Implementing Wound Balance: Outcomes and future recommendations
Non-healing wounds can reduce quality of life (QoL) for millions of people globally, are costly, and result in significant patient, clinician and healthcare system burden (Guest et al, 2020; Ahmajärvi et al, 2022; Queen and Harding, 2023; Sen, 2023). There is a significant need to proactively address the projected rise of non-healing wounds by earlier […]
Incision care and dressing selection in surgical wounds: Findings from an international meeting of surgeons from India
Surgical wound complications, such as surgical site infections (SSIs) and surgical wound dehiscence (SWD), are considerable worldwide healthcare concerns, which result in increased risk of morbidity and mortality (Allegranzi et al, 2011; Rickard et al, 2020; Sandy-Hodgetts et al, 2022a). The growing threat of antimicrobial resistance adds complexity to the treatment and prevention of SSIs […]
Clean to heal concept and experiences in practice
‘Clean to heal’ is a simple and proven concept: cleaning the wound is essential to healing (“if you want the wound to heal, you need to clean it”). In this context, ‘cleaning’ effectively means removing barriers to healing, which may include slough, debris, necrotic tissue, bioburden and/or biofilm (see Box 1 for detailed definitions of […]
The other costs of pressure ulcers
We hear a lot about how much pressure ulcers cost the US economy. Padula and Delarmente (2019) estimated that government money spent on hospital-acquired pressure injury in 2016 exceeded $26.8 billion. About 59% of these costs were disproportionately attributable to a small rate of Stage 3 and 4 full-thickness wounds. Pressure ulcers are the single […]
Top ten tips: Preventing and treating skin tears
As we age, skin naturally becomes thinner and less resilient towards force. Therefore, older adults are at higher risk of getting skin tears and more severe skin tears than when they were younger. Keeping the skin moisturised will maintain its elasticity and strength. Use fragrance free and hypoallergic products. Read the label if unsure, because […]
Wound remodelling: Approaches and techniques aimed at closure of wounds with unfavourable base or edges
When the concept of TIMERS (tissue, infection/inflammation, moisture, wound edge, repair/regeneration, social) was introduced in 2019, it outlined the components needed for hard-to-heal wounds (Atkin et al, 2019). If wound edges were not favourable, wound edge excision and evaluation for the possible need for therapies to accelerate re-epithelialisation were recommended. TIMERS also introduced the new […]
Case series of traumatic injuries to evaluate the efficacy and safety of Aiodine™ in facilitating wound healing
Wound healing is a multifaceted biological process encompassing haemostasis, inflammation, proliferation, and tissue remodelling, all of which must occur in a coordinated manner to restore skin integrity and function (Singh et al, 2017). In particular, the role of dermal fibroblasts in generating connective tissue and producing the extracellular matrix had been highlighted as essential for […]
Therapeutic wound and skin cleansing: Clinical evidence and recommendations
The Board of the International Wound Infection Institute (IWII) has developed this document based on the perceived need for definitions, clarification and practice guidance regarding wound cleansing. The document extends the guidance provided in the 2022 Wound Infection in Clinical Practice: Principles of Best Practice by presenting the best available evidence on the purpose of […]
In vitro evaluation of the capability of a silicone superabsorbent polymer (SAP) dressing to modulate pro-inflammatory cytokines
Wound healing is a complex physiological process the aim of which is to re-establish homoeostasis following epidermal surface damage. The phases required for wound healing include inflammation, re-epithelisation and scar formation (Shaw and Martin, 2009). Immediately after tissue damage, an inflammation process is triggered and polymorphonucleocytes and monocytes migrate to the damaged cutaneous tissue. The […]
Oxygen-enriched oleic matrix medical dressings for the treatment of extensive burns and related acute and post-burn complications in children: a case series
Burns are traumatic events that can be caused by several aetiological agents, including friction, cold, heat, radiation, chemical or electrical sources; however, most burns are caused by hot liquids, solids or flame (Jeschke et al, 2020). Burns cause tissue destruction due to the transfer of energy, which is in turn conditioned by the burning agent. […]
