Editorial and opinion
Figure 1. The University Hospital Zurich.
Switzerland, we feel it is important to be familiar with the whole range of dressings available on the market. For cost-saving purposes, a formulary has been devised that consists of one or two dressings from each category (eg hydrocolloids, hydrogels, etc), including products from all of the major manufacturers. For hard to heal wounds, many advanced methods are regularly used, such as collagen dressings, negative pressure wound therapy (NPWT) or shockwave therapy. A particular emphasis lies on the
use of tissue-engineered products, as Switzerland is the only country in Europe where these products are reimbursed by the health insurers if they are used in certain situations by a certified wound care centre.
What is the most unusual wound you have seen recently and how did you manage it? Once in a while, we see post-operative wounds with exposed calvarian bone on the scalp after the removal
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of a skin cancer. These wounds are usually extremely recalcitrant as there is almost no vascularisation of the exposed bone allowing the formation of granulation tissue. Recently we had a patient with
such a wound with several square centimetres of exposed bone. As the patient did not want to be operated on again in general anaesthesia to have the bone decorticated and the wound surgically covered, we tried a recently received new plant-based oil spray containing neem oil and hypericum oil. Amazingly, within three weeks
the exposed bone was covered with granulation tissue and after a further three weeks the entire wound was epithelialised. We were so impressed by this rapid induction of granulation tissue that we used this oil spray on 15 further patients with equally good results and which led to a publication on the subject.
Do you feel your service/ practice has any unique
Wounds International Vol 3 | Issue 3 | ©Wounds International 2012
obstacles that hamper your work? We have a lot of freedom to perform wound care as we see fit. However, as an interdisciplinary wound care centre we would also like to include more educational activities and inform other professionals working in and out of our hospital about our activities. For this, we would need more
administrative support, as most of our administrative work is now performed by the physicians and nurses outside of their regular working hours.
What equipment/resource/ education would make the most difference to your everyday work? Time. We have many opportunities to try new and effective wound care methods, however, a full-time administrative assistant dedicated to would be helpful so that we could pursue these as well as focusing on patients and education.
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