bluuebunny/crossref_metadata_2025 huggingface dataset:
A mother's milk: The benefits of local breastfeeding support
Authors: Heaton, Emma
Published: May 2014

Breastfeeding gives a baby the best start, but sometimes problems arise that make the early days difficult for both mother and baby. Here, one such mother talks to Ruth Donnelly about how the services provided by her local health visiting team gave her the confidence to push through the pain and breastfeed her son for the first year of his life.
Knowledge update: Early-years tooth care
Authors: Tillen Dominique
Published: May 2014

The government has set a public health target to reduce the 40% rate of tooth decay among under-fives in the UK ( Department of Health, 2010 ). As the main representatives of the health service in contact with families, health visitors have a key role to play in promoting oral health. There is a need for parents to understand the ways in which the dental needs of infants, toddlers and young children differ from those of adults. There are simple steps parents can take to care for their children's teeth, including gum care, flossing, use of xylitol, maintaining a non-sugary diet and practising good oral hygiene. Health visitors are in a position to help parents not only reduce the risk of tooth decay for their children but also benefit the oral health of the whole family. In order to fully utilize this position, closer collaboration between policymakers and the dental health community could ensure that health visitors are armed with the information they need to provide education and simple dental-care interventions to the families with whom they work.
Student project: Producing a page for the Personal Child Health Record
Authors: Fletcher Hannah , Hamilton Eleanor , Stuart Megan , Allberry Clare
Published: May 2014

Four students enrolled in the paediatric branch of an undergraduate Master's in Nursing Science at the University of Nottingham were tasked with producing a resource based on an aspect of policy related to child health. Mentored by the chair of the health visitor taskforce, Dame Elizabeth Fradd, the students chose to look at public health policy, and in particular the Health Visitor Implementation Plan ( Department of Health, 2011 ). They chose to focus on how it can be promoted in communities, while drawing from their time spent in community practice with health visitors. Reflecting on their experience, the students created an additional page in the Personal Child Health Record (PCHR) entitled: ‘What can my Health Visitor do for me?’ All parents receive the PCHR when their child is born, making it an appropriate vehicle to directly inform parents. The new page aims to raise awareness of the role of the health visitor so that parents can benefit from fully utilizing the health visiting services in their local area.
Prevention is better than cure
Authors: Oldman Crystal
Published: May 2014

The future of disease prevention through genetic profiling presents some challenging ethical questions. Crystal Oldman considers how health visitors can provide guidance.
Emotional intelligence: An essential set of skills for health visitors
Authors: Gupta Rajeev
Published: May 2014

With much evidence of how important emotional intelligence can be in health care, Rajeev Gupta suggests the core skills should be incorporated into health visitor training.
Quality and safety in a preventive service: How could inspection help?
Authors: Cowley Dame Sarah
Published: May 2014

The Care Quality Commission has proposed a new inspection scheme for health-care services. Dame Sarah Cowley considers how this might be applied to health visiting.
Helping to reduce parental anxiety in the perinatal period
Authors: Celebi Monika
Published: May 2014

During the early months and years of a baby's life, it is not unusual for parents to experience anxiety to some extent. Anxiety may inhibit parents' ability to fully bond with their baby and respond appropriately to his or her needs. This article will explore the link between reducing parental anxiety and increasing sensitive, empathetic care giving. It will look at methods such as talking therapies, video interaction guidance and baby massage, which can help parents increase their sensitive responsiveness towards their baby.
Influences on relationship-based health visiting, part 1: Reflecting on contradictions in practice
Authors: Pound Robyn
Published: May 2014

This article is the first of two in which a health visitor, in conversation with practitioners, parents and researchers, reflects on her experiences of relationship-based practice in a transforming service. In part 1 she considers contradictions and pressures on alongside relationships with families, and asks to whom she is accountable. Having consulted families, colleagues and the Senate for Health Visiting and School Nursing (SENATE–HVSN) online health visiting forum, she has identified personal, professional and organisational influences that appear widely recognised. Balance emerges as being valuable for integrating the competing demands of hard-to-measure relationship-based practice in resource-strapped organisations. In part 2, the author explores these influences more fully and arrives at some recommendations.
Creating a new approach to postnatal depression
Authors: Marriage Hannah
Published: May 2014

Student health visitor and former mental health nurse Hannah Marriage suggests specialist health visitors could help in preventing and managing postnatal depression.
Helping parents cope with head lice: The vital input of health visiting
Authors: Ibarra Joanna
Published: May 2014

Repeat infestation with head lice remains a stubborn problem for families with children attending nursery and primary school. Analysis of control measures since the 1970s identifies the crucial importance of imparting to parents the skill to detect active lice reliably. The charity-run Bug Busting programme offers evidence-based resources of demonstrated value to health-care and education staff and parents in fulfilling this need. This article highlights the vital input of health visiting today in providing the community with a workable solution to the problem of head lice.
Supporting young healthy minds
Authors: Kelvin Raphael
Published: May 2014

» Parity of esteem is now government policy—mental health should be valued as much as physical health. «
An overview of vascular access part 1: early history
Authors: Mackie Sarah
Published: May 2014

