News Wound digest Wound digest This digest summarises some of the key papers published on issues related to wound management SELECTED PAPERS OF INTEREST


1. W.A.R. scores in patients with chronic leg ulcers: Results of a multicentre study.


2. Gunshot wounds and blast injuries to the face are associated with significant morbidity and mortality: Results of an 11-year multi-institutional study of 720 patients.


3. Antibiotics and antiseptics for venous leg ulcers (Review).


4. Analysis of MRI for acute Charcot foot diagnosis


5. Optimal rocker shoe design for individuals with no diabetic foot


6. Cost of care using prophylactic negative pressure wound vacuum on closed laparotomy incisions


n The wounds created due to gunshot and blast injuries to the face (GSWBIF) are complex and the authors highlighted that there has previously been little research undertaken in this field, despite relatively high morbidity and mortality rates.


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W.A.R. scores in patients with chronic leg ulcers: Results of a multicentre study


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n Differentiating between individuals with “problematic colonised wounds”, “wounds at increased risk of infection” and “wound infection” is of crucial importance to both the patient and the clinician, in order to identify and put in place a sufficient and effective treatment regimen.


n The authors conducted a multicentre study to assess a patient’s risk of wound infection by using the wounds- at-risk (W.A.R.) score, which is a clinical test designed by interdisciplinary experts. Point values are assigned to individual patients with a score of ≥3 indicating that antimicrobial treatment is required.


n A total of 10 dermatological wound clinics in Germany were chosen for the study with 970 patients comprising the dataset (553 women, 417 men). The mean age was 69.8 years, ranging from 10 to 100 years of age and the mean duration of the leg ulcer was 41.1 months. The mean wound size was 42.8cm2


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n The authors’ study was the first to evaluate clinical data using W.A.R. scores and it was found that 26.9% of patients displayed overall scores of <3 points, while 73.1% had scores of ≥3 points.


n The findings taken from this study show that W.A.R. scores enable the clinician to better identify those at increased risk of wound infections. Even clinicians with less experience can use the tool to easily and quickly identify risk. Jockenhöfer F, Gollnick H, Herberger K et al (2014) W.A.R. scores in patients with chronic leg ulcers: Results of a multicentre study. J Wound Care 23(1) 5–12


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n Between January 1 2000 and December 31 2010, the authors carried out a multicentre retrospective cohort analysis of individuals with GSWBIF. The purpose was to identify and describe the factors associated with adverse outcomes.


n During the 11-year study period, some 720 patients with GSWBIF were treated by the authors – 539 were men, 181 were women and the median age was 29 years – and 185 patients died (26%). Of these, 146 died within 48 hours.


n As well as 26% mortality in the study group, 38% of those patients who were hospitalised for a longer period than 48 hours had complications (n=184) with the authors suggesting this was likely related to the admission physiology and the injury severity.


n These types of injuries require a multidisciplinary approach, as well as significant resource allocation. It was concluded that due to the high mortality and morbidity rates associated with GSWBIF, there is a necessity for the development of effective guidelines and a uniform approach to the treatment of this patient group.


Shackford SR, Kahl JE, Calvo RY et al (2014) Gunshot wounds and blast injuries to the face are associated with significant morbidity and mortality: Results of an 11-year multi-institutional study of 720 patients. J Trauma Acute Care Surg [Epub ahead of print]


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Antibiotics and antiseptics for venous leg ulcers (Review)


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n The authors set out to determine the effects of the two main strategies used to prevent and treat clinical infection in venous leg ulcers, namely, systemic antibiotics and topical antibiotics or antiseptics.


n A review was carried out of the Cochrane Wounds Group Specialised Register, the Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid EMBASE, and EBSCO CINAHL databases with the selection criteria being randomised controlled trials (RCTs) that focused on venous


Wounds International Vol 5 | Issue 1 | ©Wounds International 2014 | www.woundsinternational.com


mortality: Results of an 11-year multi-institutional study of 720 patients


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Gunshot wounds and blast injuries to the face are associated with significant morbidity and


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