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Editorial: Australian Wound Management Association becomes Wounds Australia
McGregor H
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The importance of collecting pre- and post-intervention practice data when conducting a randomised controlled trial
Newall N, Lewin G & Boldy D
Abstract
Both practice and outcomes data sets are integral to any randomised controlled trial (RCT) design and should be collected both before and after the intervention has been implemented to understand if a change has occurred as a result of the intervention. However, it is not unusual for only outcomes data to be collected. In this paper a mixed methods descriptive study, which was a discrete part of a moisturising RCT, is used to demonstrate the importance of collecting pre- and post-intervention practice data. This paper demonstrates how the descriptive study aimed to enhance the researchers’ understanding of the outcomes of the moisturising RCT by determining how practice changed within the facilities in each arm of the study. In summary, this study was designed to ensure the results from the moisturising RCT could be accurately interpreted and it was a critical, but independent component of the moisturising study.
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Foot-related conditions in hospitalised populations: a literature review
Lazzarini PA, Hurn SE, Kuys SS, Kamp MC & Reed L
Abstract
Background: No reviews have investigated foot-related conditions prevalence in hospitalised populations. This literature review reports foot-related conditions (foot wounds, foot infections, amputations, other) and foot risk factors (peripheral arterial disease [PAD], peripheral neuropathy [PN], foot deformity) prevalence in representative or specific
hospitalised populations.
Methods: Electronic databases were searched for publications between 1980 and 2011. Keywords and synonyms relating to foot-related conditions, foot risk factors, inpatients and prevalence were used. Studies reporting any foot-related conditions or foot risk factor prevalence in representative or specific hospitalised populations were included, and data were extracted.
Results: Of 3,297 records identified, 141 studies were included; 27 in representative and 114 in specific inpatients. Foot wound prevalence was: 0.9–8.3% in representative and 0.1-96.4% in specific inpatients; foot infection: 0.1– 1.1% in representative inpatients; amputation: 0.1–1.5% in representative, 0.2–82.5% in specific inpatients; PAD: 2.1–25.0% in representative, 9.0–72.0 in specific inpatients; and PN: 0.2–100% in specific inpatients.
Conclusions: This review suggests foot wounds are the main foot-related condition in hospitalised populations. Indications are up to 25% of representative inpatients have a foot risk factor for a foot wound, up to 8% have a foot wound and up to 1.5% an amputation. These rates were higher in specific inpatients, particularly inpatients with chronic disease and major trauma.
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Treatment of early localised infection of the Omniflow® II prosthesis with negative pressure wound therapy
Krejčí M, Staffa R & Gladiš P
Introduction
A biosynthetic vascular prosthesis is a special type of vascular graft. Implantation of this type of prosthesis can be considered for patients with limb ischaemia, diabetes mellitus, insufficient saphenous vein, and trophic ulcers. We present a rare case of successful healing of an early Szilagyi grade III vascular prosthetic infection in the groin using a topical negative pressure device and moist wound healing materials.
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Central venous catheter exit site dressings: Balancing patients’ needs, nurses’ experiences and the research evidence
Smyth W, McArdle J & Gardner A
Abstract
Background/Aims: Many patients undergoing life-preserving haemodialysis are exposed to additional risks because access is via a central venous catheter (CVC). Despite a paucity of evidence, guidelines and policies dictated the use of transparent exit site wound dressings, which was contrary to local nurses’ practice of using an opaque wound dressing. This study aimed to explore nurses’ experiences with three types of CVC exit site dressings in the context of a randomised controlled trial (RCT).
Methods: A descriptive exploratory design was used. Transcripts from seven focus groups held with haemodialysis nurses were analysed thematically.
Results: Fifteen nurses, with varying haemodialysis experience, provided comments on the ease of applying and removing the dressings, problems encountered with the dressings, which dressing types they thought best or worst, and the value of having a specific work practice instruction developed for the RCT. It was clear that, although no dressing type was perfect, the opaque dressing was the best given the properties of the dressings, the patients’ preferences, and the humid climate.
Conclusion: The perspectives voiced by the focus group participants support the need to modify the local health service’s policy, in line with revised state and national guidelines for this type of patient cohort, to allow for individual, contextual and climatic considerations.
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The challenges of managing patients with pyoderma gangrenosum: three case reports
Angel DE & van Rooyen JL
Pyoderma gangrenosum (PG), although first described nearly 100 years ago, remains challenging for clinicians. The aetiology of PG remains a mystery. There are no specific guidelines for the diagnosis and treatment of PG. Other ulcerating wounds can mimic PG, leading to misdiagnosis, which can have detrimental effects for the patient. The aim of this paper is to provide an overview of the challenges faced by the clinician in diagnosing and managing patients with PG. Three case studies demonstrate the complexity of diagnosing and treating patients with PG.
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Evidence Summary: Wound management — hydrogel dressings without additional therapeutic additives
Wound Healing and Management Node Group
QUESTION
What is the best available evidence regarding the effectiveness of hydrogel dressings without additional therapeutic additives in the management of wounds?
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Evidence Summary: Wound management: medical-grade honey
Wound Healing and Management Node Group
QUESTION
What is the best available evidence regarding the use of medical-grade honey for wound management?
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