This article focuses on and aims to clarify the role of desloughing as a priority in modern-day wound care. Ambiguity around identification and slough removal has long been a clinical challenge. Effective removal of slough involves the elimination of dead and devitalised tissue as quickly and safely as possible, to enable the wound to return to a healthy state that supports healing. Desloughing is usually associated with typically conservative techniques compared with those used to debride necrotic tissue. More specific and timely targeted action to recognise and remove slough safely will significantly improve the clinical outcomes for patients as well as influence the effective use of scarce resources. The illustrative format of this article will facilitate how clinicians can become familiar with the different types of slough and the appropriate removal techniques.

A number of leg ulcer specialist/tissue viability specialists from across the UK were invited to evaluate PICO (Smith and Nephew, Hull) as a treatment for venous leg ulcers also in conjunction with a variety of compression bandages and garments. Patients across 5 sites had PICO applied in conjunction with compression therapy. This group of treating clinicians were then asked to give feedback on the outcome of the patients on whom they had used the new device. All feedback was recorded at a meeting and this was used to create a guideline for use.

This article discusses the impact of living with a chronic wound including the individual's wellbeing and the need for clinicians to consider the complex and often challenging factors that can help or hinder the patient experience. Patient engagement in the care planning process is an important consideration in promoting concordance ( Gray et al, 2011 ). When choosing a dressing regimen, clinical decision-making should be based on holistic assessment and include the patient's perspective, expectations and attitudes ( Dowsett, 2008 ). Living with a chronic wound can have a significant impact on both the physical and psychological health of an individual and patients may suffer from multiple effects including reduced mobility, pain, poor nutrition and depression. Management plans that have been informed by patient feedback and are sensitive to their concerns can only serve to promote concordance and partnership and achieve a positive experience even when healing is not the endpoint.

This article discusses the impact of living with a chronic wound including the individual's wellbeing and the need for clinicians to consider the complex and often challenging factors that can help or hinder the patient experience. Patient engagement in the care planning process is an important consideration in promoting concordance (Gray et al, 2011). When choosing a dressing regimen, clinical decision-making should be based on holistic assessment and include the patient's perspective, expectations and attitudes (Dowsett, 2008). Living with a chronic wound can have a significant impact on both the physical and psychological health of an individual and patients may suffer from multiple effects including reduced mobility, pain, poor nutrition and depression. Management plans that have been informed by patient feedback and are sensitive to their concerns can only serve to promote concordance and partnership and achieve a positive experience even when healing is not the endpoint.

No abstract