Promoting wound healing through artificial intelligence-powered dressing development
Wound care has traditionally relied on empirical knowledge, clinician expertise, and manual assessments. However, technological advances in artificial intelligence (AI) and sensor technology are now revolutionising this field by offering the option for data-driven, real-time insights into wound healing processes and the associated wound care resources and costs. With the increasing prevalence of chronic wounds, […]
From chronicity to healing using HydroClean®: Advancing wound care through the Wound Balance concept
Chronic, hard-to-heal wounds are a significant global public health concern, placing a burden on patients, healthcare professionals, and healthcare systems. It is estimated that in developed countries, 1–2% of the population is affected by chronic wounds at any given time (Olsson et al, 2019). These wounds often require frequent healthcare visits and extended periods of […]
Negative pressure wound therapy – contemporary views on mechanisms of action
This report summarises the proceedings of an industry-sponsored symposium (held at the European Wound Management Association Conference in 2024). An international panel of scientific and clinical experts presented research data on the mechanisms of action of negative pressure wound therapy (NPWT) and shared their clinical experiences of using a canister-based single-use NPWT system (CB-suNPWT). Introduction […]
Clinical inertia in chronic wound care
Globally, chronic wounds impact millions of individuals, with estimates suggesting that up to 2% of the population in developed countries will experience a chronic wound during their lifetime. The prevalence is even higher in ageing populations, where comorbidities such as diabetes and obesity exacerbate the risk of non-healing wounds (Sen, 2019). The financial burden is […]
Wounds Digest 16-1
In this section, we present brief synopses of a range of recently published articles that may be of interest to healthcare 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 should […]
Retrospective case series: Implementation of the Wound Hygiene protocol for wound healing
Wound Hygiene is a simple, effective concept designed as a protocol of care to support the healing of hard-to-heal wounds. It focuses on cleaning and decontaminating the wound while addressing barriers to healing, particularly biofilm. The protocol consists of four simple steps: Cleanse, Debride, Refashion, and Dress [Figure 1; Table 1]. Wound Hygiene should be […]
Autolytic continuous debridement with a focus on biofilm management
Debridement: an overviewDebridement is ‘the removal of nonviable tissue, including necrotic material, slough, microorganisms, biofilm and contaminants from or adjacent to a wound’ (International Wound Infection Institute [IWII], 2022). Non-viable tissue often presents in acute wounds (e.g. surgical wounds/skin tears) and chronic wounds (e.g. DFUs [Image 1]; venous leg ulcers [VLUs]; pressure ulcers [PUs] and […]
The assessment and treatment of burn wounds in the Asia-Pacific(APAC) region: Consensus meeting report
The treatment of burn wounds requires specialist, multidisciplinary care. Burn wounds must be managed carefully to avoid adverse outcomes such as scarring, contractures and keloid scarring. Large or deep lesions require careful monitoring alongside complex and strategic treatment approaches (Hermans, 2019). The management of burn wounds is important for the prevention of further complications, which […]
Unmet needs in managing Diabetic Foot and it’s complications: Recommendations for the Gulf region
Type 2 diabetes is fast becoming a ‘modern preventable pandemic’ around the globe (Singer et al, 2022). The World Health Organization (WHO) estimates that the global number of people living with diabetes between 1980 to 2014 increased from 108 million to 422 million (WHO, 2023). Approximately 90% of all people with diabetes have type 2 […]
Incision care and dressing selection in surgical wounds: Findings from an international meeting of surgeons from Japan
Postoperative wound management is fundamental to minimising the risk of perioperative surgical site infections (SSIs). To reduce the risk of infection and surgery-related complications, it is important to select and manage dressings suited to the specific needs of the Japanese healthcare system (Sandy-Hodgetts et al, 2017; 2018; Morgan-Jones et al, 2020). In July 2024, a […]
What exactly is skin failure?
