TI S SUE VIAB I L I T Y
with dressings to control exudate. Exudate contains enzymes that can destroy the wound bed and prevent healing.20
PUs
produce high levels of exudate and leakage can cause peri wound damage and delayed healing, as well as distress for patients.4,5,27 Wounds that produce high levels of exudate require more dressing changes and frequent nurse visits.28
It is estimated that 50%
of nurses’ time is dedicated to changing dressings.29 However, in the current climate, this presents a challenge; nurses are responding to an unprecedented global health emergency where the immediate threat to life must be prioritised.30
Even prior to COVID-19, there
were already concerns about nurse shortages (estimated be around 100,000) and the implications on wound care.31,32
nurses are looking after more patients each than before.33
As such, there will be a high
number of patients discharged with a PU wound that will need to be managed by their primary care team.
PU management in the community setting In the community sector, in which the amount of district nurses has fallen by 3,000, the unprecedented challenge presented by COVID-19 has exacerbated the situation.34
This nurse In hospitals,
providing education on wound dressings to patients may help to navigate this issue. Studies have also shown that keeping wounds covered with a dressing for longer may be beneficial to promote optimal wound healing.36-38
Therefore, it is important that, for positive patient outcomes, wounds are left undisturbed for as long as possible as each time a dressing is changed healing is delayed.39
It is vital that healthcare providers use high quality dressings that are clinically effective to reduce dressing changes, such as Mepilex Border Comfort, which can be comfortably worn for up to seven days.40-43 A five-layer dressing, it is suitable for the management of PUs, with high exudate handling capacity.41-44
Excessive exudate creates anxiety in the patients.4-5 Therefore,
by selecting a dressing that maintains the moisture balance, the fear of leakage should be reduced addressing the emotional burden PUs place on patients.45
With its exudate
There is expected to be a surge of discharged patients returning from hospital into the community which will put this sector under significant strain.35
shortage and increased workloads means that frequent dressing changes may not be possible in the acute and community sector. However, innovations in wound care and
progress monitor, the spread of exudate can be assessed by the patient and carer at home to determine whether the dressing needs to be changed and how urgently. This is particularly important as it may help to limit visits to the patient’s home, addressing both the increased workload of district nurses and because of the highly contagious nature of the virus.46 With the ever-decreasing availability of nurses and the increasing prevalence of chronic wounds, self-management of wounds could alleviate some of the pressures on the NHS.47
Online resources
such as those on the Mölnlycke website, offer practical guidance on how patients and/
References for this article are available upon request.
or their carers can safely change their wound dressings. This allows patients or their carers to take control of their own wound care management in the community when nurses are unable to visit them. With innovative dressings, requiring fewer dressing changes, nurses can feel confident that their patients are comfortable and their wounds have the potential to improve. Emergency associate practitioner, Joanna Doroz, states: “Patients are more comfortable to change their wound dressing if it doesn’t cause pain on application or removal.”
Conclusion To conclude, PUs place an increasingly significant burden on the UK health system, and this may only rise as a result of the current pandemic. However, by adhering to best practice, healthcare professionals can ensure that optimal and efficient care is delivered to achieve positive patient outcomes in both the hospital and community setting.
CSJ
*Tissue Viability Nurse, Luxmi Dhoonmoon, and an educational grant from Mölnlycke have supported this article.
All Mölnlycke’s resources are available to view, download and print via patient educational resource centre:
https://www.molnlycke.co.uk/education/ wound-areas/wound-healing/how-to-look- after-your-wound/
AUGUST 2020
WWW.CLINICALSERVICESJOURNAL.COM l
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