Use of a cellulose PHMB dressing in clinical practice
Infection is the single most important contributory factor in delayed wound healing. All wounds contain micro-organisms (mainly bacteria), but not all wounds will become infected. The potential for bacteria to delay healing is influenced by the ability of the patient’s immune system to combat the bacteria as well as the number and type of bacteria […]
Is there a link between LE treatment and breast cancer reoccurence?
<p>The treatment of lymphoedema encompasses many modalities, from bandaging, compression garments, intermittent compression therapy (ICT), low level laser, a range of vibration-based and a range of manual lymphatic drainage (MLD) strategies, self/partner massage, exercise and activity, all generally forming part of what is often called complex physical therapy.</p>
The psychosocial impact of primary lymphoedema
<p class="p1"><span class="s1">This article reviews the literature on the psychosocial impact of non-cancer related lymphoedema. Relevant articles were obtained through database searches, although only a limited number of articles investigated psychological or social factors. Overall, the following psychological factors appeared to be relevant for patients with lymphoedema: body image, mobility, relationship problems, anger, anxiety and […]
Wounds digest 6(1)
<p class="p1">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.</p>n<p class="p1">Full references are provided should […]
Ten top tips: Preventing device-related pressure ulcers
<p class="p1">In the current battle to eliminate all avoidable pressure ulcers nurses now report and examine every episode of tissue damage where pressure is believed to have been a contributing factor. This reporting has led to a wealth of data which not only identify ulcer category, but also the site and source of pressure. </p>n<p> </p>
Managing high viscosity exudate
<p class="p1">Wound pain, odour and exudate have a major impact on patient quality of life. Understanding the management of these core components of wound healing is essential if patient outcomes are to be optimised. This paper discusses the role and types of exudate, the impact of high viscosity exudate on management and what to consider when selecting an appropriate dressing […]
Taking wound assessment beyond the edge
<p class="p1">Findings from a recent global anthropological study have highlighted the importance of the periwound skin and its relevance to wound progression. The study reveals that both healthcare practitioners and patients view management of the periwound skin as an integral part of wound healing. While current wound assessment tools offer a standardised approach to assessment of the wound, there is […]
Patient story: a missed opportunity to provide top-level wound care
<p class="p1">Adanna Walker is a young woman living in Ontario, Canada. She wounded her foot in an accident with a golf cart eight years ago when she was 23 years old. She recalls the story of her injury, the treatment she received for her wound and her overall experience of wound care in Canada. A wound care clinician comments […]
Topical wound oxygen therapy for chronic diabetic lower limb ulcers and sacral pressure ulcers in Japan
<p class="p1">Topical wound oxygen therapy (TWO) is widely used in North America and Europe. We initiated a clinical trial in 2010 to introduce this therapy into Japan; this involved six patients with chronic ulcers who underwent TWO. Pre- and post-treatment transcutaneous oxygen tension (TcPO2) values were evaluated at the periwound area. All cases showed increased TcPO2 values after TWO. […]
The World Union of Wound Healing Societies congress 2016
<p class="p1">It is amazing how much work goes into organising a ‘wounds’ conference. The process reminds me a little bit of cooking Christmas dinner, which similarly involves hours of planning, researching, anticipating and the inevitable last minute dramas — the cranberries have sold out on Christmas Eve, the oven breaks, or one of the guests suddenly announces they have a particular food allergy. […]
Ten top tips: Improving the diagnosis of cellulitis in the lower limb
<p class="p1">Cellulitis is a common medical condition encompassing an acute, subacute or chronic inflammation of the skin and subcutaneous tissue, usually as a result of a bacterial infection. Microorganisms found on the skin, such as <em>Streptococcus pyogenes </em>and <em>Staphylococcus aureus</em>, gain access through the skin barrier causing an infection of the subcutaneous tissue.</p>n<p class="p1"> </p>
Incontinence-associated dermatitis: moving prevention forward
Incontinence-associated dermatitis (IAD) represents a significant health challenge worldwide and is a well-recognised risk factor for pressure ulcer development. Recent consensus work has identified gaps in our current understanding and practice. The ability of clinicians to deliver evidence-based practice is hampered by lack of standardised definitions and terminology, high-quality studies, and international or national guidelines. […]
Case series evaluation: ADAPTIC TOUCH® in partial-thickness skin graft donor-site wounds
In 2013, Andreas Bruhin pioneered a novel approach to managing these particular concerns using ADAPTIC TOUCH in two patients. In these original DSW case studies, ADAPTIC TOUCH was chosen for its non-adherent properties, to encourage epithelialisation without the need to disturb the wound bed. In this new document – International case series: ADAPTIC TOUCH® in […]
Wound Infection Made Easy
It is important that clinicians understand how infection develops, how signs and symptoms manifest in various aetiologies, and how and when to initiate use of topical antimicrobials and systemic antibiotics in wounds clinically diagnosed as infected. This made easy reviews current practice and provides practical advice on how to prevent and manage infection in wounds […]
New partnerships, new strengths, and improved professional awareness and patient outcomes
<p>The identification, treatment and management of all forms of chronic oedema (lymphoedema) requires a multidisciplinary approach. We have no doubt there are many deficiencies in our knowledge, even our basic knowledge, such as what we understand about the incidence and prevalence of lymphoedema, our professional knowledge of it, the ways it impacts on patients and […]
What’s best for our lymphoedema patients?
