Evolution or revolution? Adapting to complexity in wound management

Abstract

Wound clinics are seeing an increase in the number of 'complex' wounds, which arise as the result of the interaction between multiple coexisting systemic pathologies, environmental factors and local wound factors. These complex wounds require an approach to diagnosis and management that can encapsulate all these factors. Unified wound assessment approaches such as HEIDI (History, Examination, Investigations, Diagnosis and management plan), wound bed preparation and applied wound management systems are essential to reach a definitive diagnosis and to ensure that management is agreed between the various clinical specialities that may be involved. A series of case histories is presented that illustrate the benefits of a unified approach to wound management. Results of a study into the cost-effectiveness of an improved foam dressing are presented, and the problems of demonstrating the ability to make long-term savings through short-term expenditure are discussed.

Vitamin E and wound healing: an evidence‐based review

“…Regulation of this oxidative stress and inflammatory response is important during tissue repair in order to minimise cell damage caused by ROS . Arguably, one of the most important considerations to improve wound healing while treating the patient holistically is to ensure adequate nutrition . Posthauer et al suggest that vitamin deficiency profoundly impacts cell migration and proliferation, and is thus an influential factor of prolonged wound healing.…”

An audit of the adequacy of acute wound care documentation of surgical inpatients

“…’s (2008) audit of nursing forms underlined the disparity between formal and informal documentation and noted that there were inconsistencies in current forms, structure and flow of requisite documentation. Harding et al. (2007) also raise the possibility that documentation is becoming too complex and that clinicians will find the process ‘too time‐consuming’ (p. 2).…”

Scientific Viewpoints with Emphasis on Dermal Cellular Regeneration in Wound Sites

“…Harding et al 2007 [2] have described in full detail, the benefit of whole body care before attending the presenting wound site and described the misdiagnosis of certain conditions. In the digital computer world we live in, would a (PDR) Physician Desk Reference Supplement containing photographs of wound sites with legends of: 1) Diagnosis 2) Treatment regime 3) Outcome be useful to attending Wound Care physicians?…”