Management of non-healable and maintenance wounds: a systematic integrative review and referral pathway
This systematic integrative review aims to identify, appraise, analyse, and synthesise evidence regarding non-healable and maintenance wound management to guide clinical practice. An interprofessional referral pathway for wound management is proposed.
Wounds: an overlooked burden (Part 1) – effective wound management starts with proper wound assessment
Healthcare professionals in general practice are tasked with treatment and management of wounds on a daily basis. The prognoses of these wounds are directly affected by the ability of the clinician to assess these wounds according to several parameters, including the wound type and the features which determine whether a wound is acute or transforming to a chronic wound. This can be achieved by proper and continuous wound assessment, which should guide wound treatment strategies to ensure optimal wound healing and prevent progression to complicated wounds.
The use of hypochlorous acid in an infected burn wound – a case study
It is estimated that biofilms cause up to 80 per cent of all wound infections, necessitating both the use of antiseptics and the drainage of purulent discharge. In the inflamed and infected wound, it is sometimes difficult to recognise the presence of bacterial biofilms. Here we describe an example of a non-healing, inflamed superficial to partial thickness burn wound that appeared to be associated with biofilm. Special reference to the relationship among biofilm, inflammation and non-healing of burn wounds is illustrated in the case study given. This case study also explores the use of hypochlorous acid (HOCl) in an infected burn wound.
Venous ulceration: understanding the commonest lower limb wound
This case demonstrates the importance of treating the underlying pathophysiology and discusses the imaging in the treatment of venous ulcers. The patient presented with a history of a non-healing ulcer for over five months. The patient attended a wound clinic for dressings and a negativepressure wound therapy (NPWT) dressing with no decrease in ulcer size. When the patient presented to our clinic, a duplex ultrasound (DUS) imaging was done to understand the underlying pathophysiology. The findings were deep and superficial venous reflux and obstructive disease (May–Thurner syndrome). Combined procedures to treat obstructive and superficial venous reflux were performed. Six weeks after the treatment the ulcer had completely healed with the use of compression bandagin
The wounded forefoot – an evolutionary perspective
The evolution of the human foot transformed the primitive, terrestrial and arboreal form of the foot into the specialised foot adapted to the bipedal mode of locomotion. However, it is thought that this transformation is not perfect and may lead to some of the foot disorders found in anatomically modern humans. In addition, modern lifestyles and footwear may contribute to pedal dysfunction, which may also result in foot ulcers, particularly in the forefoot. A basic understanding of the evolution of the human foot may help explain the aetiology of some foot wounds, thus assisting in planning the management of those disorders.
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