Abstract
Chronic lower limb wounds are constantly exposed to bacterial and fungal organisms and are inevitably contaminated with several organisms. The aim of the pilot study was to investigate the prevalence of fungi in chronic lower limb wounds in people with onychomycosis and/or tinea pedis.

Consecutive, consenting patients with a chronic lower limb wound and a clinical diagnosis of onychomycosis and/or tinea pedis were recruited from two wound management clinics over a five-week period following ethics approval for the relevant institutions.

Wound swabs, toenail clippings and/or skin scrapings were collected from each participant and subjected to mycological examination. Wound swabs were analysed for fungal presence by culture, while both microscopy and culture techniques analysed toenail and skin samples.

In four participants, wound cultures tested positive for the opportunistic fungal Candida species. All four participants also had onychomycosis confirmed in their toenails by either a microscopy or culture analysis. Statistical analyses did not generate any significant (p>0.05) relationships between fungal presence in wounds and wound aetiology, wound duration or positive toenail and skin samples, however fungi-positive wounds and wound location were found to be statistically significantly related (p<0.05).

Crutchfield L, Frescos N, Duncan GJ, Weller C & Woodward M. Prevalence of mycoses in chronic lower limb wounds of people with onychmycosis and/or tinea pedis. Primary Intentions 2005; 13(2): 61-67.

Abstract
The aim of this study was to report our experience with activated polyacrylate dressing ‘TenderWet24®’ dressing (Paul Hartmann AG) and to establish the effectiveness of the dressing in preparing the wound bed.

Methods : A prospective case series study was conducted from March to September 2004. Patients with wounds that were assessed as being amenable to the process of autolytic debridement as a method of wound bed preparation were recruited to the study. The wounds were assessed for infection and colonisation by wound fluid cultures and wound biopsy (punch biopsy at wound margin). The arterial blood supply was assessed as needed by clinical examination and with ankle brachial indices. The amount of tissue requiring debridement was assessed and the degree of wound debridement was followed from the first application of TenderWet 24® until the wound did not require further debridement or the treatment was judged to be a failure.

Results : Ten patients were recruited for the study. There were nine males and one female patient with an overall mean age of 62 years (range 33-92 years). Diabetes mellitus was previously diagnosed in three patients. Four wound types were recorded: venous ulcer (n=4); diabetic ulcer (n=3); arterial ulcer (n=5); and wounds due to various aetiologies not included in the other four types (n=1). Biopsy of the wound was performed in six patients.

A microbiological profile was obtained in all patients. In two patients, the dressing did not achieve debridement and an alternative agent was used. We show that the use of TenderWet 24® decreased the mean surface area wounds from 26.4 cm2 to 21.4 cm2 over a mean period of 6.5 days.

Conclusion: The results of this study suggest that activated TenderWet 24® therapy is safe and effective for the debridement of all types of wounds. However, to yield statistically significant results, larger studies must be performed.

Keywords: TenderWet 24®, wound bed preparation, leg ulcer, debridement.

BP Mwipatayi, D Angel, P Dixon, S Higgins, G Gregory & K Sieunarine. Clinical experiences with activated polyacrylate dressings (Tenderwet 24®). Primary Intentions 2005; 13(2): 69-74.

Abstract
The traditional wound probes are long slender metal instruments, which are commonly used by nurses in the management of wounds to assess cavities or sinus tracts and as instruments to introduce wound packing agents. Indiscriminate use of wound probes can lead to pain and tissue trauma. A review of the published literature was instigated to inform the development of guidelines to regulate the use of wound probes within a community nursing service. The review located limited literature, and no research-based studies, which might aid the development of guidelines for the use of wound probes. The need to extend the investigation beyond published sources and to initiate dialogue with other agencies, clinicians, and manufacturers is recommended prior to the development of much needed guidelines.

Flowers C, Pilgrim J & Carville K. Probing the literature: Recommended practice for the use of wound probes. Primary Intentions 2005; 13(2): 75-80

Abstract
This case report discusses the management of an elderly woman patient who presented with a provisional diagnosis of cellulitis of the right lower limb to a district hospital. Subsequent rapid deterioration of the limb and the development of clinical features suggestive of necrotising fasciitis led to immediate surgical intervention.

Wilkes A. Discovering an unusual wound. A case report on necrotising fasciitis. Primary Intentions 2005; 13(2): 83-88.