Skin failure is a popular phrase in the US. The problem we have with the label is that there are no formal diagnostic criteria at this point and I have no picture of one of these skin changes. However, the term continues to be used as an explanation of skin changes seen in the critically, […]
Top ten tips: preventing pressure injuries in paediatric patients
1 – PI risk factors for the paediatric population are different based on ages Pressure injury (PI) risk factors for adults have traditionally viewed as the PI risk factors for all ages of the paediatric population. As such, prevention measures/bundles are based on the adult model of prevention. New research has emerged noting that PI risk […]
Calf ulcer and calcinosis cutis in a patient with scleroderma
Calcinosis cutis is a rare disorder first described by Virchow in 1855 characterized by abnormal deposition of amorphous calcium salts under the epidermis in various parts of the body. Scleroderma is a connective tissue disorder with a complex and largely unclear pathogenesis (Mourad and Louis, 2021). Case report A 54-year-old female presented to our wound […]
Using a bacterial and fungal capture dressing coated with dialkylcarbamoylchloride and impregnated with hydrogel in the treatment of an infected neuropathic diabetic ulcer: a case report
The prevalence of diabetes continues to increase globally, and the International Diabetes Foundation (2021) estimated that 537 million adults aged 20 to 79 worldwide were living with diabetes in 2021. This situation leads to an increasing incidence of complications of the foot, including infections. Diabetes-related foot infections (DFIs) are associated with substantial morbidity and require […]
Using a single-use, canister-free negative pressure wound therapy on recalcitrant wounds: a case report series
Acute or chronic wounds are a common issue that often result from surgery, trauma, or underlying medical conditions (Wilsonet et al, 2004; Klevens et al, 2007; Spiliotis et al, 2009). Numerous therapeutic approaches can be used to treat these wounds and one such approach is the use of negative pressure wound therapy (NPWT; Stannard et […]
Accessibility in accredited lymphoedema training: digital and practical training considerations — a case study
Digital accessibility is a fundamental principle of contemporary healthcare especially as digital communication, through using the internet, has become a primary tool for communicating and engaging patients (Polukhin et al, 2023). According to the International Organization for Standardization (ISO, 2021): “Over a billion people around the world have some form of disability, so ensuring products, […]
Successful sequential management of sloughy and exudative wounds at risk of infection with polyabsorbent fibre dressings with technology lipido-colloid and silver then with technology-lipido colloid with nano-oligosaccharide factor treatment range — a case series from Poland
Wounds have been referred to as the ‘Silent Epidemic’, with huge economic burdens on health budgets worldwide (Maheshwari, 2024). Around 15% of wounds remain unresolved even up to a year or more, resulting in a persistent burden to patients, their families and health systems (Lindholm and Searle, 2021). It is estimated that in a population […]
Acute marjolin ulcer from dog bite resulting in melanoma
A 59-year-old female with diabetes presented with a hypergranulated ulcer on her left index finger from a dog bite that occurred approximately 6 months prior to her first visit to the wound clinic. She was a nurse and was caring for it by herself, but when it got larger, she made an appointment at the […]
A case series on improving the management of malignant cutaneous wounds through silicone SAP dressings
Cutaneous wounds are defined as a ‘disruption of normal anatomic structure and function’ of the skin due to an injury/break (Chhabra et al, 2017). MCWs develop when cancer cells infiltrate and proliferate within normal skin and surrounding tissues. These wounds mostly occur either due to metastatic growth of a primary skin cancer or skin invasion […]
Wounds digest 15-4
In this section, we present brief synopses of a range of recently published articles that may be of interest to healthcare 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 should […]
Ostomy Skin Care
