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WOUND MANAGEMENT


Improving education and best practice


This improved understanding of wound care is helpful for improving prevention as well as treatment. There is a better awareness of the risks of developing acute and chronic wounds, particularly among diabetes patients, but this is often in a one-on-one setting with a GP, nurse or other clinically trained practitioner. Preventing leg ulcers and associated ailments receives minimal public health messaging, especially when compared with issues like smoking. Nevertheless, the greater co-ordination and collaboration we have seen between wound care professionals and diabetes specialists is to be welcomed and helps mitigate the increase in wounds through better preventative education and intervention.


A proliferation of content, knowledge and learning has been facilitated by social media and online communities, particularly Twitter. Digital communications tools like these have made wound care developments and best practice more accessible, particularly to non- wound care clinicians working in diabetes, intensive care and other settings. Online campaigns like ‘Stop the Pressure’7 Matter’8


have helped raise awareness of


pressure and leg ulcers and the link between these and amputations. In previous decades, much of the professional development was structured and confined to conferences and formal training sessions but, in recent times, discussion is held among clinicians in real


3


2.5 2


1.5 1


0.5 0


1 4 Incubation time (hours)


Figure 1: The effectiveness of an activated carbon product (Zorflex) on MMP management vs alternative solutions


and ‘Legs


time through these platforms. Companies, including my own, have also used these tools to educate, inform and engage with others in the field, which is to be welcomed. Nevertheless, while improvements have been made and practitioners sharing best practice is to be applauded, we must caution against using this as the basis for treatment alone. A study looking at several Northern NHS Trusts found significant variations in care, with an overreliance on practices not supported by robust evidence and an underuse of evidence-based practices, suggesting there is


much to be done.9 There is also an unequal


international distribution of knowledge and best practice and many of the global gains can be achieved through better strategies and mechanisms to share wound care expertise on a global level.10,11 Perhaps the most critical of all advances in our understanding of wound care is the understanding and awareness that, as wounds differ in severity, type and stage, each requires a different response depending on factors like the level of exudate and wound depth. We have a better understanding now of the importance of controlling exudate and bacteria levels to overall wound healing12


and the importance


of appropriate antimicrobial stewardship to minimise the number of clinical infections and to use antibiotics only when necessary.13 Incorrectly diagnosing a wound delays healing, increases cost and the likelihood that the wound will become chronic and non-healing. Part of the challenge lies in care providers being able to identify and apply the correct product for a particular wound. Awareness of, and access to, innovative materials and dressings is largely dependent on system and country.


Improving the tools we use There are a plethora of products, dressings and materials in use, some of which have been used by wound care professionals for decades, others are more recent newcomers to the market. A whole study could be devoted to considering which materials are most suitable for specific wound types, but a review of this kind is outside the scope of this article. Others have already set out excellent guides that provide a comprehensive overview of many of the different solutions that are widely used, particularly for chronic wounds.14


Activated carbon dressings are particularly effective for chronic non-healing wounds 50 l WWW.CLINICALSERVICESJOURNAL.COM


Instead, I want to draw attention to the use of new and innovative materials


AUGUST 2021 24


MMP-2 N-A Knitted Viscose MMP-2 Zorflex MMP-9 N-A-Knitted Viscose MMP-9 Zorflex


MMP Concentration (ngml-1


)


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