WOUND MANAGEMENT
Advances in wound care management
Bob Brown provides an insight into advances in wound care management and discusses some of the innovation that is helping to drive improvement.
The last quarter century has seen advances in the way wound care management is carried out, both in terms of diagnosis and treatment. Advances and developments, like the introduction of Negative Pressure Wound Therapy, have brought benefits to patients and wound care practitioners alike and helped deliver better outcomes. Despite these improvements, the overall cost to the NHS to treat approximately 3.8m patients with a wound (2017/18 figures) is estimated to be c. £8.3bn, with a 71% increase in the annual prevalence of wounds between 2012/13 and 2017/18.1
To put
this in context, the NHS spent c. £6.1bn on overweight and obesity-related ill-health in 2014/15.2
There is significantly less public awareness about wound prevention and treatment but the cost burden is equally as significant, making any improvements in treatment extremely impactful. This article will focus on two factors that have been significant in advancing wound care management over recent years. Firstly, there is now a better understanding of how
to identify and treat wounds, driven by the wider dissemination of new research and best practice, which has helped practitioners improve the way they provide care. Secondly, as understanding and practice has improved, so have the materials and products available to treat wounds. Industry has improved existing materials and developed new innovative dressings designed to improve wound care, particularly for chronic wounds.
Improving the way we diagnose, treat and prevent
The criteria for how to effectively identify wounds published by Cutting and Harding in 19943
has become a widely used
resource for many clinicians. Since then, wound diagnosis and our understanding
Managing wounds effectively to prevent them becoming chronic, and dealing with them quickly when they do become chronic, is one way wound care professionals can actively play a part in reducing AMR and improving patient outcomes.
AUGUST 2021
of which wound types require which response has changed. In a revised approach set out in 2004, Cutting and White argued that the catch-all approach was less effective and, instead, we should move towards considering major wound categories separately to avoid overlooking the presence of infection.4
As identifying
and rapidly treating infected wounds is a critical intervention required to prevent them becoming chronic, this revised approach is welcome and demonstrates how the field is advancing. In their article, Cutting and White argue the key to identifying wound infection lies in the subtle signs and we must continuously revise these clinical indicators as our knowledge advances.
Many of the contributions to the literature that focus on how specific emphases can help promote wound healing have been made in recent years. Interventions that involve following a systematic approach and focusing on wound bed preparation are key to managing chronic wounds,5
according to
Frykberg and Banks. Our understanding of which factors are more significant in helping improve the efficacy and speed of treatment has improved, so we can target specific aspects like managing the gap between the wound bed and the dressing,6 by Keast et al.
as advocated
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