The ability to recognise the need for debridement is a vital skill for general practice nurses (GPNs), since it is an important part of preparing the wound for healing. Debridement removes dead tissue within the wound that can otherwise provide a physical barrier to healing, while also providing an ideal environment for micro-organisms, increasing the risk of infection. In order for healing to progress, it is important to debride the wound promptly. Failure to do so can result in wound chronicity and an associated impact on resources and patient quality of life. While there are different methods of debridement available, this article focuses on autolytic and mechanical, explaining how they work and their benefits and limitations.
The cost of treating wounds in the UK is comparable to obesity or cancer, and has a considerable impact on healthcare budgets. However, wound care receives surprisingly little attention, with education on this topic overlooked within the wider healthcare sector. Inadequate training can result in varying levels of care, impacting on patient outcomes, quality of life, and time and money spent on care. This article discusses the importance of accessible and flexible education. It looks at the National Wound Care Strategy Progamme, which aims, among other goals, to improve access to education for practitioners, patients and carers. The importance of continued professional development (CPD) and its impact on patient outcomes and quality of service is also addressed. It then goes on to look at the types of education available, and how we can keep up with the rapid developments in wound care science and available treatments.
This advertorial is the first in a sequence of educational articles, which will be published over the next few months. These individual learning activities will help to improve your understanding of the AQUACEL dressing range.
The number of patients with venous leg ulcers is growing as the population ages. Recent estimates indicate that 730,000 people with venous leg ulcers were treated in 2012/13 (Guest et al, 2015); a number that is predicted to increase year on year. Venous leg ulcers can be difficult to manage in some patients despite best practice, particularly in those with multiple comorbidities. These patients can develop chronic ulceration that can be present for months or even years in some cases. The cost of managing these patients presents a significant burden to the NHS. An evaluation was carried out to determine the efficacy of LQD® wound spray, a unique spray-on wound dressing that contains Chitosan FH02™, in promoting wound healing in patients with longstanding venous leg ulcers. The results indicated that LQD wound spray contributed to putting the wounds onto a healing trajectory.
Long-term conditions: compression therapy and venous leg ulceration.
Compression therapy is the recommended treatment for the prevention and management of venous leg ulceration and lymphatic insufficiency (Scottish Intercollegiate Guidelines Network [SIGN], 2010; Harding et al, 2015; Wounds UK, 2016). Various methods of delivering compression are used in the UK, including bandaging, hosiery and Velcro® wraps. Selecting the correct device can be challenging for clinicians. This article explores the different compression systems available to help general practice nurses (GPNs) make appropriate choices for their patients, i.e. an option which is acceptable to the patient and can be applied safely and proficiently.
Kathryn Evans gives her views on what needs to be done to provide high value wound care.
I have always been passionate about wound care and, as a practising district nurse, I learnt by experience and training to measure wounds, take photographs and undertake Doppler assessments (a noninvasive method to identify arterial insufficiency in the leg). This helped me to establish the treatment that each wound needed.
What I did not know was the effectiveness of my prescribed care and how my healing rates compared with another nurse’s care. I also could not say with any accuracy how quickly a patient could expect their wound to heal. I wish I had known…
So, my questions to you would be: Do you know? And, why is it important?
Here, Denise Woodd, talks about her role as a trainer/ lecturer in leg ulceration and wound care in primary care.
WHAT IS A TYPICAL DAY?
I work independently so I plan my own schedule, but a clinical day would be seeing patients who have been referred to me with the nurse in their surgery in Portsmouth. We undertake a full holistic leg assessment, including Doppler together, agree the priorities of care, triage if needed, and refer on. Once the day is over, I come home and write the reports and recommendations for ongoing treatment, etc. Other days are carrying out education and training.
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.
The trend for tattoos and body piercings has become increasingly popular in Europe and Western countries (Kluger, 2013). It has been estimated that 20% of the United Kingdom population has a tattoo and 10% of the adult population has a piercing of some kind, with a self-reported complication rate of 28% (Bone et al, 2008; White, 2012). It is therefore quite likely that general practice nurses (GPNs) will encounter wound-related problems, such as infection, associated with tattoos and piercings during their day-to-day clinical practice. This article explores some of the complications that can arise and provides an overview of how to manage them effectively.
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