Skin Care Resources

Debridement is a key component of wound bed preparation, which should not be seen as a one-off procedure, but rather as something to be done on a regular basis and included in the patient care pathway. It plays a vital part in removing dead and contaminated tissue, which harbour bacteria posing a barrier to timely healing. Debridement can also remove the presence of biofilm. Wound cleansing is also an integral part of wound care practice. However, there is little evidence about the best method, frequency, or solution to use, which causes wound cleansing often to be seen as a controversial procedure. With developments in the wound care product market and smarter dressings and wound care therapies becoming available, little attention has been given to the use of cleansing solutions. Wound cleansing is technically defined as the use of fluids to remove loosely adherent debris and necrotic tissue from the wound bed to create an optimal wound healing environment.

Atopic eczema is becoming more prevalent across all age groups. It is a condition that occurs in childhood and can resurface or develop for the first time in later life in those who may/may not have previously had asthma or hayfever. Other forms of eczema, such as asteatotic eczema (where the skin is abnormally dry) and varicose eczema (which affects the lower limbs and is common alongside varicose veins), often develop in older people, while irritant or allergic contact dermatitis can develop as a result of occupational activities or hobbies which involve contact with disinfectants or petroleum products. Management of atopic eczema involves leave-on topical creams in mild cases, to the use of systemic immunosuppressive medication in severe cases. However, understanding environmental factors and physiological changes that can occur in atopic eczema, and which can affect the severity of the condition, can assist general practice nurses (GPNs) to eliminate or reduce patients’ exposure, thus improving the control of the condition and reducing the risk of exacerbations.

Shingles is a painful and debilitating disease which disproportionately affects older adults. Despite an effective vaccine, the use of which has reduced cases of shingles and the subsequent complication of postherpetic neuralgia, many eligible older adults are not receiving the vaccine. Uptake is lower than would be hoped for and has declined each year since the programme was introduced in 2013. This year, efforts are being made to reinvigorate interest in the vaccination programme and to provide supporting literature and information. General practice nurses (GPNs) are instrumental in advising patients about vaccination and will deliver the majority of vaccines. This article provides an overview of the disease, its cause, the role of immunity, risk and incidence, disease course, treatment, prevention and how to improve uptake by employing best practice initiatives. GPNs can use this information to advocate shingle vaccination and improve uptake and protection for the vulnerable older adults in the population.

Long-term conditions: skin care

Skin conditions are commonly seen by nurses in primary care. Not only do they have a significant impact on patient health and quality of life, they also have implications for healthcare resources, requiring long-term regular treatment. This article provides an overview of the anatomy and physiology of healthy skin, as well as outlining its primary functions. Managing common skin conditions such as psoriasis and atopic eczema is also discussed, alongside the various preparations that can help general practice nurses (GPNs) to maintain the patient’s skin integrity. A guide to the use of skin care treatments such as emollients, with particular emphasis on quantities and application technique, is also given.

What is fascinating since the launch of the Journal of General Practice Nursing in May 2015, is that we have become increasingly aware of the demands that delivering skin and wound care places on community- and practice-based nurses.