|
 |
|
||
 |
||||
|
||||
|
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||
In the UK approximately £229.2 million is spent on dressing products alone. This does not reflect litigation costs that result from complications or indeed the hidden costs to the patients such as pain, depression and social isolation. A considerable number of dressings are available for use and it is often confusing and difficult for clinicians to make choices. In order to address these issues and ensure appropriate dressing selection many areas have developed wound care formularies. The TIME framework was used to develop a wound care formulary in one London trust, to ensure appropriate wound care treatments based on the problems identified at the wound bed. It was developed as a joint formulary between primary and secondary care to ensure continuity of care between health care settings.
The development process involved:
Following consultation and approval the formulary was launched in May 2006. Posters were printed for all the wards and departments and diary-sized laminated versions were made for the community nurses. A recent audit of the formulary shows 80% concordance. New products that are not on the formulary continue to be evaluated and considered for inclusion when the formulary is reviewed in 2008. Using TIME as the framework for the formulary has ensured correct and appropriate use of wound products. It has also been useful in terms of providing prompt solutions to nurses at the bedside when deciding treatment interventions. The formulary is attached for information and can be used as a template for those in the process of developing a formulary. Click here to download the pdf
Caroline Dowsett
At last, a use for the appendix, well a theory worth considering anyway! The Journal of Theoretical Biology, carries a paper suggesting that the appendix is a 'good' bacteria reservoir. The scientists say its function seems to be related to regulating the massive amounts of bacteria populating the human digestive system. When infectious diarrhoea diseases clear the gut of useful bacteria, the appendix reboots the digestive system. So not everything that glisters is gold and neither everything that is dull is decrepit!
Medscape (2007) Appendix protects good germs. In the news. 8th Oct 2007.
References Durupt, F., Mayor, L., Bes, M. Et al (2007) Prevalence of S aureus toxins and nasal carriage in furuncles and impetigo. Br. J. Derm. OnlineEarly Articles). doi:10.1111/j.1365-2133.2007.08197.x
Talley Group expand UK manufacturing facility
For more information please contact: Activa Healthcare Chronic Oedema Study Days There are still opportunities to come and explore the assessment and management of chronic oedema with Professor Christine Moffatt and other UK experts at:-
The Inchyra Grange Hotel, Falkirk - 6th November Call Activa Customer Care on 08450 606707 BSN Medical Wound Infection Management Roadshows BSN Medical with Wounds UK are holding two free study days in December entitled 'How to Manage Infected Wounds Clinically and Cost-effectively without Silver'. The days will explore the patient and societal implications of wound infection including health economics, and how to clinically manage the problem. A new non-antimicrobial method of managing this problem will be discussed and the evidence to support it shared.
University of Worcester, Cotswold Suite - 5th December
Book your place by calling 01482 670132 or email to advancedwoundcare@bsnmedical.com
Sorbion sachet S will be available on Drug Tariff from Dec 1 2007. It is a sterile hydroactive wound dressing for the treatment of moderate to highly exuding wounds. It functions by absorbing and retaining chronic wound exudate, including the high levels of protease enzymes (MMPs) postulated to impair wound healing. The sachet is a hypoallergenic fleece envelope, containing super-absorbent (water-binding polymers included in a cellulose matrix) with reputedly highly efficient liquid-uptake and retention properties, even under compression, ensuring long wear time and hence cost effectiveness. The interim results of a multicentre 30 patients clinical evaluation (Cutting et al 2007) provides details of the ability to absorb (when required) copious volume of exudate, the reduction in frequency of dressing change, patient acceptance of the dressing, improved quality of life together with and associated cost benefit. The full trial results will be available next month at Harrogate 2007.
Reference
Ever come across a wound that you thought might have a suspicious aetiology, then the wounds section on http://www.forensicmed.co.uk/index.htm might be a useful site providing lots of insight on definitions of common traumatic wound terms and how they can be produced.
Correlation coefficient
A correlation co-efficient test checks to see if there is a relationship and what the strength of that relationship is between the two variables. When both variables are plotted on an X and Y axis graph (called a scatter diagram) they might appear to form in an approximately linear (line-like) fashion suggesting the possibility of a correlation, or be randomly spread out suggesting there is no relationship. There is also the possibility of a u-shaped or curvilinear relationship, but let's leave that for another day! The test checks to see if any correlation exists and whether it is in a positive or negative direction. A positive relationship means that as one variable increases in value or frequency the other correlated variable does too, A hypothetical example of this for patients with wound infection could be as C-reactive protein values rise so too does the body temperature . A negative (or inverse) relationship means that as one variable increases, the other decreases. A perfect positive correlation has a score of +1.00, no correlation is indicated by 0.00, and a perfect negative correlation scores -1.00. Pearson's correlation coefficient (denoted by the letter 'r'), shortened from its full name the Pearson product moment correlation coefficient,is used when the variables are suitable for analysis using parametric statistics (i.e., both the variables have interval and continuous level data). Spearman's rank correlation test (given the letters 'rho') is used instead of Pearson's test when the level of measurement of the data is ordinal).The strength of the 'r' scores is not affected by the direction of the relationship (positive or negative), if
References Dorak M (2007) Common concepts in statistics http://www.dorak.info/mtd/glosstat.html (accessed 1.10.07) Everitt B (2003) Medical statistics from A to Z. Cambridge University Press, Cambridge Munro, B. (2005) Statistical Methods for Healthcare Research (5th Edn.). Philadelphia: Lippincott Williams and Wilkins
Harding, K., Gray, D., Timmons, J., Hurd, T. (2007) Evolution or revolution? Adapting to complexity in wound management. Int Wound J. 2: Suppl 1 - 12. Shai, A., Avrin, V et al (2007) Scaled healing Assessment Index: a novel method for measuring the degree of wound bed preparation. Skin Res Technol. 13: 3; 227 - 235.