<p>In a recent issue of the Journal of Lymphoedema, Nickolaidis and Karlsson (2013) indicated that most of the standard treatments for lymphoedema patients were explored and developed early last century, and suggested that holistic assessment of the individual is critical for good outcomes, but that perhaps “less emphasis should be placed on manual lymphatic drainage […]
Abstracts from the 5th International Lymphoedema Framework Conference
<p>The theme of the 5th International Lymphoedema Framework Conference was: “Reduced Incidence, Prevalence and Impact: Making these Realistic Goals.” Collaboration, communication and holistic awareness and management based on sound evidence are the keystones of good outcomes. Patient education, involvement and self-management are critical if we are to reduce the numbers of those developing lymphoedema, the severity of their […]
Audit of childhood lymphoedema in the United Kingdom undertaken by members of the Children’s Lymphoedema Special Interest Group
<p>Childhood lymphoedema is a rare and poorly recognised condition with only a few specialist lymphoedema centres that have the experience of diagnosing and treating this group. The Children’s Lymphoedema Special Interest Group (CLSIG) was formed in a bid to improve service provision and enhance practitioner knowledge and support. this innovative audit was undertaken to help […]
The perceived role of cancer specialists in breast cancer-related arm morbidity care
<p>This article addresses a gap in the cancer survivorship literature regarding clinician responsibility for the treatment of breast cancer-related arm morbidity. The authors interviewed cancer specialists in Canada about their role in the continuing care needs of breast cancer survivors. Utilising a grounded theory methodology, 14 cancer specialists (medical, radiation, and surgical oncologists) from British […]
Facing up to the obesity crisis: outcomes of a bariatric lymphoedema clinic
<p>There has been an increasing number of referrals of obese patient to lymphoedema services Lymphoedema in obesity is oḀen complicated by multiple comorbidities. Treatments for lymphoedema have been shown to be unsuccessful without concurrent and sustained weight loss. This article describes the initiatives of a specialist lymphoedema service in aᴀempting to manage lymphoedema in the […]
Congenital pulmonary lymphangiectasia
<p>Congenital pulmonary lymphangiectasia is a rare condition caused by failure of pulmonary lymphatic vessels to develop normally. It is a known cause of non-immune hydops fetalis and congenital chylothorax. While it has been recognised in the literature since the 1950s, no standardised treatment has yet emerged and a definitive cause is still unknown. This review […]
Lipoedema — a family story
<p>Lipoedema is an adipose tissue disorder, commonly confused with lymphoedema, which affects around 300 million women worldwide (Fonder et al, 2007). The causes of the condition, which leaves people with a large build up of faᴀy tissue in their limbs, especially the lower ones, are still largely unknown, the symptoms often misunderstood and dismissed, and […]
Wound management with the Biatain® Silicone foam dressing: A multicentre product evaluation
<p>Exudate management is one of the key challenges for those involved in wound care. Matching dressing properties to wound requirements is a fundamental aspect of any protocol of care. This article reports the findings of an international multicentre product evaluation of the new Biatain® Silicone (Coloplast A/S) dressing for the treatment of acute and chronic […]
Wounds digest 5(4)
<p>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 […]
Patient story: the challenges of living with a non-healing leg ulcer
<p>In this article, the author describes her 15-year experience of living with leg ulcers. She explains the challenges these ulcers have brought in her daily life and the particular problems with pain management she has encountered. The author describes how different approaches to manage these ulcers have worked, and the most successful treatment to date.</p>
20 years in wound healing: where we are now
<p>For 20 years, or more, I have attended the Wounds UK annual conference held in the international conference centre in Harrogate in North Yorkshire, England. This year the event, billed as ‘Decoding Science — Transforming Practice’ was bigger and better than ever before. With over 1,500 delegates visiting the conference, the symposium sessions were well […]
Ten top tips: reducing antibiotic resistance