This is the first of three articles: The first two outline the development of vascular access which dates back hundreds of years; while the third will look at accurate ways to clinically assess a patient's vascular access. Here Sarah Mackie describes the events that led to the development of vascular access.
Palliative care in the management of chronic kidney disease
Authors: Shepherd Kate A , Watson Sarah , Murphy Emma L
Published: May 2014

Kate Shepherd, Sarah Watson and Emma Murphy discuss the development of specialist renal palliative care roles, and the aims of conservative care pathways for patients with chronic kidney disease who do not wish to pursue renal replacement therapy.
Living with a long-term condition: how self-management can help
Authors: Nicholson-Banks Kathy
Published: May 2014

Kathy Nicholson-Banks gives an account of Alastair Gibson's story, describing how the Expert Patient Programme (EPP), a self-management programme for patient's with long-term conditions, changed his life. From being in a wheelchair, he got himself fit and well again, taking part in life as he used to.
The commissioning of the national peritoneal dialysis pathway
Authors: Dollery Barbara
Published: May 2014

Barbara Dollery helped to develop the first comprehensive guide to best practice peritoneal dialysis (PD)—the National Specification for Peritoneal Dialysis Pathway. Published in October 2009, the author gives some background information and an overview of the guidelines.
At home with haemodialysis
Authors: Bevan Jane
Published: May 2014

Jane Bevan, 64, was diagnosed with kidney failure in 2004 and has been on home haemodialysis for the last four years. Here, she talks about the advantages of having her treatment at home, and how the support of a good medical team can make all the difference
book reviews
Authors: Jones Chris
Published: May 2014

The Oxford Handbook of Dialysis is similar to the Daugirdas et al Handbook of Dialysis (also reviewed here) in providing an easyto- use, small-format publication describing dialysis, its uses and complications.
Urinalysis: analysing urine and interpreting the results
Authors: Foxley Susan
Published: May 2014

Urinalysis is a fundamental component of the holistic and symptom assessment of any individual in poor health. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms. Susan Foxley explains in this article how urine should best be collected so that test results can be used to screen, diagnose and manage diseases—including those affecting the kidneys.
Coping with established renal failure, transplant and graft loss
Authors: Afuwape Sarah A
Published: May 2014

In this article, Sarah Afuwape looks at the psychological aspects of established renal failure (EFR), transplantation and kidney graft failure. She also reports on whether patients returning to dialysis after graft loss suffer greater anguish than dialysis patients who never received a transplant.
I had three organ transplants
Authors: Schwodler Sheila
Published: May 2014

Here Sheila Schwodler describes how her Alpha-1 antitrypsin deficiency led to first her lungs and then her kidneys failing her. She takes us through her experiences and how her three transplantation were her best survival option.
Go green in kidney care: evolution or revolution?
Authors: Macdonald Jane
Published: May 2014

Sometimes a campaign starts a revolution. In this case, the Campaign for Greener Healthcare has delivered step-wise changes with gathering momentum and is therefore more closely aligned to a social movement, akin to evolutionary change.
How to lead and manage difficult members of the team
Authors: Ellis Peter , Abbott Jane
Published: May 2014

Peter Ellis and Jane Abbott identify some of the classic difficult staff types and explore what might cause their difficult behaviour. They explain uncovering what the underlying motives for difficult behaviour can be used to positively encourage seemingly difficult staff to become team players.
research roundup
Authors: Ellis Peter
Published: May 2014

In this section Peter Ellis presents a brief synopsis of a range of recently published articles which may be of interest to nurses working in the renal setting. The aim of this roundup is to provide a brief overview, rather than a detailed summary and critique, of the research papers selected. Should you wish to look at any of the papers in more detail for yourself, a full reference is provided.
book reviews
Authors: Jones Chris
Published: May 2014

Clinical Nursing Skills provides the reader with a detailed description of the common clinical skills required of all general nurses.
An overview of how to manage patients with heart failure
Authors: Simpson Sue
Published: May 2014

Sue Simpson provides an overview of the key aspects of care and management of patients with heart failure. She describes the symptoms of heart failure and their classification, which despite the arrival of new technology, have been used for over five decades. The main focus of article, however, is the explanation of the different pharmacological treatment methods of heart failure.
Electrical safety in the dialysis unit: a shocking state of affairs
Authors: Morgan Ian
Published: May 2014

In the dialysis unit the clinician connects the dialysis machine to the mains power supply and switches it on. It may then be connected to a central venous catheter (CVC) placed into the patient’s blood circulation. What happens if something goes wrong, can the patient be electrocuted and if so what can the renal nurse do to reduce the likelihood of this happening?
Anatomy and physiology series: looking at the kidney as a whole
Authors: Velho Albertina M , Velho Rochelle M
Published: May 2014

