Diabetic foot ulcer wound management Quick Guide
The Diabetic Foot Ulcer Wound Management Quick Guide comprises: A review of the TIME framework to optimise wound management A management plan for each step of DFU care to avoid amputation A visual guide to DFU classification and decision-making overview for local wound treatment. Supported by B Braun
Ten Top Tips… Using negative pressure wound therapy effectively
<p>Negative pressure wound therapy (NPWT) has revolutionised the approach to complex wounds, enabling a breakthrough in wound management.Drawing on current research-based evidence and expert consensus opinion, the following top 10 tips can be used to aid appropriate use for optimal outcomes.</p>
Adapting policies and guidelines makes good sense
<p>It has been an absolute pleasure to work with the members of the International Wound Infection Institute (IWII) committee who have produced two of the articles included this issue of Wounds International.</p>
International Wound Infection Institute: Leaders in wound infection understanding, prevention, and management
<p>Wound infection is a source of morbidity and mortality the world over; be it in acute wounds, or the ever-growing number of chronic wounds. Much remains to be done by the clinicians in the field and researchers in the lab to better understand and manage wound infection. Though common, the nuances of many of the […]
New Zealand’s 2013 STOP Pressure Injury Day Campaign: Successes of the New Zealand Wound Care Society
<p>New Zealand faces many of the same issues as other countries around the world with an aging population, increasing numbers of chronically sick patients, and tight health care cost constraints. This is true of wound care, and here the authors report a campaign to address avoidable pressure injuries.</p>
Ten Top Tips… Preventing orthopaedic surgery-related wound blisters
<p>Superficial wound blisters are an abnormal swelling (i.e. filling with fluid) in the epidermal layer of the skin in response to trauma. Blistering in postoperative wounds may be caused by skin stripping from removal of medical tape, or prolonged exposure of the skin to adhesive contact layers of dressings and associated with the presence of […]
Ten Top Tips… Understanding and managing wound biofilm
<p>Our understanding of the factors that delay wound healing continues to improve through advances in research into the microenvironment. There is now strong evidence that biofilm is present in the majority of chronic wounds. The pathogenesis of biofilms continues to be evaluated, but current knowledge suggests they are detrimental to wound healing and degrade the […]
Pyoderma gangrenosum associated with melanoma
<p>Pyoderma gangrenosum – a rare, neutrophilic dermatosis – is associated with diseases including inflammatory bowel disease, arthritis and haematologic disease. This case story describes an unusual association between pyoderma gangrenosum and malignant melanoma. Clinicians should consider malignant melanoma in all patients with pyoderma gangrenosum.</p>
Sciatic nerve block: A useful procedure for diabetic foot surgery
<p>The range of comorbidities experienced by people who require lower-limb surgery to manage diabetic foot disease are many. These comorbidites make the undertaken of general anaesthesia both difficult and places them at high risk of complications during surgery or in the immediate postoperative period. In this article the authors present a description of a peripheral […]
Best practice guidelines: Effective skin and wound management in non-complex burns
This document is a practical guide to the management of burn injuries for healthcare professionals everywhere who are non-burns specialists. With an emphasis on presenting hands-on and relevant clinical information, it focuses on the evaluation and management of non-complex burn injuries that are appropriate for treatment outside of specialist burns units.
Best practice guidelines: Effective skin and wound management in non-complex burns
This document is a practical guide to the management of burn injuries for healthcare professionals everywhere who are non-burns specialists. With an emphasis on presenting hands-on and relevant clinical information, it focuses on the evaluation and management of non-complex burn injuries that are appropriate for treatment outside of specialist burns units.
Infographic on pressure ulcer prevention
Ten Top Tips… The management of burn wounds
<p>Many people will experience a burn injury in their lifetime. Burn injuries range from the most severe – requiring high levels of critical care and surgical intervention – to simple burns, for which self-treatment may suffice. Burn injuries pose a considerable burden to heathcare resources across the globe.[1] In the UK, the figures are considerable, […]
Book review: A Closer Look At Silver: A Clinical Information Tool (CIT) To Help You Choose The Right Silver Wound Dressing For Your Patient!