<p>The World Health Organization (WHO)’s 2014 report on global surveillance of antimicrobial resistance reveals that antibiotic resistance is no longer a prediction for the future; it is happening now, across the world. This has been driven by antibiotic overuse in humans and food-producing animals, globalisation, and suboptimal infection control. Underuse and misuse of medicines also […]
100 days, 100% hospital-acquired pressure ulcer-free campaign at a Saudi Arabian rehabilitation facility
<p>This article describes the 100 days campaign at the Sultan Bin Abdulaziz Humanitarian City Rehabilitation and Medical Center, which aimed for the hospital to be 100% free of hospital-acquired pressure ulcers (HAPUs) during the 100-day campaign period. The campaign involved the whole organisation with 17 inpatient units participating. The centre’s practices regarding the management of […]
Ten top tips: preventing pressure ulcers in the surgical patient
<p>Pressure ulcers attributable to the operating room (OR) are not uncommon; they account for up to 45% of all hospital-acquired pressure ulcers.The incidence of pressure ulcers occurring during surgery was addressed in international pressure ulcer guidelines in 2014, reflecting the research and work that has been done in this area. Prevention begins before surgery, continues […]
Expert commentary: pressure ulcers in the surgical patient
<p>On reading the article by Joyce Black, Debra Fawcett and Susan Scott, we are reminded of the importance of pressure ulcer prevention strategies for patients in the operating room.</p>
Management of a non-healing postoperative wound using a bacteria and fungi-binding mesh
<p>This case report describes the use of Sorbact®, a bacteria and fungi-binding dressing, to treat a chronic surgical wound in a patient with a history of substance abuse and peripheral arterial disease. The wound had previously been treated unsuccessfully with negative pressure wound therapy and antimicrobial dressings, and had not healed 7 months after surgery. […]
Adding a new perspective: learning from patient stories
<p>It is always extremely thought-provoking when patients are overheard describing their experience of living with wounds. At this year’s European Pressure Ulcer Advisory Panel (EPUAP) annual conference in Stockholm at the end of August, the delegates were silenced by the first two speakers; Ronny Persson and Claes Hultling told the audience exactly how it is […]
Ten top tips: repositioning a patient to prevent pressure ulcers
<p>Having an understanding of the exact cause of pressure ulcers helps place the role of repositioning into context. As such, a pressure ulcer is deἀned as localised injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear.</p>
Clinical innovation: wound management in an outpatient setting
<p>Rising healthcare costs are an ongoing concern for employers, insurers, patients and governmental agencies in the USA. In 2012, healthcare spending increased by 3.7% to approximately $2.8 trillion. Of this, $882.3 billion was attributed to hospitals. Growth in spending from Medicare, Medicaid, and private health insurance providers all accelerated in 2012 compared to 2011, influenced […]
Ten top tips: managing surgical site infections
<p>The definition of surgical site infection (SSI) by the Centres for Disease Control and Prevention (CDC)[1] of North America [Table 1] is the most commonly used and comprehensive. Leaper and Fry state that an SSI is the most preventable healthcare-associated infection. According to hospital data in Canada, SSIs are the third leading cause of hospital-acquired […]
Use of a bioplastic material containing hyaluronic acid on a chronic leg ulcer
<p>Chronic leg ulcers of various aetiologies are commonly seen in a regional dermatology unit in Russia and patients are treated with a range of surgical and therapeutic techniques. An important trend in the modern treatment of patients with complex chronic ulcers is the adjunctive use of a new group of dressings made of bioplastic materials. […]
Patient story: the importance of dressing selection after heart surgery
<p>In this article, the author describes undergoing open heart surgery for bicuspid aortic valve disease describes how the dressings chosen for his postoperative care affected his recovery. He explains how, despite having more than 25 years experience working in wound care marketing, he was surprised at how much the wrong dressing could influence his physical […]
The role of wound cleansing in the management of wounds