This new series, written by Albertina M Velho and Rochelle M Velho, looks at the kidney as a whole—its structure as well as its function. In this first instalment, the authors explain how the development of the urinary and genital systems are closely related and how the development of the kidneys in the fetus, through a series of successive phases, is marked by the emergence of a more and more advanced kidney. The authors then give an overview of congenital anomalies that may arise during this development and how these lead to problems and diseases of the kidney later.
The Francis report: every renal manager's responsibility
Authors: Ellis Peter , Abbott Jane
Published: May 2014

The Francis report into the failings at Mid Staffordshire NHS Foundation Trust makes some key observations about the culture of care that allowed such failings to occur. Here Peter Ellis and Jane Abbott identify the key aspects of the report and its recommendations, which the renal manager must be aware of. The authors then explore how the renal manager can achieve cultural change and ensure high quality care.
Anatomy and physiology series: the kidney and lower urinary tract
Authors: Velho Albertina M , Velho Rochelle M
Published: May 2014

Following on from the first article in this series, which tracked the development of the kidney, this second instalment traces the urinary pathway and the specific functions performed by the individual components. The general role of the urinary system in homeostatic mechanisms and the anatomy of the kidneys, ureters, urinary bladder and urethra are described as well as the influence of autonomic regulation, neuronal pathways and reflexes during the storage and voiding (micturition) of urine. The authors identify some of the congenital and acquired anomalies of the lower urinary tract, concluding that patient care will benefit from a multidisciplinary approach based on the underlying cause.
Anatomy and physiology series: infrastructure of the kidney
Authors: Velho Albertina M , Velho Rochelle M
Published: May 2014

The first two articles in this anatomy and physiology series tracked the development of the kidney and the structure and function of the urinary pathway components. This third instalment on the kidney identifies the anatomical associations of the individual kidneys, undertakes a macroscopic journey beyond the layers of tissue around the kidney, and explores the renal infrastructure.
Dementia and renal care: keeping the person at the centre
Authors: Clarke Charlotte L , Gibbs Stephanie
Published: May 2014

Hospitals are unfamiliar environments for many patients with renal care needs; however, those with dementia can find being admitted a particularly challenging experience. Charlotte L Clarke and Stephanie Gibbs provide some useful, practical advice for renal nurses who are treating patients with dementia and associated problems such as depression and delirium.
Reflections on a revolutionary era
Authors: Eady Robin AJ
Published: May 2014

Robin Eady was one of the first patients to be treated by dialysis for chronic renal failure, which was a diagnosis made while he was a medical student. In this article, he describes his early experiences as a renal patient undergoing pioneering haemodialysis treatment in the 1960s
An update on the research in phosphate management
Authors: Flint Jan
Published: May 2014

Jan Flint summarises research on phosphate binders over the last few decades and highlights how this has affected the patient population with chronic kidney disease mineral bone disorder. It is evident that further research needs to be conducted in order to improve long-term outcomes for patients
Back to basics part 2: living donation
Authors: Curran David
Published: May 2014

Donating a kidney is a major decision and it takes courage to be a kidney donor. There are many options available to people volunteering to donate, which health professionals should be aware of. David Curran outlines these in the second part of this series.
Increasing quality in renal services through collaborative working
Authors: Gallagher Hugh
Published: May 2014

A series of projects from sites across the UK have demonstrated how collaborative working, patient involvement and system improvement can increase the quality of care provided to people with kidney disease. The projects focused on improving renal diagnosis and treatment in primary care, promoting self-management, and improving clinical systems in secondary care. The initiatives involved a range of approaches, including a decision support tool, a care bundle, a cluster randomised trial and a laboratory-based system to identify patients at risk of disease progression. The projects demonstrate that quality of care can be increased for patients at every stage of chronic kidney disease (CKD), from people with asymptomatic early changes to end-stage renal disease (ESRD). Learning from the projects will help others in the renal community who are looking to implement change programmes to improve quality.
The influence of nutrition and sepsis upon wound healing
Authors: Carlson G.L.
Published: May 2014

A review of the evidence linking impaired wound healing with nutritional status and sepsis.
Use of a silicone net dressing in severe mycosis fungoides
Authors: Taylor R.
Published: May 2014

A report on the use of a silicone net dressing as an adjuvant analgesic in a patient with severe mycosis fungoides.
Questions & answers
Authors: Collier M.
Published: May 2014

As a staff nurse who has recently moved to work in a primary care setting, I am often confused by the views of colleagues who appear unsure as to which is the right solution (tap water or saline) to use when cleaning wounds, most of them chronic. Is there a definitive answer to this question?
From the journals
Authors: Baxter Helena
Published: May 2014

Following its early success, the Wound Healing Research Unit at the University of Wales College of Medicine, Cardiff, set up several specialist clinics, including a diabetic foot clinic. All advocated a seamless, multidisciplinary approach. This study tracked the developments in nursing practice and evaluated the healing and referral rates achieved during the first seven (1993–1999) years of the diabetic foot clinic.
From the journals
Authors: Baxter Helena
Published: May 2014

There is little definitive data on the magnitude of the problem in delaying treatment for plastic and hand surgery. In order to investigate further, two synchronous audits were carried out in three tertiary centres for plastic surgery — Addenbrooke's, Cambridge; The Lister, Stevenage; and West Norwich, Norfolk. These audits examined two areas — fasting times and injury-to-theatre times.
Can laboratory investigations help us to decide when to discontinue larval therapy?
Authors: Steenvoorde P. , Jukema G.N.
Published: May 2014

Objective:

This study investigated retrospectively whether three laboratory investigations — testing for leucocyte levels, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) — can be used to guide the decision of when to discontinue larval therapy.

