism most often isolated from genitourinary and gastrointestinal sources, causing diarrhoea and urogenital symptoms. The authors present a case of P. rettgeri causing cellulitis in a patient lacking the typical risk factors normally associated with the bacterium. There was limited clinical improvement with empirical antimicrobial therapy. Blood […]

Benefits of stepping down negative pressure wound therapy

Negative pressure wound therapy (NPWT) is used for the advanced management of many wound types. Traditional NPWT systems are used in the acute setting and have demonstrated improved healing rates compared with standard care modalities. Newer, portable NPWT devices can facilitate earlier discharge from hospital, reduced resource allocation and greater quality of life for the […]

Achieving excellence for all ages

Inspiration for the title of this year’s Wounds UK Annual Conference ‘Overcoming the challenges in delivering clinical excellence’, came from the notion that achieving high standards of care delivery in 2015 is often difficult. Clinicians report that the ever-increasing workload and lack of resources mean that, on occasion, they are faced with the prospect of ‘simply achieving […]

Top tips: preventing pressure ulcers in premature babies and neonates

Improvements in the care of ill and critically ill newborns over the past 15 years have resulted in the ability to save the lives of the majority of even the sickest and smallest babies. These ten top tips for preventing pressure ulcers focuses on the specialist area of premature babies (born before 37 weeks gestation) […]

Top tips: taking photographs of wounds and data protection

A good photograph of a wound can be an extremely useful tool when evaluating the healing of wounds. Wound photos can be used as an adjunct to clinical care, for discussions about care with colleagues, for education, for publication in nursing (or medical) journals or as part of medical research. A recent ‘straw poll’ of clinicians at […]

Insights into high-viscous exudate: results of an international survey

In February–March 2015, Wounds International opened a survey to clinicians on the topic of high-viscous exudate. The online survey was open for 40 days, and 1,475 clinicians responded from over 20 countries around the world in a range of languages (English, Spanish and Dutch being the top three languages used by respondents). The three key aims […]

Advances in pressure ulcer prevention and treatment Made Easy

Statistically significant advancements in clinical practice and technology with regard to pressure ulcer prevention and treatment have been made over the past 20 years. This has been driven by clinicians, researchers, educators, administrators and, more recently, governments, with clinical practice guidelines that underpin these activities. This Made Easy highlights the latest national and international guidance […]

Meeting report: changing the way we look at viscous exudate

This article is based on a satellite symposium held at the European Wound Management Association (EWMA) conference in London, UK, on May 14, 2015. The symposium outlined the importance of exudate control in wound healing, and emphasised that the management of exudate viscosity is still an underdeveloped area of clinical practice. The speakers highlighted the […]

Wounds digest 6(3)

Special attributes required for wound care nurses

As a student nurse, there were inevitable occasions when I would be asked to write an essay exploring the skills required to become a ‘good nurse’, enabling and encouraging me to focus on improving my proficiency in those I thought were most important. Many years have passed since that time, and the expectation and role expansion […]

Total contact casting: a South African approach to offloading the diabetic foot

Foot ulceration is the most common complication associated with those living with diabetes. Total contact casting (TCC) is regarded as the gold standard offloading method in aiding rapid healing of neuropathic plantar foot ulcers, and numerous studies and papers indicate its effectiveness. Several TCC methods are used worldwide, the most well-known being the application of TCC […]

Clinical innovation: results from a 5-year pressure ulcer prevention project in an Australian university

This paper presents the results of a 5-year pressure ulcer prevention programme at The Royal Melbourne Hospital in Australia. The programme involved multiple interventions coordinated by the hospital’s Skin Integrity Committee. Three hospital-wide point prevalence surveys were used to monitor progress that showed that prevalence of hospital-acquired pressure ulcers decreased from 6.6% in 2010 to […]

Ten top tips: bariatric skin care

The number of obese patients is rising worldwide, with estimates of nearly 2 billion adults being overweight (body mass index (BMI) >25) and 600 million being obese (BMI>30)[1]. These numbers mean that, on a daily basis, most healthcare providers are working with bariatric patients as bariatrics deals with the causes, prevention, and treatment of obesity. Obese patients […]

Lympho-logical thinking in self-management of lymphoedema

The Kaiser Permanente triangle suggests that up to 80% of all people with long-term conditions can control their disease using supported self care. The main aim of this investigation was to clarify the core components required for learning effective self care for patients with lymphoedema. A retrospective analysis of patient surveys and interviews over a […]