What are ostomies? Ostomy is an umbrella term for surgical procedures in which a ‘stoma’ is created. A stoma is a surgically created opening onto the surface of the body to exteriorise a hollow organ and maintain the passage (Fletcher et al, 2020). Different types of ostomies Colostomy = exteriorisation of a section of the […]
Skin substitutes for the management of hard-to-heal wounds
Skin substitutes—which may also be referred to under the umbrella terms ‘tissue scaffolds’ or ‘tissue-engineered products’, ‘cellular tissue products (CTPs)’, and ‘cellular, acellular and matrix-like products (CAMPs)’—have seen exponential development in recent years and become a commonplace tool within wound care. As products have been developed and the evidence base has grown, these products offer […]
Incision care and dressing selection in obstetrics and gynaecology: Findings from an international meeting of obstetricians and gynaecologists
Surgical wound complications such as surgical site infection (SSI) and surgical wound dehiscence (SWD) represent a considerable issue in global healthcare across surgical disciplines (Sandy-Hodgetts et al, 2022a). A panel meeting of clinical experts was convened to examine post-incisional care and dressing selection in OB-GYN practice. The attending clinicians work across the APAC region, united […]
The importance and relevance of patient education about lymphology and lymphoedemas
Throughout our lives we learn from those around us – our parents, teachers, friends and colleague – through what we discuss, hear, see and read. These experiences make us what we are today, but along the way perhaps there were some times when we have doubted or questioned the information, its sources, its accuracy and […]
X marks the spot… and “X factor” marks the need?
“Without continual growth and progress, such words as improvement, achievement, and success have no meaning”– Benjamin Franklin Lymphedema – Guerrilla Warrior General (LymphoGWG) presumes (hopes!) there is tremendous importance attached to the study of lymph (lymphology – the physiology and the pathology) in the proverbial and real grand scheme of things within the world of […]
Celebrating 15 years of progress and impact from the Canadian Lymphedema Framework
As we mark the 15th anniversary of the 2009 inception of the Canadian Lymphedema Framework (CLF),I am filled with immense pride and gratitude. Over the past decade and a half, we have grown from a fledgling organisation to a formidable force in the field of lymphoedema education, research and advocacy. This milestone serves as a […]
The British Lymphology Society update and a look forward to the 40th anniversary year
Next year marks a significant milestone for the British Lymphology Society (BLS) as we celebrate our 40th anniversary! Founded initially as a small and relatively informal group of practitioners and healthcare professionals, we’re unsure of the exact founding date, which is a great excuse to make it a year-long celebration! This year we were also […]
A case of lower leg amputation: A sequelae of lymphoedema compression garment complication during the Covid-19 pandemic
The Covid-19 pandemic led to mandated social distancing and self-isolation in order to prevent spread of infection (Yuki et al, 2020). As a result, the incidence of symptoms of fear, depression and anxiety significantly increased, with mental health sufferers being more at risk of exacerbation of their symptoms (Yao et al, 2020). Many outpatient activities […]
Improvement in quality of life and speech: Case study of a head and neck cancer patient using manual lymphatic drainage and bioelectric massage therapy
Lymphoedema and manual lymphatic drainage (MLD) often emphasise volume reduction, but improvements in skin texture and the softening of adhesions are equally crucial. Up to 75% of head and neck cancer (HNC) patients who undergo radiotherapy exhibit lymphoedema symptoms. Additionally, the prevalence of psychosocial issues in these patients post-radiotherapy is estimated at around 63% (Nayak […]
An innovative approach of Fast’n Go™ for lymphoedema self-care
Lymphoedema is a chronic inflammatory condition that affects millions of people worldwide. It is characterised by the abnormal accumulation of tissue fluid resulting in oedema, fibrosis, and fatty tissue deposition. (Bowman and Rockson, 2024). In the Casley-Smith method of treating lymphoedema, bandaging is a core component of care (Casley-Smith and Casley-Smith 1997). Traditional bandaging can […]
Accessibility in lymphoedema practice: digital and practical therapy considerations