Method:

Between 1999 and 2002 we administered larval therapy to 16 inpatients. In all cases the decision to discontinue therapy was a clinical one made by the surgeon who headed the trauma department. We retrospectively analysed laboratory investigations, testing for leucocyte levels, CRP and ESR, on the first and last days of therapy to ascertain if the results could have guided this decision.

Results:

The median leucocyte count on the first day of larval therapy was 10.5 (x 10e9/L) compared with 8.4 (x 10e9/L) on the last day (Friedman test: p<0.05). CRP and ESR showed a non-significant tendency towards lower values.

Conclusion:

Although the methodological limitations of this open-label non-comparative cohort study preclude a definite conclusion, we believe that laboratory investigations, particularly leucocyte count, can guide the decision of when to discontinue larval therapy. However, this objective parameter cannot replace clinical judgement.

Declaration of interest:

None.
From the journals
Authors: Baxter Helena
Published: May 2014

Very little has been written about cross-European collaboration. This paper explores the management of patients with chronic leg ulcers by nurses in two centres — one in Sweden and one in the UK.
From the journals
Authors: Baxter Helena
Published: May 2014

This Indian follow-up study aimed to determine the efficacy of therapeutic footwear in preventing foot ulcers and reducing plantar pressure in patients with diabetes.
Introducing a nurse-led clinic for patients who self-harm
Authors: Corser R. , Ebanks L.
Published: May 2014

Health professionals often misunderstand the concept of self-harm because it is hard to comprehend why a person would deliberately injure themselves. However, self-harm is not a new phenomenon. In the centuries following Christ’s death his followers are thought to have flagellated themselves as a way of relieving religious guilt. Many cultures, both primitive and modern, have used forms of self-harm to create marks that are a sign of belonging and community beliefs. For example, Native American tribes developed elaborate rituals of facial decorations, markings and cuttings; Hindu women denote their faith with a red dot on the forehead; various African peoples are known for their distinctive tattooing, scarification and facepainting practices.
The beneficial effect of motorised ankle dorsiflexion on the healing of diabetic foot ulcers
Authors: Garcia M.C. , Lund K.T.
Published: May 2014

Foot ulcers are a major complication in patients with type 2 diabetes and are more commonly found in older patients. Healing occurs when adequate perfusion has been achieved at the wound site. This has been commonly accomplished by distal bypass surgery, angioplasty, moist heat or hyperbaric oxygenation. Adequate perfusion is particularly important in patients needing tight glucose control.
Is this leg ulcer venous? Unusual aetiologies of lower leg ulcers
Authors: King B.
Published: May 2014

The overwhelming majority of ulcers (95%) are vascular in origin. Most of these are venous (70%), and the rest are arterial (10%) or of mixed aetiology. The remaining 5% have other causes. This paper provides an overview of these rarer causes of leg ulceration, which can result in complex cases.
Commission for Health Improvement: an update
Authors: Godfrey Kate
Published: May 2014

Acknowledging that the Commission for Health Improvement (CHI) was soon to be superseded by the Commission for Health Audit and Inspection (Health Commission), it seemed timely to revisit the work of CHI and outline some of its major successes.
Managing risk: an overview
Authors: Ainge Lynne
Published: May 2014

Risk management is vital to protect patients, staff and the NHS and to minimise the potential for harm and litigation. This session aimed to provide delegates with an opportunity to increase awareness of risk management and to illustrate how a multidisciplinary approach to risk assessment can significantly reduce risk within an organisation.
Pressure ulcer benchmarking
Authors: Ayello Elizabeth A.
Published: May 2014

Benchmarking is about telling a story, a process to identify where the best practice is, for continuous improvement and for comparison and sharing. It is best illustrated as a continuum (Fig 1).
Aetiology of pressure ulcers: identifying the critical factors
Authors: Bader Dan
Published: May 2014

In 1997 an audit undertaken in the Netherlands indicated that pressure ulcers are the fourth largest financial burden on the health service, with a prevalence of between 10% and 20%. Unfortunately, this figure has altered little over the past 10 years.
Benefits of intermittent compression therapy in wound healing
Authors: Butcher Martyn
Published: May 2014

Caring for patients with lower limb wounds is not without problems. These include:
What difference can I make? Our Scholarship winners speak out
Authors: Collier Mark , Fraser Dorothy
Published: May 2014

In September, I described what it is like to win the Journal of Wound Care/Tendra (Mölnlycke) Scholarship for an experienced practitioner. My objective was to use the Scholarship money on a PhD I had just started. The research involves developing an assessment tool for patients at risk of developing a pressure ulcer on the heel.
Causes of and treatment options for abnormal scar tissue
Authors: Smith F.R.
Published: May 2014