Citric acid treatment of chronic postoperative wound infection after exposed surgical implant

Although many improvements have been made regarding the prevention of post-surgical infection during the past few decades, implant-related infections with bacteria that are resistant to multiple antibiotics remain an important and challenging clinical problem in orthopaedic surgery. This case study presents a chronic postoperative wound infection associated with exposed surgical implant. It did not respond […]

Nanova Therapy System Quick Guide

The Nanova Therapy System enhances an easy-to-use, absorbent dressing by combining it with negative pressure wound therapy, to aid in the effective management of hard-to-heal wounds. This Quick Guide describes the use of Nanova Therapy System (including patient selection), the benefits of combining an advanced dressing with NPWT, and how the system is constructed and […]

Randall Wolcott on biofilm-based wound care

Dr Wolcott presents on the importance biofilm-based wound care with a focus on the diabetic foot. This was filmed at the Wounds UK 2013 Conference in Harrogate.

The search for answers about diagnosis and management of lymphoedema in South Africa

I am Louise Stadler, a 35-year-old woman living in South Africa, and wife and mother of four. After working for 9 years as an occupational therapist treating children with autism and learning disabilities, I decided to spend more time with my family. In 2010, I was diagnosed with primary lymphoedema. The road to my diagnosis was […]

Case series: ADAPTIC TOUCH in conjunction with negative pressure wound therapy

ADAPTIC TOUCH is a non-adherent, flexible, open-mesh primary wound contact layer composed of cellulose acetate coated with a soft-tack silicone that may assist dressing application. In this series of international case studies, ADAPTIC TOUCH was used as an alternative to traditional wound contact layers under NPWT to benefit patients with a range of wound types. […]

Climate change, global warming and lymphoedemas

With the advent of earlier detection of cancers, the increasing use of sentinel node biopsy/sampling, the introduction of 3D radiotherapy and improved detection of the early signs of lymphatic failure, we are seeing a decrease in the incidence/prevalence/severity of cancer-related lymphoedemas, which is great news. However, there is also some bad news on the horizon; the […]

Management of obesity-related chronic oedema

A collaborative, multidisciplinary and long-term treatment approach, with the implementation of an effective therapy and management regimen, based on an agreed treatment pathway and goals, can bring about significant health and psychological benefits for those with obesity-related chronic oedema. Aim: To illustrate the role of compression bandaging as part of decongestive lymphatic therapy (phase I) […]

Toe and foot oedema: a step forward

The management of leg ulceration in the UK is supported by a number of national guidelines that help inform practice and improve patient outcomes (Royal College of Nursing, 2006; Scottish Intercollegiate Guidelines Network, 2010).

Indocyanine green lymphography following axillary lymph node dissection

n<div>Postoperative seroma is a well-recognised complication after regional lymph </div>n<div>node dissection, resulting in significant morbidity, inconvenience and associated financial costs. Objective: To determine the feasibility of indocyanine green (ICG) lymphography to intraoperatively identify leaking lymphatic vessels after axillary lymph node dissection (ALND). The authors hypothesised that identification and ligation of these leaking lymphatics would reduce the incidence […]

The 'chronic' wound debate

In recent years, many books on wound management have used terminology such as 'chronic wound care' or 'chronic wound management' [1-5]. Other descriptors have also appeared in the literature, eg 'problem wound' [6], 'chronic and non-healing wounds' [7], 'non-healing wounds' 8], 'hard-to-heal wounds' [9], 'recalcitrant wounds' [10], ‘difficult’ [11] or ‘complex’ (see above).

Triangle of Wound Assessment Made Easy

Wound assessment is essential in informing the selection of appropriate therapeutic strategies to achieve clinical goals, e.g. wound healing and improved patient wellbeing. This Made Easy describes a new approach to wound assessment that encourages clinicians to look beyond the wound edge to routinely assess and manage the periwound skin using the new Triangle of […]

Wound care — a complicated business

At a recent pressure ulcer study day in the UK, Kath Vowden delivered an excellent presentation on the legal aspects of documentation. The session entitled ‘practical guidance for writing care plans — learning from mistakes: writing documentation that will pass legal scrutiny‘. Kath commented on the extensive number of tick boxes that clinicians need to complete […]

