Wounds UK 2003 featured a Question Time session with a panel of experts, organised in conjuction with the Tissue Viability Society. The panel were:
- Helen Orchard
- Andrew Kingsley
- Deborah Thomson
- Dr Michael Clark
The discussion was chaired by Professor Keith Harding
The questions below are transcripts of those asked during Question Time Session. Please choose the link which best suits your connection speed to watch video of the answers from the panel.
Question 1:
Name me one significant development which has taken place in wound healing or tissue viability over the last 10 years that's made a difference to your day to day practice.
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Question 2:
Do you believe there is any value in using laboratory data or laboratory information to predict clinical outcomes?
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Question 3:
We had quite a debate in the morning session about people's responses to papers. And we joked about the Journal of Tissue viability letters page previously being like War and Peace. But actually it's quite sad that it's probably the only venue for serious written debate that exists within the UK. And I'd really like the panel to answer a quick question. Have you ever felt very strongly about an article you've read, and if so did you do anything about it?
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Question 4:
Every time I open the letters page they seem to be fewer and farther between. Is this our fault because we're not writing enough, or are editors actually not accepting as many letters for publication?
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Question 5:
With relation to lab test, do lab test have any relevance, especially in relation to microbiology; it's about 150 years since Louis Pasteur did his thing. We've had about 150 years of research in bacteriology and we still don't know the answer. So it seems to me that we know more and more about less and less. First question is: are we doing the wrong sort or research, or could it be more focused? Second question is, why are we doing the wrong sort if research, if we are? Which relates to the debate about critiquing papers. There was a special issue of the BMJ earlier this year where they looked at bias in publications and the observation was that commercially funded research tends never to report negative results on the sponsoring company's products. So my second question is are the sources of funding directed in the most appropriate way to answer the questions we want to answer?
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Question 6:
Industrial espionage. Does it exist in the wound healing world - yes or no?
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Question 7:
We use steroids, oral and topical, on non-healing wounds. I know that other people do but there's very little evidence to support it. I don't believe it's licensed to go on open wounds and I wonder if the panel would have any opinions?
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Question 8:
As a manager, is it fair or appropriate to use pressure ulcer incidence as a quality indicator of health care delivery?
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Question 9:
Does the panel agree that reverse staging appears endemic within the UK, particularly the number of prevalence studies now taking place, and if so, who is responsible in the professional bodies for reversing that situation?
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Question 10:
If you were faced with a pressure ulcer tomorrow, going down to subcutaneous tissues, and you can grade it with whichever system you wish, which did appear to be healing but which had all the features of critical colonisation, which antiseptic agent would you choose?
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Question 11:
I'd like to ask about digital photography. Locally we have an issue with people thinking that because the images can be manipulated in some way, that it is not such a good form of documentation as photography taken with a normal camera. I just wondered what the panel's opinion was on that.
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Question 12:
Does the panel think that the inclusion of the statement 'consider use of alternating pressure or other hi-tech pressure systems when a lo-tech device has failed' in the new NICE guidelines is useful, or even ethical?
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Question 13:
Does the lack of evidence from independent randomised control trials undermine and devalue the role of the tissue viability nurses?
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Question 14:
Final question. I started off by asking what did you see as the most significant development in the last 10 years that had influenced your practice. Get your crystal balls out and see if you can suggest ways in which your practice may change in the next 10 years.
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