Wound healing is a complex and lengthy physiological process that involves a number of different cells, hormones and inter-related factors. This paper reviews the changes in this process that lead to the formation of abnormal scarring.
Letters
Authors: Softova E.B.
Published: May 2014

In reference to a review by Garrett and Garrett, published in Journal of Wound Care in 19971 examining cellular communication and the role of growth factors during wound healing, we would like to observe that the development of processes in postoperative wound depends on various general and local risk factors present before, during and after the operation.
Passion is our byword
Authors: Zeiger Barbara
Published: May 2014

In a perfect world the passion that directs our choices maintains its intensity throughout our lives. The reality is that passion is tested and the objective is often to just get the job done. Guidelines and protocols play a dual role in our ability to nurture passion. They add to the complexity of to-do lists but also ensure facility and government-imposed standards are met when passion/perfection falters.
Modification of the tensor fasciae latae flap for reconstruction of the abdominal wall: a case report
Authors: Swindells M.G. , Patel I.A. , Tweed C.
Published: May 2014

Full-thickness periumbilical wounds after extensive abdominal surgery present a major challenge. In this case report the traditional tensor fasciae latae flap was modifi ed, improving fl ap mobility while also facilitating donor defect repair
A raised profile and a clearer vision: testimonies of two winners
Authors: Collier Mark , Fraser Dorothy
Published: May 2014

In my last report, I highlighted how I anticipated that the Journal of Wound Care/Tendra (Mölnlycke) Scholarship would help me make a positive impact on future patient care by enabling me to undertake my PhD studies. More specifically, I said that I will use the Scholarship money to attend a three-week statistics course later in the summer. I also noted that, on conclusion of my research, I am hopeful that I will be able to demonstrate that I have made a real difference to the outcomes of patients with assessed tissueviability needs. But what difference has winning the Scholarship already made to my daily work pattern?
Making the publishing process transparent
Authors: Glover Deborah
Published: May 2014

When I became editor of Journal of Wound Care, I was young and naïve. Well, okay, I was naïve. I wanted to provide clinicians with essential, practical information to make their working lives a little easier. I also wanted to develop new writers rather than rely on the ‘usual suspects’, so that the journal would offer a rich mix of experience and knowledge.
Redesigning the process of providing compression hosiery to patients attending hospital clinics
Authors: Andrews M.
Published: May 2014

Problems relating to the provision of items through the orthotic service that are not strictly orthotic appliances, such as compression hosiery, were identified by Gloucestershire Health Community. A system of direct supply was set up instead
Patients have responsibilities too
Authors: Glover Deborah
Published: May 2014

It’s very fashionable to knock nursing, medical and other health-care staff at the moment. By all accounts, and especially in the opinion of such esteemed organs as the Daily Mail, unless we go back to weekend cleaning and matron inspecting every conceivable surface with a Hubble-type telescope, all patients can go to hell in a handcart, taking their infections with them.
Entries that reveal hard work and commitment
Authors: Glover Deborah
Published: May 2014

Apparently, according to some of the national press, passing exams is getting easier and easier, but those who have managed to get ‘A’ grades can barely read or string a coherent sentence together on paper. Aside from the obvious contradiction inherent in this belief, from what I can gather from colleagues who have children going through this process, the excellent pass rates are the result of a lot of hard, hard work.
A perfect venue for the celebration of success
Authors: Glover Deborah
Published: May 2014

It’s not often one gets to stand on the terrace at the House of Commons and wave importantly to passing tourists in boats chugging up and down the Thames. But that’s exactly what the JWC/Tendra Honours and Scholarships winners, their guests and an assortment of wound-care professionals did on 21 September at the awards luncheon.
An exploration of the use of ultrasound in the treatment of chronic venous leg ulcers.
Authors: Watson J. , Nelson E.A.
Published: May 2014

Leg ulceration is a chronic, relapsing and remitting condition, which has a significant personal impact on older people’s health and quality of life. In developed countries venous leg ulcers represent up to 84% of all leg ulcer cases. The total cost of leg ulcer management in the UK in 1989 was estimated to be between £150 million and £600 million per annum, with more than 60% of this attributed to community-based nursing services.
A suggested code of conduct for editors of peer-reviewed journals
Authors: Glover D.
Published: May 2014

The Journal of Wound Care strives to meet the interests of its readers, authors, editorial advisory board, publisher, advertisers and the discipline as a whole. Clearly, this cannot be done without appropriate frameworks and guidelines for the editor, reviewers, authors and advertisers.
A busy and exciting agenda for this year’s Scholarship winners
Authors: Bethell Elaine , Evans J.
Published: May 2014

I was very proud to be selected as a finalist for the 2005 JWC/Tendra Scholarships and Honours, bearing in mind the high level of other entries. Come the Awards lunch, I was nervous and excited but never expected to win, although always hopeful.
Necrotising soft-tissue infection at the inguinal region caused by a strangulated hernia: a case report
Authors: Coskun H. , Demir U. , Bostanci O. , Mihmanli M.
Published: May 2014

