Abstract
Cleansing is a vital component of wound management. However, there is limited research to inform protocols. Although research has focused on types of dressings, little attention has been given to the solutions and techniques to be used for cleansing purposes. The available evidence about the effectiveness of solutions and techniques in the prevention of wound infection and the promotion of healing has not been systematically quantified in a manner that would assist clinicians in choosing a solution and the appropriate technique. This study aimed to critically review the literature and present the best available evidence that investigates the effectiveness of solutions and techniques for wound cleansing.
A key word search of wound care journals was completed. At least two types of solutions and techniques had to be compared and the infection rate and/or healing rates analysed. Two independent reviewers extracted data on population, intervention, outcome and methodological quality. In the only study comparing tap water to normal saline, the infection rate in wounds cleansed with tap water was noted to be lower than wounds cleansed with normal saline. Studies that compared normal saline, boiled water, distilled water and povidone-iodine for wound cleansing demonstrated no difference in the infection rate of wounds. However, one study demonstrated a statistical difference in the infection rate in wounds that were not cleaned compared to those that were soaked in normal saline. No randomised controlled trials (RCTs) were identified that compared swabbing or scrubbing as techniques for cleansing wounds. In post-operative patients, showering the wound did not demonstrate a significant difference in the rate of infection and healing; however, it was reported to enhance a feeling of cleanliness and well-being amongst those patients. Insufficient data exists to determine the effect of tap water on chronic wounds. Considering the widespread use of tap water for wound cleansing in the community, more large high quality RCTs of the effectiveness of tap water and the techniques used for wound cleansing are warranted.

Abstract
This is a pilot study to determine if podiatrists prefer to use a clinical pathway in ulcer management rather than their current documentation procedure. A clinical pathway was developed at The Queen Elizabeth Hospital (TQEH) podiatry department to decrease the amount of time spent documenting details of ulcer therapy. The podiatry department sees predominantly high-risk patients in an outpatient setting. These patients often suffer from diabetes and its complications resulting in foot ulceration(s). The clinical pathway was used as a tool to provide outcomes on ulcer therapy that could easily be monitored or evaluated.
Rural and metropolitan South Australian public sector podiatrists agreed to participate in this study. The podiatrists trialled the clinical pathway for approximately 3 months, after which a questionnaire was completed. The results from this pilot study indicated that the majority of the podiatrists agreed and supported the concept of clinical pathways. However, there was a more varied response as to whether they would implement it in their current workplace.

Abstract
In 1996, lack of wound management services within the north and western suburbs of Melbourne was highlighted by the number of bed days devoted in one hospital to a single diagnostic related group (DRG); the then North West Hospital, a rehabilitation and aged care facility, funded 7,050 bed days to the treatment of leg ulcers alone. The mean average length of stay was 51 days. This observation formed the catalyst for the successful submission by the campus to develop and implement an age-specific wound management clinic at the North West Hospital -now known as Melbourne Extended Care and Rehabilitation Service Parkville Campus. This paper will discuss the aims and objectives of the clinic, analysis of clients referred to the service and
examples of how theory has been linked to the practical application of this clinic.

Abstract
Endothelial cell growth factors (ECGFs) are potent mitogens of endothelial cells and fibroblasts which are important cells in the granulation tissue of wounds. The effects of bovine brain-derived ECGFs on skin ulcer healing were investigated in 14 patients with 42 skin ulcers using a self-control design. The skin ulcers were varicose, decubitus and vasculitis ulcers.
The mean time to reach a 50 per cent healing was significantly shorter with ECGFs than with the control. The healing rate was approximately 1cm2 per week in ECGFs treated ulcers. The skin ulcers treated with ECGFs also demonstrated a fast growth of granulation tissue. At the time of reaching 100 per cent healing, vasculitis ulcers had taken longer than non-vasculitis ulcers (varicose ulcer and decubitus ulcer). These results suggest that ECGFs can accelerate the healing of skin ulcers. It also suggests that the degree of vessel injury in skin ulcers has an impact on the effect of ECGFs on healing.