Current Issues Available

  

IssueNameMain ArticleCase Study

1

POST-OP WOUND CARE 

In this issue, Jane Rice looks at post-operative wound care, specifically wounds that heal by primary intention. The factors that affect wound healing are reviewed, and measures that can be taken to prevent or limit wound breakdown are examined 

In the following case study, Prue Hannon, a community nurse, recounts the story of a patient whose post-operative experiences illustrate the importance of appropriate wound management.

2

PRACTICAL MANAGEMENT OF BURNS IN THE COMMUNITY 

In this issue we focus on burns and scar management. Firstly Sandy Dean explores the differences between superficial, superficial dermal, deep dermal and full thickness burns and the management of each including dressing selection. Dr Fiona Woods provides excellent practical tips for scar management. 

In this case study, Kate Greenwood, recounts the management of a partial thickness burn sustained by a young woman from the UK while traveling in Australia late last year.

3

DIAGNOSIS AND MANAGEMENT OF VENOUS ULCERATION 

In this issue Dr Denise Findlay discuss the cause, clinical features, diagnosis and management of venous ulcers. Gain a clearer understanding of the different types of compression bandages and their application. Professor Michael Stacey overviews the effectiveness of various procedures, including surgery, in the prevention and treatment of venous ulceration. 

Ms Joanne Campbell, a clinical nurse consultant, provides a case study highlighting the role of compression therapy in facilitating the healing process in venous ulceration

4

CARE OF THE DIABETIC FOOT ASSESSMENT TREATMENT & MANAGEMENT 

In this issue Jane Tennant discusses the assessment, diagnosis and management of the diabetic foot ulcers. Gain a podiatrist perspective on how peripheral, motor and autonomic neuropathy impacts the lower limb and foot. Understand how appropriate footwear can prevent harm One of these studies highlightsthe effectiveness of Dermagraft® in the treatment of diabetic foot ulcers and another demonstrates the success ofhyperbaric oxygen therapy in treating ‘die-back’ following toe amputation

Michelle Robins, a Diabetes Nurse Educator at the Melbourne Extended Care and Rehabilitation Service in Victoria, presents a case study illustrating the importance of appropriate management of diabetic foot ulcers. Prevention is better than cure when it comes to diabetic foot ulcers.

5

PRACTICE MANAGEMENT OF PRESSURE ULCERS 

In this issue Linda Murray outlines the prevalence, causes, classification and management of pressure ulcers. It all comes down to reduction of pressure, shear and friction. Practical management of pressure ulcers through a multi disciplinary approach and effective care plans is discussed.We present a case study of a diabetic patient with a pressure ulcer on the heel, which illustrates the importance of preventive measures.Numerous seating devices are evaluated and compared, and we also answer some important questions relating to the treatment of pressure ulcers.

Jenny Matthew, Clinical Nurse Consultant, Blue Care, presents a case study illustrating the importance of preventive measures in avoiding pressure ulcers.

6

THE AGING SKIN AND SKIN TEARS 

Jenny Matthew in this issue discusses the aging process of the skin and why skin tears occur in the elderly. Kerrie Coleman provides some great tips on how to treat, protect and prevent skin tears. 

Maree Plucinski present a case study of an elderly patient with skin tears on the arm, which provides clear evidence of the value of leaving the epidermal flap on a healing wound.

7

EARLY IDENTIFICATION AND MANAGEMENT OF INFECTED WOUNDS 

Rhia Martin in this issue discusses the differences between inflammation and infection and the practical management of each. Gain a better understanding how to diagnose infection and the pro’s and con’s of swabbing versus tissue biopsy. Identify the differences between several antimicrobials like Acticoat, Honey, Silvazine, Iodosorb.

Michelle Robins presents a case study on the treatment of a venous leg ulcer, which illustrates the benefit of using an antimicrobial dressing to help prevent bacterial contamination.Shan Lawrence, clinical podiatrist with the Royal Melbourne Hospital, looks at the need for the early detectionof osteomyelitis to reduce the likelihood of surgical intervention.