Inguinal hernia affects about 5% of adult men, and it is generally agreed that hernias should be electively repaired to avoid complications. However, 5–15% of patients remain undiagnosed or are reluctant to undergo surgical correction, and as a result emergency procedures are required to correct complications. The most frequent complications include:
Using a protease-modulating dressing to treat necrobiosis lipoidica diabeticorum
Authors: Stewart E.
Published: May 2014

Almost one-third of patients with diabetes mellitus have some type of dermatological manifestation, such as bacterial and fungal infections, diabetic dermopathy, diabetic blisters (bullosis diabeticorum), eruptive xanthomatosis and necrobiosis lipoidica diabeticorum (NLD). These dermatological conditions are most often caused by the degenerative effect of diabetes on the microvascular and nervous systems, causing dermopathy and neuropathy.
The role of surgery in the management of venous leg ulcers
Authors: Wu K.C.P. , Cherry G.W.
Published: May 2014

There is currently no agreed definition of a leg ulcer, although the term generally describes an area where there is an abnormal break in the epithelial surface that typically fails to heal after six weeks. Venous insufficiency is by far the most common cause of ulceration, with a prevalence of 0.06–2.0% and a female-to-male ratio of 1.6:1, but there are other important causes to consider (Table 1), while some ulcers will have multiple aetiologies.
Guest editorial: True cost of guideline implementation
Authors: Clark Michael
Published: May 2014

Towards the end of 2005 the National Institute for Health and Clinical Excellence (NICE) released a new clinical practice guideline on pressure ulcer management. It is approximately 500 pages long, and includes a detailed slide set. Such a focus on pressure ulcers was, no doubt, warmly welcomed by all readers of Journal of Wound Care. What may be less enthusiastically received is the observation in the report that implementing the guideline’s recommendations will have no cost implications for the NHS. In short, this means we may be expected to implement the guideline, but additional funding will not be forthcoming to support this.
Non-healing anal ulcers associated with nicorandil
Authors: Biggins J. , Barrow E. , Watson A.J.M
Published: May 2014

Nicorandil-associated anal ulceration was initially described in 2002. Since then a number of reports from different centres have described series of patients who developed atypical anal ulcers while taking the drug. Ulceration is not confined to the anal area: buccal, small bowel and peristomal ulceration have also been described.6-8 There is often a considerable delay in associating these ulcers with the drug. A large proportion of these patients will be under the care of nurses involved in wound care; the aim of this article is to bring nicorandil-associated ulceration to the attention of these wound-care practitioners.
Topical negative pressure for the treatment of complex cavity wounds associated with osteitis
Authors: Chaouat M. , Bonnet F. , Seroussi D. , Smarrito S. , Mimoun M.
Published: May 2014

The treatment of pressure ulcers complicated by osteitis in patients with paraplegia is often complex. Surgical debridement of a pressure ulcer and infected bone often creates a large wound that is left to heal by either secondary intention or covered with a flap (immediately or later). Topical negative pressure (TNP) therapy, delivered using the Vacuum Assisted Closure device (KCI International, the Netherlands), is a non-invasive technique for healing by negative pressure. We report its use in the treatment of large wounds following segmentary resection of osteitis of the lower limbs in two paraplegic patients.
Looking back over a Scholarship year that is producing results
Authors: Bethell Elaine , Evans J.
Published: May 2014

The last year certainly has been a memorable one — from a macro to a micro level. Winning the Scholarship has provided good publicity for my trust at a time when NHS services are receiving cut backs and bad press, and opportunities for me.
Use of topical negative pressure therapy with an abdominal dressing in management of a laparostomy
Authors: Dakin J. , Thompson S.
Published: May 2014

Laparostomy is the technique of leaving the abdomen open following a laparotomy; it is sometimes referred to as an open abdomen. The most common reason for laparostomy formation is dehiscence of a laparotomy wound, but it is also a favoured surgical technique employed if further abdominal exploration will be needed, or in the case of abdominal compartment syndrome.
Book review
Authors: Fletcher J.
Published: May 2014

MedLogic trumpet the launch of their ‘different kind of wound education pack’ in a pre-launch press release, yet it is difficult to see what sets this apart from other resources, except for its many inaccuracies and errors.
Our motivation to improve patient care wills us to succeed
Authors: Curry Catriona , Geraghty Jemell , Brown Annemarie , Rivers Christine , Middleton Heather
Published: May 2014

I am now well on the way to fulfilling my objectives of obtaining ethics and research and development approval for my PhD on developing a disease-specific self-efficacy tool for patients with healed leg ulcers. However, I feel like I am jumping through hoops to satisfy the ethics committee’s requirements. I have never been one to give up easily and so, with stoic determination, am now planning the datacollection phase of my study.
Modern dressings: must do better
Authors: Pollard Tom
Published: May 2014