<p>The cost-effective, efficient management of individuals with wounds is a key factor in providing quality wound management services. Whereas this espoused principle may seem relatively straightforward, in reality it is not. A lack of evidence to support dressing use, along with a lack of sustained availability of the right dressing for the right patient, often […]
Implementing evidence-based leg ulcer care in an Azorean healthcare centre
<p>The Azores are a Portuguese territory and comprise nine volcanic islands situated in the North Atlantic Ocean. The largest and most populous island in this archipelago is São Miguel, which is famous for its beautiful lakes and green mountains.</p>
Ten Top Tips… Taking high-quality digital images of wounds
<p>"Use a picture. It's worth a thousand words."</p>
Ten Top Tips… Promoting your wound care centre
<p>In many countries, health care is largely provided by private sector businesses. Elsewhere, traditionally state-run health services are currently undergoing a shift – not least due the burden of providing care for aging populations – towards the provision of specific health services by the private sector (see, for example, physiotherapy and podiatry in the UK).</p>
Biatain® Silicone dressings: A case series evaluation
<p>A multicentre case series was performed as a product evaluation of two new silicone wound dressings, Biatain® Silicone and Biatain® Silicone Lite (Coloplast A/S, Humlebaek, Denmark). This addressed the dressings’ overall usability (focusing on comfort for the patients and dressing handling for the healthcare practitioners) in a total of 39 patients who fulfilled the evaluation […]
Ten top tips from Wounds International in 2014
<p>Wounds International is delighted to announce that we are now averaging over 50 000 visitors to the website each month from 150 different countries. In October and November 2013, we recorded a large jump in our figures, mainly due to the interest created around the International Wound Care Conference held in Kuala Lumpur, Malaysia in […]
February 2014 Volume 5 Issue 1: Full Issue
An online practice-based journal for clinicians worldwide
An opportunity to learn, discuss and share experiences
<p>Welcome to the autumn edition of the journal. It gives me great pleasure to introduce the first International Lymphoedema Framework (ILF) Conference that will be taking place at the Ascot conference centre, near London, from the 21st to the 23rd April, 2009. This is an important event in the calendar of the ILF project, as […]
Capitalising on the momentum through collaboration
<p>Lymphoedema (LE) is a dreaded condition. It is debilitating, chronic, and progressive, and is most commonly the result of cancer treatment (i.e. the surgical removal of lymph nodes or disruption to lymphatic pathways) in industrialised countries, or of filariasis in lesser developed countries. Lymphoedema is associated with significant medical, economic, and quality of life consequences, […]
Presentation of childhood lymphoedema
<p>Childhood lymphoedema is a relatively rare condition, uncommon outside of specialist clinics, but which has a significant effect on the affected individual and the family. As a lifelong condition with, at present, no cure, management of the condition by dedicated lymphoedema therapists is of paramount importance. Increasingly, the underlying molecular genetic cause of some forms […]
A general hospital’s multidisciplinary approach to BCRL
<p>The physical, psychological and financial burden of lymphoedema can be varied and complex. Approaching these problems in a thorough manner, involving the skills of many different providers of care offers the patient a more comprehensive plan of care than can be accomplished by a sole practitioner. The purpose of this article is to describe how […]
Society update Vol 5, No 1
<p>- National Lymphedema Network – The British Lymphology Society (BLS) – The Global Alliance to Eliminate Lymphatic Filariasis (GAELF) – The Austrian LymphLiga (ÖLL) – The Dutch Lymphedema Network (NLNet) – The Lymphoedema Association of Australia (LAA) – The Lymphoedema Support Network – The Leg Club</p>
A new way to assess superficial changes to lymphoedema
<p>Background: Appropriate management of lymphoedema requires an accurate diagnosis of the changes in fibrotic induration in order to target treatment. Tonometry is used to measure tissue’s resistance to compression and provide an objective assessment of the stage of lymphoedema, tissue changes and treatment efficacy. The mechanical tonometer that is commonly used has some shortcomings, as […]
Lymphoedema education needs of clinicians: a national study
<p>Background: Poor knowledge of lymphoedema among clinicians can delay its management, increasing the burden on affected individuals, carers, and services. Aims: To determine the nature of, and means to address, lymphoedema education needs of clinicians within the context of their working lives.</p>n<p>Methods: Electronic surveys of lymphoedema specialists and generalist clinicians in Scotland, followed by focus […]
Lymphoedema — primary or secondary, how does one tell?