8

MANAGEMENT OF MIXED ATERIAL ULCERS 

Dr Dianne Smith in this issue discusses the practical management of complicated mixed/arterial ulcers. Gain an understanding of how to use a Doppler to differentially diagnose venous leg ulcers using ABPI’s. A good explanation of the role compression plays in mixed arterial and venous leg ulcers is provided. Jane Rice also introduces new technologies like electrical stimulation, hyperbaric treatment, ultrasonic, ultrasound, and human skin replacement products..

Tabatha Rando presents case study of the treatment of mixed vessel disease ulcers and rheumatoid arthritis, which illustrates the Need to keep these wounds infection-free and to support the integrity of surrounding skin.

9

ISSUES IN WOUND MANAGEMENT 

Dr Denise Findlay address some of the myths associatedwith wound healing and considers common questions and comments made by patients,nurses and doctors. In particular the concept of moist wound healing, cost effective healing and choosing an appropriate dressing is covered. 

Jane Rice describes her own experiences of healing an acute trauma injury with Cutinova Hydro

10

WOUND BED PREPARATION - A WOUND MANAGEMENT IMPRERATIVE 

Tal Ellis introduces the concept of Wound Bed Preparation, WBP is about influencing local conditions that affect healing, essentially about removing barriers to healing from within the wound.1. Removal of necrotic burden2. Removal of bacterial burden3. Optimising exudate levels4. Removal of cellular burden5. Correction of biochemical imbalances.

Learn from the Gold Coast Hospital’s experience using ultrasonic wound debridement to create a clean wound bed.

11

MANAGEMENT OF SKIN GRAFTS AND DONOR SITES 

Patricia Terrill discusses the practical management of skin grafts and donor sites in every day practice. We also case study the effectiveness of bioengineered skin with a non-healing wound, and review new technologies for wound healing. 

Gillian Shaw and Kristen Whaley describe how they used Dermagraph to heal a non-healing wound

12

PRESERVATION OF SKIN INTEGRITY IN AGED CARE 

In this issue Jane Rice discusses the preservation of skin integrity in aged care. Yvonne Coleman covers the important role nutrition plays nutritionaldeficits and wound healing and pharmacological impacts on healing.

Geoff Sussman provides a great overview of how systemic treatments impact wound healing.

13

WOUND INFECTION: THE ROLE OF SILVER AS AN ANTI-MICROBIAL 

Kerrie Coleman reviews the role silver dressings play in wound management, looking at the type of silver, the delivery of silver into the wound. This should provide you with a better appreciation of what dressings are bactericidal, bacteria static and the concept of toxicity and bacterial resistance

Margi Moncrieff describes the use of Acticoat Absorbent on a full thickness wound healing the wound in eight weeks and substantially reducing pain.

14

VENOUS LEG ULCERS - ASSESSMENT AND MANAGEMENT 

Sheri Sanderson details the merits of compression therapy for venous leg ulcers and the practical use with patients. Sue Hoskin supports this by giving tips on single and multi-layer bandaging

This case study provides insight into how a patient’s situation is taken into consideration to determine the appropriate compression bandage. Also patient education is stressed as an important factor in healing.

15

BANDAGE SELECTION AND TECHNIQUES

Sue Templeton provides a systematic way to select an appropriate bandage and illustrates how they should be applied. Geoff Sussman complements this with a description of retention, compression (short stretch and long stretch bandages).

Anne Lee provides solutions to common problems with bandaging like slippage. 

16

HEALING WOUNDS IN THE COMMUNITY…WHERE TO GO FOR SUPPORT?

Pam Morey describes how to implement a holistic approach to wound management and ensure a multi disciplinary team approach in the community. Maree Bernoth describes the support group “Hunter Wound Interest Group” which is a group of healthcare professionals supporting people with chronic wounds collaboratively.

Jill Sparks recounts a patient who enjoyed the benefit of a multidisciplinary approach.

17

MANAGING THE OVERALL COST OF WOUND MANAGEMENT 

In this issue Bill McGuiness discusses reducing the overall cost of wound management, including the importance of taking account of the patient’s circumstances, the clinician’s involvement, correct product selection and careful tracking of the patient’s progress. The actual unit cost of a dressing is not the true cost. 