Another month, another review that casts doubt on current wound-care practice. An article published in the October 2007 issue of Archives of Dermatology presents the outcomes of a systematic review by a group of French medics of efficacy studies on modern wound dressings. The review is worthy of particular note for the English-speaking wound world because it includes studies published in French and English, and so covers a wider range of journals than we might otherwise consider.
A tribute to Lilian Bradley
Authors: Donnelly Jeannie , Patton Judith , Rogers Joan
Published: May 2014

Lilian began her nurse training in 1965 but following her marriage to Ken Bradley, a Methodist minister, she spent several years supporting his ministry at home and abroad, which included missionary work in French-speaking West Africa. On her return to Northern Ireland, Lilian nursed in many different health-care settings, including intensive care and treatment rooms.
Can tight blood glucose control reduce post-cardiac surgical wound complications?
Authors: Gannon R.
Published: May 2014

Post-surgical wound dehiscence is strongly linked with diabetes and hyperglycaemia. This paper examines the evidence on whether tight blood glucose control in diabetic patients undergoing cardiac surgery reduces their risk of wound complications
The impact of introducing a care pathway for the treatment of minor paediatrics burns
Authors: Singh T. , Arbuthnot J.E. , Stevenson H. , Brown L.
Published: May 2014

Clinical pathways are developed colla boratively by clinicians, nurses, pharmacists and other allied health-care professionals, with the aim of improving the quality of patient care and applying an agreed, standardised, ‘best management’ plan.
A prospective observational study of the efficacy of a novel hydroactive impregnated dressing
Authors: Meuleneire F. , Zoellner P. , Swerev M. , Holfeld O. , Effing J. , Bapt S. , Tholon N. , Felder E. , Streit B. , Kapp H. , Smola H.
Published: May 2014

Objective:

To assess the clinical efficacy, tolerance and acceptance of a novel, hydroactive-impregnated dressing (Hydrotul) in the local treatment of acute and chronic wounds.

Method:

In a prospective observational study 24 centres in France, Belgium, Germany and Austria recruited 74 patients. At each dressing change the investigators evaluated the condition of the wound, perilesional skin and patient-reported pain. Overall, five dressing changes were documented, or until complete healing occurred. The hydroactive properties of the dressing were assessed in laboratory tests by measuring fluid absorption capacity and kinetics.

Results:

Patients were treated for an average of 17 days. The wound condition improved markedly during the observation period. The wound area covered with fibrinous slough decreased from 29% to 14%, epithelialisation increased from 19% to 54% and 22 wounds were completely healed by the end of the study. The number of patients reporting severe and moderate wound pain decreased from 35% to 19% and the proportion of patients without wound pain doubled from 27% to 60%. In laboratory tests, Hydrotul absorbed two to three times the amount of fluid compared with other impregnated wound dressings and the kinetics of absorption was much faster.

Conclusion:

The novel hydroactive impregnated dressing supports the healing process in patients with acute and chronic wounds and reduces wound pain. The dressing absorbs excess wound exudate while keeping the wound surface moist and protecting perilesional skin.

Declaration of interest:

This study was sponsored by Paul Hartmann AG, Heidenheim, Germany.
Letters
Authors: Kaehn M.
Published: May 2014

In the February issue Steenvoorde et al. reported the findings of a pilot study on the use of Dermacyn (Occulus Innovative Systems) on the infected foot ulcers of 10 patients. Four patients discontinued the treatment due to pain during immersion and Staphylococcus aureus was eliminated in only one of the six patients tested.
A lively conference with plenty of debate for the NPUAP in Texas
Authors: Lyder C.H.
Published: May 2014

The 10th National Pressure Ulcer Advisory Panel (NPUAP) biennial conference and 20th anniversary celebration took place in February in San Antonio, Texas. Although discussion also focused on support surfaces, since 75% of the debate was on staging, that is the focus of this report.
Editorial: Scholarship winners thrive under pressure
Authors: Glover Deborah
Published: May 2014

In this issue, the 2006 Scholarship winners present their final progress report (p214). Clearly, all had a momentous year in more ways than one. Their experiences haven’t all been positive, making the achievement of objectives seem somewhat more distant than would be ideal. However, working on the principle that what doesn’t kill you makes you stronger, all the winners agree that the Scholarships have helped them develop personally and professionally and that their journey isn’t at an end. I wish them the best of luck in their endeavours.
A new research focus for skin breakdown
Authors: Pollard Tom
Published: May 2014

For many specialists, it must sometimes seem as if they are living in a bubble. No matter how much effort they put into education and training, an astonishing number of people still develop skin ulceration unnecessarily. Simple neglect or lack of awareness by carers, lack of patient concordance or, worst, poor practice can all contribute to the epidemic of skin breakdown. As the population ages, the problem will become ever more urgent.
Editorial: Scholarship winners are an example to all
Authors: Pollard Tom
Published: May 2014

In the last few weeks, Tracy Cowan and I have made two trips to the north of England to meet three of this year’s JWC/Mölnlycke Scholarship winners (see pp 331–3 for a Scholarship update). The trips have served for me as a potent reminder of several aspects of the current UK health service. First and foremost, I was struck by the extremely high level of dedication displayed by the wound-care practitioners we met. In the face of an often bad press, it is sometimes easy to forget that health care is for many a vocation, not just a job. In the face of many challenges, each Scholar has not only remained focused on the job in hand, but also found the time to advance themselves, their skills and their service, all to the benefit of the patients for whom they care.
A salutory lesson in the benefits of audit
Authors: Cowan Tracy
Published: May 2014