<p>A recent editorial in Lymphatic Research and Biology suggests that many cases of apparent secondary lymphoedema may, in fact, have an underlying primary cause, even though the primary event cannot yet be identified (Rockson, 2008). A primary disease is usually defined as one arising spontaneously and not associated with, or caused by, a previous disease […]
USA-South African partnership for lymphoedema education
<p>Curricula for providing lymphoedema education varies internationally. The Lymphology Association of North America (LANA) has established curriculum criteria (135 hours), accepted as the standard model across the United States (US). This educational mode was successfully introduced in the Western Cape, South Africa (SA) in an inaugural course in 2008. This report outlines the necessary resources […]
Global Initiative for Wound and Lymphoedema Care (GIWLC)
<p>Over the past two decades the world has seen tremendous medical advances in modern wound care and lymphoedema management, principally due to new scientific knowledge, techniques and materials. These advances have occurred mainly in the developed countries. The diagnosis and treatment of chronic wounds and lymphoedema, both primary and secondary in aetiology, involves all medical […]
Selected abstracts from the BLS annual conference 2009
<p>The British Lymphology Society Research Advisory Board (BLS RAB) is pleased that the Journal of Lymphoedema has agreed to publish the following selected abstracts from last year’s conference in Sheffield. We would like to encourage members and other healthcare professionals to submit abstracts for this year’s conference to be held in Manchester. Jacquelyne Todd, Chair […]
Anatomy and physiology in relation to compression of the upper limb and thorax
<p>An understanding of arterial, venous and lymphatic flow in the upper body in normal limbs and those at risk of, or with lymphoedema will greatly improve patient outcomes. However, there is much we do not know in this area, including the effects of compression upon lymphatic flow and drainage. Imaging and measuring capabilities are improving […]
Use of a tissue mobilising compression system
<p>The standard treatment for lymphoedema is complete or complex decongestive therapy (CDT) that combines manual lymphatic drainage (MLD), skin care, multilayer, multi-component bandaging, exercises and patient education (Cheville et al, 2003; International Lymphoedema Framework, 2006). Intermittent pneumatic compression (IPC) therapy can also be used in conjunction with CDT (Mayrovitz, 2007). Although CDT is well established […]
Yoga for women with breast cancer-related lymphoedema: a preliminary 6-month study
<p>Background: The lifelong nature of breast cancer-related lymphoedema (BCRL) requires an exploration of activities that may be of potential benefit. Exercise trials in BCRL are becoming more common. Aims: To determine if the continued practice of yoga for 6 months imparts measureable benefits in reduction of lymphoedema, self-reported symptoms, and quality of life (QOL).</p>n<p>Methods: Women […]
Factors precipitating an episode of lymphatic swelling
<p>Background: People with lymphoedema may be advised to avoid or take caution with certain activities, such as airline flights and wearing tight clothing in order to reduce the risk of an episode of lymphatic swelling. However, the association between these activities and the occurrence of lymphoedema has infrequently been evaluated. Aims: To document the patient-reported […]
Genital oedema
<p>Chronic oedema of the external genitalia has been classified as congenital or acquired (McDougal, 2003), and, as with other oedemas, is often referred to as ‘primary’ or ‘secondary’ lymphoedema.</p>
Cellulitis and lymphoedema: a vicious cycle
<p>Cellulitis is a relatively common infection of the skin and subcutaneous tissue associated with high morbidity and a burden on healthcare resources. Lymphoedema — the accumulation of fluid in interstitial spaces — can occur as a consequence of cellulitis. Similarly, the presence of chronic lymphoedema can predispose to recurrent episodes of cellulitis. This article explores […]
ILF is spreading the global lymphoedema message
<p>The International Lymphoedema Framework (ILF) was launched at the first International Lymphoedema Framework Conference at Royal Ascot in 2009 and has since grown into a fully-fledged global organisation. So far, it has given rise to national frameworks in Canada, the United States, Sweden, Japan and Australia.</p>
Selected abstracts from the BLS annual conference 2011