Leg ulcers Anderson, I. (2007) A review of the four layer vs. short stretch bandage system. Br J Nurs. 16: 15; S4
Foot Ulcers
Pressure Ulcers Suriadi, Sanada, H., Sugama, J., et al (2007) Risk factors in the development of pressure ulcers in an intensive care unit in Pontianak, Indonesia. International Wound Journal. 4: 3; 208 - 215. doi:10.1111/j.1742-481X.2007.00315.x Gefen A (2007) The biomechanics of sitting-acquired pressure ulcers in patients with spinal cord injury or lesions. International Wound Journal. 4: 3; 222 - 231. doi:10.1111/j.1742-481X.2007.00330.x
Vascular Surgical Kaya D, Agartan C, Muhterem Y (2007) Agents as a Cause of Surgical Wound Infections: An Overview of Host Factors. 19: 8; 218 - 222. McCallum, I., King, P., Bruce, J. (2007) Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev. 17: 4; CD006213.
Dermatology Lawton, S. (2007) Skin barrier function and the use of emollients in dermatological nursing. Br J Nurs. 16: 12; 712 - 719.
Trauma
Infection Markov, G., Kirov, G., Lyutskanov, V et al (2007) Necrotizing fasciitis and myonecrosis due to Aeromonas hydrophilia. 19: 8; 223 - 226 Topical Negative Pressure McNulty, A., Schmidt, M., Feeley, T., Kieswetter, K (2007) Effects of negative pressure wound therapy on fibroblast viability, chemotactic signaling, and proliferation in a provisional wound (fibrin) matrix. Wound Repair and Regeneration (OnlineEarly Articles). doi:10.1111/j.1524-475X.2007.00287.x Hunter, J., Teot, L., Horch, R., Banwell, P. (2007) Evidence-based medicine: vacuum-assisted closure in wound care management International Wound Journal 4 (3), 256-269. doi:10.1111/j.1742-481X.2007.00361.x Leijnen, M., Steenvoorde, P., van Doorn, L. Et al (2007) A non-healing sinus of the lower leg 5 years after Vacuum assisted closure therapy due to a gossypiboma. Wounds. 19: 8; 227 - 230. Horn, P., Ruth, B., Kean, J. (2007) use of VAC therapy in pediatric patients with infected spinal wounds: a retrospective review. Orthop Nurs. 26: 5; 317 - 322. Gerry, R., Kwei, S. et al (2007) Silver-impregnated vacuum-assited closure in the treatment of recalcitrant venous stasis ulcers. Ann Plast Surg. 59: 1; 58 - 62. Andrabi S., Ahmad, J. (2007) Negative pressure therapy for laparotomy wounds - a word of caution. J Wound Ostomy Continence. 34: 4; 425 - 427. Wasiak, J., Cleland, H. (2007) Topical negative pressure (TNP) for partial thickness burns. Cochrane Database Syst Rev. Jul 18;(3):CD006215.
Oxygen Svehlik, J., Zabavnikova, M., et al (2007) Hyperbaric oxygen therapy as a possible means of preventing ischemic changes in skin grafts used for soft tissue defect closure. Acta Chir Plast. 49: 2; 31 - 35. Davis, S., Cazzaniga, A. et al (2007) Topical oxygen emulsion. Arch Dermatol. 143: 10; 1252 - 1256. Various Jemmott, T., Foster, A., Edmonds, M. (2007) An unusual cause of ulceration: ainhum (dactylolysis spontanea). International Wound Journal. 4: 3; 251 - 254. doi:10.1111/j.1742-481X.2007.00297.x Durupt, F., Mayor, L., Bes, M. Et al (2007) Prevalence of S aureus toxins and nasal carriage in furuncles and impetigo. Br. J. Derm. OnlineEarly Articles). doi:10.1111/j.1365-2133.2007.08197.x Shaw, J., Hughes, C., Lagan, K., Bell, P (2007) The clinical effect of topical phenytoin on wound healing: a systematic review. British Journal of Dermatology. 157: 5; 997 - 1004 doi:10.1111/j.1365-2133.2007.08160.x Kupitz, S., Enoch, S., Harding, K. (2007) Chronic ulcers, calcificiation and calcified fibrous tumours: phenotypic manifestations of a congenital disorder of heterotopic ossification. Int Wound J. 4: 3; 273 - 280. Cummins, D., Anhalt, G. et al (2007) Treatment of pyoderma gangrenosum with intravenous immunoglobulin. Br J Dermatol. Epub ahead of print. Vaneau, M., Chaby, G et al (2007) Consensus Panel Recommendations for Chronic and Acute Wound Dressings . Arch Dermatol. 143: 1291 - 1294.
|
||||||||||||||||||||||||||||||||||||||||
Download this newsletter in PDF formatNovember 2007 |
|