Lymphoedema therapy, under the Casley Smith method, is focused on manual lymphatic drainage compression bandaging, and the prescription of compression garments and encompasses various clinical assessment methods and techniques, including limb circumferences and volume measurement (Casley-Smith and Casley-Smith, 1992). Accessibility According to the World Health Organization (2023), globally at least 2.2 billion people have a […]
Urban, rural/small-town, Hispanic/Latina, and Ghanaian breast cancer survivors with lymphoedema returning to work
Breast cancer annual incidence exceeds 2 million people since 2022, making it the most common women’s cancer worldwide (World Health Organization, 2024). Breast cancer-related lymphoedema (BCRL) is a cancer treatment-related sequelae conservatively affecting 20–40% of women treated for breast cancer (Tandra et al, 2019; Armer et al, 2020; International Society of Lymphology [ISL], 2020; González- […]
Using a twin herbal formula for the treatment of upper limb lymphoedema after breast cancer resection
Upper limb lymphoedema is a common complication after breast cancer surgery. It is reported that the incidence ranges from 6% to 30% (Soran et al, 2006). With the implementation of adjuvant radiotherapy, the incidence has increased up to 90% (Erickson et al, 2001; Rupp et al, 2019). This is a chronic progressive disease, often accompanied […]
Comparative study of central intranodal lymphangiography patterns between patients with primary lymphoedema and patients with lymphatic leak
Lymphoedema is a localised accumulation of interstitial oedema due to impaired lymphatic drainage (Warren et al, 2007; Grada and Phillips, 2017; Lee et al, 2022). Generally, lymphoedema is categorised into two subtypes: primary, caused by developmental anomalies of lymphatic channels (Warren et al, 2007; Grada and Phillips, 2017; Brouillard et al, 2021), and secondary, caused […]
Encouraging exercise: the role of the ENCORE programme in supporting breast cancer care
An Australian is diagnosed with cancer every 4 minutes (Cormie et al, 2020). Physical activity and exercise has increasingly been recognised as a crucial component in the comprehensive care of individuals diagnosed with cancer. Misiąg et al (2022) stated: “Physical activity decreases the severity of side effects of cancer treatment, reduces fatigue, improves quality of […]
Generative artificial intelligence in lymphoedema care
Artificial intelligence (AI) is integrated to our everyday lives: “Netflix knows which films and series people prefer to watch, Amazon knows which items people like to buy when and where, and Google knows which symptoms and conditions people are searching for” (Bohr, 2020). The technology behind these common software applications, such as Netflix understanding viewing […]
Assessment questionnaires for self-reported symptoms of lymphoedema among cancer survivors: A systematic review
Lymphoedema is a chronic and debilitating condition that can arise as a consequence of cancer treatment, particularly lymph node dissection and radiation therapy. It is characterised by the accumulation of protein-rich fluid in the interstitial spaces, resulting from a disruption in the lymphatic transport system (International Society of Lymphology, 2020). Cancer-related lymphoedema is one of […]
Climate and lymphoedema: What we know from the literature
“I’m worse when it’s humid but with anything over 30 degrees, basically I try to avoid going out because I can really tell it affects my lymphoedema.” This sentiment, reported recently in a focus group conducted by Witt et al (2024), is heard frequently by all of us. Our patients with lymphoedema indicate that their […]
Know your accomplice
T here is no doubt that getting patients out of bed is beneficial. Humans were not designed to lay in bed, we were designed to be up and about. However, progressive mobility, according to the Critical Care Nurses in the US is “a series of planned movements in a sequential manner beginning at a patient’s […]
Top ten tips: medications that benefit wound healing
As the tip states, medications you may classify as beneficial may not be appropriate for each patient. We will be discussing medications that have been shown to improve wound healing. However, any medication addition needs to be critically analysed for its risk-benefit ratio, polypharmacy and social determinants of health. The risk-benefit ratio is a patient-specific […]