<p>The British Lymphology Society (BLS) Scientific Committee is pleased that the Journal of Lymphoedema has agreed to publish the following selected abstracts from this year’s conference in Nottingham We would like to encourage members and other healthcare professionals to submit abstracts for next year’s conference to be held in Cardiff. Jacquelyne Todd, Chair of the […]
Treating lymphoedema patients in Indian villages
<p>In 2004, the Institute of Applied Dermatology (IAD) developed an integrated treatment programme for lymphatic filariasis (LF) for rural communities. This included a combination of treatment elements from allopathy, Ayurveda and yoga therapy, to deliver low cost, home-based, self-care treatment with the support of a family member. Patients were treated at the outpatient department in […]
Lymphogenic cardiomyopathy
<p>The lymphatic system plays a major role in the maintenance of cardiac function. Dysfunction of the cardiac lymphatics can lead to the onset of new pathology, aggravation of existing pathology or worsening of the long-term prognosis. Obstruction or severance of the principal trunks of the cardiac lymphatics results in phenotypic lymphogenic cardiomyopathy, which can manifest […]
Imperatives for research to move the field forward
<p>Worldwide, more than a million women are newly diagnosed with breast cancer every year, accounting for one-tenth of all new cancers and nearly one-quarter (23%) of all female cancer cases (American Cancer Society [ACS], 2007).</p>
Pilot study of a handheld massage unit
<p>Background: Secondary arm lymphoedema is a chronic condition which affects a significant number of women and requires ongoing management. Aims: To pilot a new handheld massage unit which delivered vibration to the arm tissues and can be used in the home environment.</p>n<p>Methods: Women with established arm lymphoedema secondary to breast cancer treatment used the handheld […]
22nd International Congress of Lymphology
<p>It was a great pleasure to attend the 22nd International Congress of Lymphology in Sydney, Australia. This was an excellent meeting organised by Neil Piller and his team and was attended by many from across the globe. The different professional groups were well represented and the meeting was further enhanced by a public meeting for […]
Achieving independence through self-management
<p>Lymphoedema is a debilitating and chronic condition for which there is no curative treatment (Lymphoedema Framework, 2006).</p>
Acupuncture in lymphoedema management: a feasibility study
<p>Background: Acupuncture in lymphoedema management is controversial, with assumptions it will introduce infection or exacerbate swelling.</p>n<p>Aims: This three-step, patient-centred, mixed-methods study assessed acceptability, impact on quality of life, and adverse events of traditional acupuncture as an adjunct to maintenance care for people with lymphoedema secondary to breast and head and neck cancers.</p>n<p>Methods: Step 1: focus […]
Moving forward with the American Lymphedema Framework Project (ALFP)
<p>We are moving ahead in year two of the three-year National Library of Medicine G08 grant on Cyber Informatics Tools for Lymphoedema Stakeholders which enables us to develop and build the infrastructure for the American Lymphoedema Framework Projecct (ALFP) lymphoedema minimum data set (MDS). The ultimate goal is to create an operational cyber infrastructure that […]
Understanding the differences between lipoedema and lymphoedema
<p>An incorrect diagnosis can be a significant event for the individual. Money will be wasted on wrong or poorly targeted treatment, relevant interventions will not be put in place, and there will be a detrimental impact on the person’s quality of life. This is my story of a misdiagnosis and what it meant for me […]
Haemodynamics of lymphoedema
<p>The Starling hypothesis and available data on the physiology of the microcirculation provide a clear model for understanding how arterial, capillary and venous haemodynamics may affect the production of lymphatic fluid. This review considers the studies that have focused on venous and arterial haemodynamics and calf muscle pump function. Although the evidence base available is […]
Field experience of Handicap International
<p>Even if around 180 million people suffer from lymphoedema worldwide (Casley-Smith et al, 1997), its impact as a public health problem is underestimated. The main reason for this being the lack of epidemiology. Both in developed and developing countries, the prevalence and incidence of lymphoedema is unknown. In developing countries, lymphatic filariasis (LF) is seen […]
