Technology update The importance of debridement in wound bed preparation
These include: n The patient's perspective — practitioners should identify areas of concern to the patient specialist and ensure he or she is involved in the decision-making process
n The patient’s medical state — it is important to ensure that the clinician is fully aware of the patient’s medical condition so that contraindications to treatment methods may be accounted for
n The competency of the care provider n The environment in which care is being provided and the ease of access to specialist services [13]
. These considerations underline the
importance of competency and of ensuring that the safety of the patient is paramount throughout the decision-making process[40]
Indeed, Young argues that knowledge of issues regarding patient safety and clinical competence are central to the provision of effective wound management services[41]
.
CONCLUSION Debridement is a key component in the wound management trajectory and today there are a wide variety of treatment methods available, including surgical/sharp debridement, mechanical debridement and autolytic debridement. Other interesting treatment choices include larval therapy and the use of ultrasonic energy. Assessment of the patient and
identification of any possible contraindications to treatments is essential. In addition, consideration of competency, skills and access to specialist services is vital in ensuring that the right form of debridement is selected. Furthermore, to ensure that a patient-centred focus is adopted, it is the author's opinion that the patient should be included in all care planning. Central to wound management is patient
safety. Equally important is the efficiency and effectiveness of the treatments used. By adhering to these points, practitioners can make the right choice for their patients[42]
.
AUTHOR DETAILS Zena Moore, PhD, MSc, FFNMRCSI, PG Dip, Dip Management, RGN, is a Lecturer in wound healing and tissue repair at the faculty of Nursing and Midwifery, RCSI, in Dublin, Ireland
References
34. Bradbury S, Fletcher J. Prontosan® made easy. Wounds International 2011; Available at: http://
www.woundsinternational.com/made-easys/prontosan-made-easy (accessed 3 May, 2012).
35.Wolcott RD, Rhoads DD, Bennett ME, Wolcott BM, Gogokhia L, Costerton JW, Dowd SE. Chronic wounds and the medical biofilm paradigm. J Wound Care 2010; 19: 45.
36. Chin C, Schultz G, Stacey M. Principles of wound bed preparation and their application to the treatment of chronic wounds. 2003; Primary Intention 11: 171.
37. An Bord Altranais. The Code of Professional Conduct for Each Nurse and Midwife. 2000; An Bord Altranais, Dublin.
38.Moore Z. Bridging the theory-practice gap in pressure ulcer prevention. Br J Nurs 2010; 19(suppl): 15–18.
39.Moore Z, Price PE. Nurses’ attitudes, behaviours and perceived barriers towards pressure ulcer prevention. J Clin Nurs 2004; 13: 942–51.
40. Department of Health and Children (2008) Building a culture of patient safety, report of the comission on patient safety and quality assurance. Stationary Office, Dublin. Available at: http://
www.dohc.ie/publications/pdf/en_patientsafety.pdf (accessed on 1/12/ 2011).
41. Young T. Wound debridement in the community setting. Br J Comm Nurs 2011; 16(6 Suppl): 14–20.
42.Muir Gray JA. Evidence-based Health Care. 2001; Churchill Livingstone, Edinburgh . Page Points
1. Debridement is a key component in the wound management trajectory and today there are a wide variety of treatment methods available, including surgical/sharp debridement, mechanical debridement and autolytic debridement
2. Assessment of the patient and identification of any possible contraindications to treatments is essential
3. Central to wound management is patient safety. Equally important is the efficiency and effectiveness of the treatments used. By adhering to these points, practitioners can make the right choice for their patients
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Technology and product reviews
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