<p>Wound cleansing should be seen as an integral part of wound bed preparation to optimise the wound environment by removing debris, reducing bacterial load and preventing biofilm activity. Clinicians have a number of options to choose from when selecting an appropriate wound irrigation solution. One factor to consider includes the ability to mount a rapid […]
Meeting report: stepping up to customised wound care
<p>A one-hour symposium was held by Urgo Medical on Thursday 15th May 2014 at the annual European Wound Management Association (EWMA) Conference in Madrid, entitled ‘Stepping up to customised wound care’. The objective of the session was to highlight the benefits of a sequential treatment in chronic wounds. This is an important concept that creates […]
Jobst® Opaque and Bellavar ready-to-wear hosiery range
<p>Compression hosiery is an important part of lymphoedema management. However, due to the patient’s inability to tolerate use of a garment, it is often under-used. To maximise patient concordance, clinicians should work with the patient to develop a regimen that is effective and comfortable and acceptable to the patient. This product review describes the Jobst® Opaque and Bellavar […]
Diabetic foot care training in developing countries: Addressing the skills shortage-wint
The growing prevalence of diabetes is accompanied by increases in the number of diabetic complications, including those of the foot. This will especially affect developing countries, where the percentage of the population with diabetes is rapidly out-pacing that in the developed world. With only 19 countries worldwide having licensed schools of podiatry, and trained podiatrists […]
Manual Lymphatic Drainage UK (MLDuk)
<p>MLDUK was formed in 1994 to educate healthcare professionals and the general public about the benefits of manual lymph drainage (MLD) and how it can be used to treat lymphoedema and other conditions. As well as promoting and providing information to better educate MLD therapists, healthcare professionals and the wider public, it has compiled an official register of […]
Society update
<p>Society update.</p>
Proactive treatment needed for lymphoedema patients
<p>No matter what the aetiology of lymphoedema, the physical, social and psychological effects of the condition can have a signiἀcant impact (Ahmed et al, 2008).</p>
Clinical research in the UK: the beginning of a new era
<p>The lack of high quality evidence for some of the treatments of lymphoedema and other chronic oedemas is well recognised (Lymphoedema Framework, 2006). </p>
Lymphoedema care and management in Canada
<p>Lymphoedema is a global health condition; one person in 30 worldwide is estimated to suffer from lymphoedema which has been termed ‘the hidden epidemic’ (MacDonald and Geyer, 2010).</p>
Retrospective audit of a prevention clinic for BCRL
<p>Historically within the Wrexham and Flintshire area, patients with arm swelling as a result of breast cancer surgery or radiotherapy (RT) were treated reactively and referred to the lymphoedema service when they the lymphoedema service when they swelling. Following surgery, all patients were given written information on prevention of lymphoedema, including advice on cellulitis, skin care and exercises and were seen postoperatively by the […]
Clinicians’ training and interests in LE research
<p>Lymphoedema is a chronic and debilitating condition that has been largely neglected by the healthcare community, resulting in limited clinical and basic science research in the field (Pyszel et al, 2006; McLaughlin et al, 2008; Cormier et al, 2009; Fu and Rosedale, 2009).</p>
Incidence of LE due to treating cutaneous melanoma
<p>The rates of morbidity associated with lymphadenectomy as a treatment for cutaneous melanoma, as reported in the literature, vary due to the different methods used in the studies. As a result, it is difficult to compare data from different research (Kretschemer et al, 2008). Assessing the incidence of lymphoedema and other morbidities in patients with melanoma is important, as over time the […]
Diet and BCRL: facts and fallacies on the web
<p>Lymphoedema is a common sequela to breast cancer treatment. Until recently, patients were limited in how they obtained information, but now a range of medical-related websites provide numerous alternatives for managing the condition. With many patients consulting grey and popular literature, healthcare professionals need to be better aware of inaccurate or potentially dangerous information in the media and […]
