Click here for the Wounds UK Home Page November 2005

Healthcare Associated Infection Progress   Harrogate Approaches	Government focus on health It would appear that, on the surface at least that the government is taking measures which may have a positive impact on the nations' health. The proposed white paper on a smoking ban in public places is one which has the potential to benefit a large section of society both smokers and non smokers alike. This will not prove to be plain sailing as already some MP's have lodged objections to the blanket ban and would like to see a less stringent order put in place, for example that smoking be permitted in night clubs where food is not being served. I think that we have to look to the experience of the Republic of Ireland to find the true benefits of such a ban. With over 10,000 people stopping smoking in the first 2 years and this number growing consistently over time, it is hard to create a logical argument against this type of progress. In healthcare we are all too aware of the damage that 'lifestyle' can cause to our patients. From lung cancer and respiratory illness to peripheral vascular disease there are huge numbers of patients who suffer as a result of this destructive habit. Tobacco smoke contains over 4000 different compounds or gases. The most well recognised nicotine and carbon monoxide, however, many toxic compounds such as cyanide heavy metals and other additives are also present. From a wound healing perspective there is substantial evidence to suggest that smoking is damaging to the wound healing process in a number of ways. Carbon monoxide from the tobacco smoke binds to haemoglobin to form carboxy-haemoglobin, displacing oxygen and making less oxygen available for the tissues. This reduction in oxygen supply to the tissue is viewed as a major impediment to wound healing, particularly in the post surgical patient (Jensen Goodson Williams and Hunt 1991). It has also been shown that collagen is depleted in smokers, indicating the potential for reduced wound tensile strength and dehiscence in the acute wound (Jorgensen Kallehave, Christensen, Siana and Gottrup et al 1998) Studies have also demonstrated that abstinence from smoking resulted in a decreased incidence of wound infection (Sorensen, Neilsen, Kharazmi, Karlsmark and Gottrup 2003) There are of course too many health benefits to mention with regards to reducing smoking in the population, so as health care practitioners we can only hope that the Government listens to the voice of reason and not the voice of the very taxable tobacco industry. John Timmons Editor Email: John.Timmons@gcal.ac.uk	References Latest journal references

Healthcare Associated Infection Progress The Scottish Surveillance of Health Care Associated Infection Programme (SSHAIP) has been involved in a project to focus and record HAI in Intensive Care Units. The Ward Watcher system normally used to collect demographic, diagnosis and treatment data has been adapted to include data on healthcare related infection such as central venous catheter related infection, pneumonia and bloodstream infection. This project is currently being piloted in five sites but should be made more widely available once the true value of the system is known. The use of such systems should make monitoring of wound related infections more accessible and could provide a useful audit trail to assist in the planning of care and treatment regimes in use. Health Protection Scotland is planning a prevalence survey of all HAI across acute and non acute sites in Scotland. This will be the largest study of its kind and should provide invaluable information to help target resources and estimate costs associated with HAI.   Keep reading for: Harrogate Approaches Latest journal references Download this newsletter in PDF format Harrogate Approaches The Wounds UK team has been putting the finishing touches to what should be an exciting and informative conference. Day one will focus on the challenges of treating the diabetic foot ulcer, with symposia to follow. Professor Keith Harding will open the conference with an analysis Best Practice in Diabetic foot management. Day two will examine the problems of complex and challenging wounds. Day three will focus on the free papers and poster sessions. Symposia have been arranged in individual time slots to allow more people to attend. The speaker list for the conference reads like the who's who of wound management and there is an huge range of international range of speakers. Overall this promises to be an excellent meeting and an excellent learning opportunity for all levels of practitioner and all disciplines. Keep reading for: Latest journal references Download this newsletter in PDF format References Chatterjee, J A critical review of irrigation techniques in acute wounds INTERNATIONAL WOUND JOURNAL VOL 2; NUMBER 3 pp. 258-265 Barbosa-Silva, M. C.; Barros, A. J. (2005) Bioelectric impedance and individual characteristics as prognostic factors for post-operative complications CLINICAL NUTRITION -QUARTERLY THEN BIMONTHLY-VOL 24; NUMBER 5; pp. 830-838 Datiashvili, R. O.; Knox, K. R. (2005) Negative Pressure Dressings: An Alternative to Free Tissue Transfers? WOUNDS VOL 17; NUMB 8; pp. 206-212 Flaxman, D.; Griffiths, P (2005) Mini-Review Is tea tree oil effective at eradicating MRSA colonization?. BRITISH JOURNAL OF COMMUNITY NURSING VOL 10; NUMB 3; pp. 123-126 Hanson, D.; Langemo, D.; Thompson, P.; Anderson, J.; Hunter, S. (2005) RESEARCH FORUM Understanding Wound Fluid and the Phases of Healing. ADVANCES IN SKIN AND WOUND CARE VOL 18; NUMB 7 pp 360-363 Moues, C. M.; Vos, M. C.; Van Den Bemd, G. J.; Stijnen, T.; Hovius, S. E. (2004) Bacterial load in relation to vacuum-assisted closure wound therapy: A prospective randomized trial WOUND REPAIR AND REGENERATION VOL 12; NUMBER 1; p. 11-17 Parsons, D.; Bowler, P. G.; Myles, V.; Jones, S (2005) Silver Antimicrobial Dressings in Wound Management: A Comparison of Antibacterial, Physical, and Chemical Characteristics WOUNDS VOL 17; NUMB 8; pp. 222-232 Rosindale, S.; Asimakopoulou, K. (2005) Blood glucose meters in the community: Are the results accurate? JOURNAL OF DIABETES NURSING VOL 9; NUMB 8; pp. 291-296 Tomaselli, N. L Teaching the Patient with a Chronic Wound ADVANCES IN SKIN AND WOUND CARE VOL 18; NUMB 7; pp. 379-387 Wilson, J. R.; Mills, J. G.; Prather, I. D.; Dimitrijevich, S. D. (2005) A Toxicity Index of Skin and Wound Cleansers Used on In Vitro Fibroblasts and Keratinocytes pp. 373-378 Wlaschek, M.; Scharffetter-Kochanek, K (2005), Oxidative stress in chronic venous leg ulcers, WOUND REPAIR AND REGENERATION VOL 13; NUMBER 5; pp. 452-461   Download this newsletter in PDF format