WOUND MANAGEMENT


has advanced wound care practice is the use of intact decellularised fish skin used to treat chronic wounds like pressure and diabetic ulcers. This treatment is not widespread but is already being used in the United States and is not an antibiotic solution, meaning resistant MRSA is not a barrier to its use. This natural option provides wound care professionals with another innovative solution to consider for patients that fail to respond to more typical treatments. Some companies are providing these in multiple shapes and sizes, making them ideal for many wounds including trauma wounds and surgical wounds.21


Where next? We have seen significant advances in wound care over the last few decades driven both by better understanding and more innovative products. Identifying wounds at the right time, diagnosing them correctly and treating them with appropriate products and materials may seem obvious, but wounds are complex, nuanced problems where effective treatment relies as much on a clinician’s judgement and experience as it does on national guidance and training.


As to be expected, there is room for improvement in making sure practitioners are making decisions based on evidence, and likewise, making sure research catches up with practice and investigates better ways of diagnosing and treating wounds. That being said, the field has made significant advances and we have become better at managing complex wounds. Industry has a vital role to play and has worked more closely and collaboratively with frontline teams than ever before. Many companies now develop products in collaboration with clinicians and seek input via advisory boards and focus groups much earlier on in the product development life cycle. By innovating our way to discovering, repurposing and deploying better materials, we can help clinicians improve outcomes and enable patients to live fuller, more active lives. I feel confident and optimistic that the next 20 years will see a continuation in the trend we have seen over the last 20, with our knowledge increasing, the tools to treat wounds improving and better management techniques leading to shorter clinical visits and earlier discharges.


References 1 J. Guest, ‘Burden of wounds to the NHS: what has changed since 2012/13?’, Wounds UK, 17,1 (2021)


2 Gov.uk, Health matters: obesity and the food environment (2017). Available at: https:// www.gov.uk/government/publications/health- matters-obesity-and-the-food-environment/ health-matters-obesity-and-the-food-environment- -2#:~:text=The%20overall%20cost%20of%20


Identifying wounds at the right time, diagnosing them correctly and treating them with appropriate products and materials may seem obvious, but wounds are complex, nuanced problems where effective treatment relies as much on a clinician’s judgement and experience as it does on national guidance and training.


obesity,%C2%A349.9%20billion%20per%20year.


3 K. Cutting, K Harding, ‘Criteria for identifying wound infection’, Journal of Wound Care, 3, 4 (1994) 198 – 201.


4 K. Cutting, R. White, ‘Defined and refined: criteria for identifying wound infection revisited’, Wound Care, (2004).


5 R. G. Frykberg, J. Banks, ‘Challenges in the Treatment of Chronic Wounds’, Advances in Wound Care, 4, 9 (2015). Available at: https://www. liebertpub.com/doi/10.1089/wound.2015.0635.


6 D. Keast et al. ‘Managing the gap to promote healing in chronic wounds – an international consensus’, Wounds International, 11, 3 (2020).


7 https://nhs.stopthepressure.co.uk/ 8 https://legsmatter.org/ 9 T. A. Gray et al. ‘Opportunities for better value wound care: a multiservice, cross-sectional survey of complex wounds and their care in a UK community population,’ BMJ Open, (2018) . Availabe at: https://bmjopen.bmj.com/content/8/3/ e019440.


10 R. G. Sibbald et al. ‘A global Perspective of Wound Care’, Advances in Skin & Wound care, (2012). Available at: https://www.researchgate.net/ profile/Brian-Ostrow/publication/221759947_A_ Global_Perspective_of_Wound_Care/ links/5b03139e0f7e9be94bdabc56/A-Global- Perspective-of-Wound-Care.pdf.


11 D. Keast, ‘Managing the gap to promote healing in chronic wounds – an international consensus’.


12 G.S. Schultz, G. R. Sibbald, V. Falanga et al. ‘Wound Bed Preparation: a systematic approach to wound management’. Wound Repair Regen, 11, 2 (2003) 1–28


CSJ


13 B. A. Lipsky et al. ‘Antimicrobial stewardship in wound care: a Position Paper from the British Society for Antimicrobial Chemotherapy and European Wound Management Association’, Journal of Antimicrobial Chemotherapy, 71, 11 (2016) 3026–3035. Available at https://doi.org/10.1093/ jac/dkw287


14 C. Wiegand et al. ‘Clinical efficacy of dressings for treatment of heavily exuding chronic wounds’, Chronic Wound Management and Research, 2 (2015) 101 – 111.


15 https://www.who.int/news-room/fact-sheets/detail/ antibiotic-resistance


16 HM Government, ‘Tackling antimicrobial resistance 2019 – 2024: The UK’s five-year national action


52 l WWW.CLINICALSERVICESJOURNAL.COM About the author


Bob Brown is the global sales manager for Chemviron Carbon’s Cloth Division and has been involved in the supply of activated carbon textiles for the last 20 years for use in wound care and other medical devices. More recently he was involved with the launch of the company’s own range of Zorflex wound dressings.


AUGUST 2021


plan’, (2019). Available at: https://assets. publishing.service.gov.uk/government/uploads/ system/uploads/attachment_data/file/784894/ UK_AMR_5_year_national_action_plan.pdf.


17 H. S. Scheer, M. Kaiser, U. Zingg, ‘Results of directly applied activated carbon cloth in chronic wounds’, Journal of Wound Care, 26, 8 (2017).


18 N. Murphy, ‘Reducing infection in chronic leg ulcers with an activate carbon cloth dressing’, British Journal of Nursing, 25, 12 (2016).


19 J. Carney, H. Thomas, S. J. Westgate, ‘Antimicrobial properties of, and proteinase modulation by an activated carbon cloth. Poster presented at SAWC 2017.


20 B. Cullen, et al. ‘MMPs Made Easy’, Wounds International, (2014). Available here: https://www. woundsinternational.com/resources/details/mmps- made-easy


21 https://www.kerecis.com/omega3-wound


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