Wound care
Non-diabetic wounds haven’t received as much focus and investment as diabetic foot ulcers, according to Ahmad.
guidance tell us to concentrate mainly on diabetic foot ulcers, but non-diabetic foot and leg ulcers in particular are big problems that haven’t had as much attention, meaning the services have been left behind and are not as developed or as invested in as diabetic wound care.” The strategy he wants to see implemented across the country is “a whole systems approach to healthcare”. “What I mean by whole systems is public health, community hospitals, digital and finance, working together on clinical pathways so that we have fuss-free referrals across the entire pathway,” says Ahmad. “A unique opportunity that integrated care offers is getting everybody together in the same room and joining together all the points that affect the patients care. We’ve been able to demonstrate that this works by reducing amputations and we’ve been able to care for everybody, without reducing the care or being detrimental to diabetic wound care,” He points to the MARS programme that he’s part of as evidence of effective collaboration. “We’ve noticed over the last six years, between 2016–2017 and 2021–2022, there’s been a 21% reduction in lower limb amputation and in another pilot study, we’ve reduced amputation by 42%,” he says. In 2021, the topic of rising chronic wounds was discussed in parliament, with the government advising that, “an increase in wounds in younger patients is likely to be related to an increase in the prevalence of comorbidities in a younger population, as chronic wounds are usually due to
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comorbidities that affect wound healing, such as diabetes, arterial disease and venous disease.” While the awareness surrounding wound care in diabetic patients remains promising, the same cannot be said for other comorbid conditions. Research and training in these areas is necessary to ensure preventative measures can be implemented. Currently in the UK, wound management is predominantly a nurse-led discipline, the complex nature of chronic wounds and the need for tissue viability and other specialist nurses, as well as the cost of resources such as dressing and bandages, means the overall cost of chronic wound care is significant. While the NHS has aimed to address this issue by initiating The National Wound Care Strategy Programme (NWCSP), an initiative that aims to address the issue of sub-optimal wound care by developing recommendations which can enhance the way in which we prevent, assess and treat wounds and minimise the potential and burden of wounds for patients, it is crucial that this issue continues to be addressed by both healthcare services and the government.
The NHS has also identified that this is an area that requires improvement in their long-term plan and believe that the recent shift to integrated care systems will bring together primary and specialist care services to reduce the burden of wound care. However, the true impact of these initiatives in reducing the prevalence of chronic wound cases will only be made clear with time.
Practical Patient Care /
www.practical-patient-care.com
Thomas Schauer/
Shutterstock.com
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