Abstract
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Abstract
The human lymphatic system is an integral part of homeostasis, as it serves to drain excess fluid from the tissues while acting as a roadway for the cells of the immune system. In lymphoedema, these roadways become blocked, preventing the fluid from being drained, resulting in swelling in the area distal to the blockage.
One of the side effects of lymphoedema is the increased prevalence of cellulitis infections in the affected areas due to the disruption of the immune pathways. A review was undertaken with the goal of establishing the methods and timelines of treatment. As a corollary, the literature was examined with an interest in methicillin-resistant Staphylococcus aureus (MRSA) infections and whether treatment methods differed for those infections. A total of 34 studies were examined, and showed that beta-lactam antibiotics with activity against penicillinase are used to treat acute cellulitis and phenoxymethyl penicillin is used prophylactically to prevent further infections. However, limited information was available regarding both the duration of treatment, as well as the effectiveness of treatment for MRSA infections in patients with lymphoedema. This review aims to establish areas of potential research and set the groundwork for future studies on cellulitis occurring in conjunction with lymphoedema

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Abstract
Lymphoedema is a debilitating condition associated with high morbidity. Swelling as a result of lymphatic insufficiency will often lead to pathological skin changes. These skin changes can worsen the degree of swelling in the patient and lead to significant discomfort. This review outlines the ways in which skin changes resultant from lymphoedema can be effectively managed. This includes: good clinical practice in the areas of initial assessment, skin cleansing and moisturisation, treatment of infection as well as wound management and debridement, plus advice on avoiding sunburn and exercising in an appropriate fashion.

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Abstract
Lymphoedema is the accumulation of fluid in the tissues. Higher cytokine levels within this fluid can cause chronic inflammation, which leads to poor tissue health and repair. As lymphatic failure progresses, lymphoedema worsens, resulting in visible swelling and mobility issues. These issues are associated with discomfort, heaviness and pain. Lymphoedema is more commonly recognised as secondary to cancer and its treatment; however, it can also occur after trauma with extensive soft tissue damage or loss. Severe open fractures due to high-energy trauma require soft tissue reconstruction with local, regional or free tissue in addition to the fixation of bony injury. Oedema, both within and surrounding the reconstructed site, can present acutely in the post-surgery setting. However, in some patients the swelling fails to resolve and the patient develops chronic oedema. This is lymphoedema, when the lymphatic system is in a state of failure, either due to its inability to regenerate in the wounded area or its inability to handle the increased load imposed in the post-traumatic period. Findings in this literature review show no current best practice protocols are available at this stage of traumatic lower limb lymphoedema. However, new lymphatic imaging techniques focused on lymphatic function may provide a better understanding of lymphatic failure, possibly identifying the reasons for poor regrowth and inosculation of lymphatic channels, or the effect of increased loads on the existing system. This literature review is in preparation for a clinical study.

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Abstract
The use of negative pressure wound therapy (vacuum dressings) is increasing in surgical incisions where there is a high risk of dehiscence, seroma, and other wound healing complications. In response to the growing use of various vacuum dressings in the prophylactic treatment of surgical incisions, a product evaluation of three products was undertaken in a hospital in Queensland, Australia. In this evaluation, the three aspects of product usability were considered in a specified context of use: 1) effectiveness; 2) efficiency; and 3) satisfaction. The perspectives of the treating medical officers, nursing staff and patients were elicited. Prior to the commencement, a two-week product-specific education program was implemented. Fifteen patients were recruited, with five patients for each dressing product. The evaluation was completed in its entirety for 13/15 (86.6%) of the dressing products. The majority of surgeons and ward nurses, who used the negative pressure dressing products, recommended them. Overall, surgeons preferred the Prevena™ while nurses and patients preferenced the PICO™ product. The products evaluated here have individual features that make them appropriate to be used for certain incisional wounds. Product selection should be based on the type of surgery, the amount of wound ooze anticipated, and the level of risk associated with the incision. However, in the current economic climate, product cost will ultimately dictate product use.

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Question
What is the best available evidence in the effectiveness of polyhexamethylene biguanide (PHMB) for managing wounds?

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Question
What is the best available evidence in the effectiveness of iodophors to denature biofilm in wounds?.

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Abstract
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Question
What is the best available evidence regarding the effectiveness of alginate dressings in the management of wounds?

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Question
What is the best available evidence regarding the use of autolysis for debridement of chronic wounds?

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Question
What is the best available evidence regarding green tea for managing wound odour?