It is surely shocking when an audit reveals unethical practice. Yet this is what happened when community nurses in one UK region were asked to describe how they would pack a drained perineal abscess, as outlined in an article in this issue on page 437. Needless to say, the majority of respondents (82%) said they would pack it loosely, but 15% said they would pack it tightly and 3% that they would do this until the patient felt discomfort! It is not clear why they felt this was an acceptable thing to do. Admittedly, there is no high-level evidence on how to pack perineal abscesses, but then this is a common and simple postoperative procedure that should not cause the patient any harm.
Community nurses’ practices in managing perianal abscesses
Authors: Yeung J.M.C. , Stratton R. , Watts E. , Pankhurst S.
Published: May 2014

A survey of community nurses identified that a wide range of dressings, and in some cases unethical practices, are being used for this simple postoperative condition. Communication between hospital, community staff and patients was poor
Let's cross these specialty boundaries
Authors: Cowan Tracy
Published: May 2014

The defining characteristic of JWC is its multidisciplinary content. As well as tissue viability nurses, our readers include vascular nurses and surgeons, podiatrists, podiatric surgeons, plastic surgeons, doctors, district nurses, researchers, scientists and others. This, of course, reflects the multidisciplinary teamwork required to achieve optimum outcomes for patients being treated within tissue viability services.
Book review
Authors: Donnelly Jeannie
Published: May 2014

The second edition of Wound Care Practice edited by Paul J. Sheffield and Caroline E. Fife is a riveting, two-volume read which discusses the overarching principles of diagnosing and managing a diverse range of chronic wounds — from pressure ulcers to venomous spider bites.
A showcase to the wider community of our Scholarship winners' worth
Authors: Stevens Julie
Published: May 2014

It has been a year of achievement for this year’s winners, in which they have developed their skills and services beyond initial expectation. Here, they describe the benefits they have reaped for themselves, their patients and trusts
Whose wound is it anyway? Issues relating to wound photography
Authors: Fletcher J.
Published: May 2014

In this digital age it is easy to obtain images of wounds without permission from the owner or patient. A debate is needed to clarify who rightfully owns clinical images and the implications for patient consent of using them in different media
Necrotising fasciitis of the cervicofacial region: a bizarre presentation
Authors: Tandon A. , Gupta A. , Yateesh S. , Dua A. , Kumar S.
Published: May 2014

The following paper presents the case of a middle-aged woman, who presented with a necrotising soft tissue infection of the cervicofacial region with maggots in situ. She was managed with aggressive surgical debridement, but eventually succumbed to the disease because of erosion of the great vessels of the neck by the maggots. The purpose of this case report is to emphasise the severity of this disease and also to present an unusual case, which had a fatal outcome.
Effect of activated charcoal dressings on healing outcomes of chronic wounds
Authors: Kerihuel J.C.
Published: May 2014

Objective

To compare the ability of activated charcoal dressings with that of a hydrocolloid dressing to reduce the wound area of chronic wounds.

Method

Two separate randomised controlled trials (RCTs) were undertaken; both used the same hydrocolloid as the control. One RCT compared Actisorb (without silver) with the control on chronic pressure ulcers and the other RCT compared Actisorb Silver 220 with the control on chronic venous leg ulcers. Patients were followed for four weeks. Baseline patient demographic and wound characteristics were comparable between the treatment and control groups. Wounds were assessed at weekly intervals. Ulcers were photographed and then traced by an experienced, independent investigator. Both the reduction in ulcer area and the percentage reduction were calculated.

Results

Sixty patients were enrolled into each study, although data for one patient were not available in the pressure ulcer study. There were differences in results at week 1 in favour of the treatment group in both studies, although the results for the two groups in each study were comparable at week 4. Activated charcoal dressing was better tolerated than the control.

Conclusion

These clinical data indicate the potential usefulness of using activated charcoal impregnated with silver in the management of chronic wounds, even at the debridement stage. This dressing may help remove fluids and toxins that impair the healing process.

Declaration of interest

These studies were sponsored by Systagenix Wound Management.
Improving care: the power of the pen
Authors: Nelson E.A.
Published: May 2014

Andrea Nelson, Professor of wound healing and a member of the Cochrane Wounds Group, describes how the written word can improve wound care
Foreword
Authors: Cutting Keith F
Published: May 2014

While there have been many advances in wound dressing technology in recent years, the development of an universal dressing remains elusive. In the past, our reasons for dressing wounds were relatively simple: to protect, absorb, prevent loss of blood/fluids, provide an optimal environment and aesthetic. Delivery of these aims relied on the knowledge prevailing at the time. In the 21st century, other reasons for dressing wounds have come into play, such as pain management. With chronic wounds, the focus now tends to be on the dressing's ability to manage exudate efficiently.