The frequently asked questions section puts forward thought provoking questions on cost to help identify really what is the cost to heal a wound. Surprisingly labour and the time taken to heal are significant drivers in cost.

18

PRESSURE ULCER PREVENTION

In this issue Wendy Sandom details a project conducted at Box Hill Emergency Department to reduce the prevalence of pressure ulcers using Allevyn. Tal Ellis also describes how medical grade sheep skin is helping reduce pressure ulcers in aged care. 

The concept of Wound Bed Preparation and T.I.M.E from the International Advisory Board of Wound Bed Preparation is described

19

COST EFFECTIVENESS OF MODERN WOUND DRESSINGS

In this issue we consider the health economics of wound management to determine the total cost of healing wounds and the influence of funding on dressing affordability. Sandy Dean further explores the concept of affordability by offeringthought provoking questions and tips regarding traditional versus advanced wound care. We are fortunate to have internationally renowned Keith Harding present his view of using silver to heal chronic wounds.

Ever wondered how to interpret clinical papers with all the talk about statistics, randomized trials, P-values and statistical significance? Well this paper provides a clear understanding of such terms.

20

FUTURE PATHWAYS TO BETTER WOUND PREVENTION AND MANAGEMENT FOR AGED CARE

In this issue, Tal Ellis considers our rapidly changing population demographic and its effect onfuture woundcare provision. He also offers some worthwhile tips on adhering sacral dressings andanswers some common woundcare questions..

In our woundcare case study, Sandy Dean reviews the assessment, treatment and outcomes of a complex leg ulcer

21

IS THE WOUND REALLY HEALING? MEASURING WOUNDS

In this issue Wendy White discuss the role of measuring and monitoring wounds throughout the episode of care. Recent literature has explored the benefit of monitoring the percentage reduction in wound surface area and the role of this information in assisting healthcare providers to determine the most appropriate treatment regime. A graphical representation of the wound decreasing in size has alsobeen shown to have a positive impact on a patient’s compliance to treatment

Sally Warmington provides an example of how measuring a wound with Visitrak helped gain the support of the patient as changes could be quantified. She explains how wound assessment and measurementallowed deterioration and improvement to be easily identified and tracked and played an essential role informulating plans ofcare.

22

POST CARE TREATMENT OF PEOPLE WHO HAD AN ULCER

In this Wendy White explores new initiatives which aim to provide people with support post treatment of their wound. The Northern Sydney Central Coast Area Health Service (NSCCAHS) has implemented ‘Legs Alive’ to enhance patients’ lifestyle through health promotion, and prevention of leg ulcers. 

How to rejuvenate? We explore the health benefits of improved breathing, visualisation and massage therapy foryou and your patients.

23

HOW TO SUBSIDISE-THAT IS THE “DRESSING” QUESTIONS! 

In this issue we raise an important issue of wound dressing subsidies which is supported by the ‘Elephant in the Room’ campaign by the Australian Wound Management Association. 

Virginia Fazio provides a guide as to how nutrition can support wound healing

24

NEGATIVE PRESSURE WOUND THERAPY

In this issue, Negative Pressure Wound Dressings and Therapy (NPWT) feature as Plastic and Reconstructive Surgeon James Savundra explores the Background and concept behind negative pressure dressings and their applications. NPWT and offer some practical advice on how it may best be used to aid wound healing.

Jean Applin trials Negative Pressure Wound Therapyin the healing a of a large excised pilonidal sinus

25

Lymphoedema

In this issue we look at a disease – Lymphoedema – which whilst said not to be common, does
appear to be under diagnosed. Professor Neil Piller of Flinders Medical Centre provides us with a comprehensive overview of lymphoedema – physiology, diagnosis and management. 

Jenny Jensz, a rural lymphoedema specialist assists us with a selection of handy hints we can pass on to our patients and there is a small case study highlighting the skin issues which may be seen in these clients who have gone unmanaged