Clinical innovation: SEE & WRITE — a new approach for effective recording

A fundamental element of nursing is accurate record keeping and this article introduces a new approach developed in Italy, which aims to provide clinicians with the means to prompt both a thorough assessment of the wound and an accurate written record of observations made. Proper documentation ensures safe and effective care, supports clinical decision-making, as […]

Ten top tips: seating and pressure ulcer prevention

A pressure ulcer (PU) is defined as ‘localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. A number of contributing or confounding factors are also associated with pressure ulcers; the significance of these factors is yet to be elucidated’ [1]. Pressure […]

Breaking the cycle of hard-to-heal wounds: balancing cost and care

Hard-to-heal wounds have a negative impact on patient wellbeing, are challenging for clinicians to manage and are costly to the health economy. Globally, healthcare providers are facing significant cost-efficiency drives and increasingly under pressure to balance the cost of care with the delivery of high-quality patient outcomes. Breaking the cycle of hard to heal wounds […]

Ten top tips: identification of wound infection in a chronic wound

Wound healing is a complex process that can be interrupted or impaired by a variety of factors. This article will focus on the microbial bioburden in chronic wounds. The classic signs of infection may not be obvious in patients who are immunocompromised, such as people with diabetes mellitus, those with peripheral vascular disease, or those taking […]

Patient story: journey to the centre of a wound

In this article, the author describes the childhood accident that was to have a huge impact on the rest of his life. He explains both the physical and psychological damage it caused, and how these combined to pose challenges to his subsequent experiences with the healthcare system. The author outlines the development of his diabetic […]

Negative pressure wound therapy for treating wounds in antiphospholipid antibody syndrome

Individuals presenting with antiphospholipid syndrome (APS) — an autoimmune disease with prothrombotic condition — have a high incidence of recurrent thrombosis. In many cases, anticoagulation therapy cannot be avoided, however, the nature of this therapy remains controversial. This case study describes a female patient with APS associated with recurrent thrombosis and haematoma formation that resulted in […]

Understanding the use of collagen/oxidised regenerated cellulose dressings

Collagen-containing dressings have a broad evidence base for efficacious use; collagen/oxidised regenerated cellulose (ORC) in particular restores balance to the wound’s microenvironment, which is critical to healing. Clinicians should consider collagen/ORC dressings when faced with a stalled wound, or where healing may be complicated by risk factors. In three case studies detailed herein, holistic assessment […]

Wound inflammation and the role of a multifunctional polymeric dressing

Temporary inflammation is a normal response in acute wound healing. However, in chronic wounds, the inflammatory phase is dysfunctional in nature. This results in delayed healing, and causes further problems such as increased pain, odour and high levels of exudate production. It is important to choose a dressing that addresses all of these factors while meeting the […]

Technological advancements in the fight against antimicrobial resistance

Over-prescription and misuse of antibiotics has contributed to the global crisis of antimicrobial resistance (AMR)[1]. In order to manage this growing crisis, it is crucial that new technologies and techniques are developed to deal with infection. Infection in chronic wounds is a common problem, which is often targeted ineffectively by antibiotics. In addition, biofilms in […]

Wounds digest 6(2)

Patient safety: Surgical Site Infections Quick Guide

Routine administration of antibiotics for every surgical procedure is unnecessary. Overuse of prophylactic antibiotics increases the risk of adverse effects and continues to contribute to the emergence of resistant bacteria worldwide. This Quick Guide provides important steps for reducing reliance on antibiotics, strategies for preventing infections throughout the surgical process, and quick facts and figures […]

Simplifying venous leg ulcer management: consensus recommendations

Many countries have published guidelines, which state that compression therapy is the ‘gold standard’ treatment for venous leg ulcers. Compression therapy is known to significantly increase VLU healing rates and reduce the risk of recurrence. Despite this, efforts to heal VLUs are often focused on the use of advanced wound dressings and other therapies, while […]

PolyMem dressings Made Easy

As healthcare budgets are put under pressure, providers increasingly need to balance reduced cost with providing high-quality outcomes. This has led to more wounds being treated in the community, creating a need for non-specialists to acquire knowledge about advanced wound care products. However, the wide variety of dressings available means that there is often confusion […]

Hybrid support surfaces Made Easy

The number of people at risk from pressure ulcers is increasing due to an ageing population and a rising prevalence of long-term conditions globally. Since most pressure ulcers are preventable, greater demands are being placed on practitioners to implement strategies for prevention. The variety of support surfaces available for pressure ulcer care, however, often makes […]

Author: lucas.conrado

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