EP.TU.854Happy Patients and Updated Open Wound Management Protocols

Abstract Introduction Open injuries have a potential for serious bacterial wound infections and may lead to long term disabilities, chronic wound or bone infection, and even death. This QI study was undertaken to ring in changes to the current management protocol and align them as per WHO guidelines. Method Implementing changes through a Plan-Do-Study-Act (PDSA) cycle post an initial clinical audit among 38 patients of the organization. Re-audits were done to measure the outcome against the standard and establish a new protocol. Results Initial audit showed only a dismal 37% (n = 14) of patients being managed as per WHO protocol. Patient satisfaction percentage (as measured by a questionnaire) was also low with only 54% of patients satisfied with the treatment. Significant variations were noted post implementation of changes after the first PDSA cycle where >90% (n = 35) of patients reported that they noticed better wound healing, transition to optimal performance and were satisfied with treatment outcomes. Conclusions Timely wound dressings, appropriate antibiotic prophylaxis and increased patient’s awareness on wound hygiene through means of regular educational sessions and updated management protocols have led to healthier patients, lesser long term disabilities and happy patients.

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TP9.1.5Optimizing Patient Outcomes and Improving Organization Efficiency through Enhanced Management of Low Back Ache and Sciatica

British Journal of Surgery ◽

10.1093/bjs/znab362.103 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Harish Peri ◽

Rafique Umer Harvitkar ◽

Khursheed Ansari

Keyword(s):

Patient Outcomes ◽

Clinical Audit ◽

Treatment Modalities ◽

Risk Category ◽

Work Output ◽

Low Back ◽

Psychological Counselling ◽

Pdsa Cycle ◽

Management Protocol ◽

Back Ache

Abstract Aim This study was undertaken to tackle the rising incidence of Low Back Ache and Sciatica in a primary care government setup, which had contributed to a disabled and diminished workforce. The aim being improving patient outcomes by implementing changes in the current management protocol (measured against the standard NICE guidelines by an initial clinical audit) Method Two Plan-Do-Study-Act (PDSA) cycles were implemented post an initial clinical audit among 59 patients of the institution. Data was collected using self-made questionnaires and then analyzed. Re-audits were done to measure the outcome against a set standard. Results 20-30% (n = 12-18) of patients were aware of their risk category, understood various treatment modalities and use of orthotics in the initial clinical audit. 56% (n = 33), 73% (n = 43), 88% (n = 51) of the patients were absent from work or had diminished work output, were offered imaging and were put on medication respectively. 10% of the patients were offered psychological counselling. Post implementation of changes from the first PDSA cycle, the set target of 90% was achieved in most of the categories. Further, 24% (n = 14) of patients reported that they were still apprehensive about their condition. A second PDSA cycle was undertaken and post implementation of changes, the set standard of 10% or less patients being apprehensive was noted. Conclusions Increased awareness among patients through means of regular educational sessions, psychological counselling, updated management protocols have led to healthier patients, less absence from duty and improved work output thereby increasing the organizational efficiency as a whole.

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A CHRONIC NOCARDIAL INFECTION FOLLOWING CONSERVATIVE TREATMENT OF A HIGH PRESSURE INJECTION INJURY OF AIR

Hand Surgery ◽

10.1142/s0218810405002796 ◽

2005 ◽

Vol 10 (02n03) ◽

pp. 255-259 ◽

Cited By ~ 2

Author(s):

J. Y. L. Lee ◽

F. C. Yong

Keyword(s):

High Pressure ◽

Air Injection ◽

Wound Management ◽

Chronic Infections ◽

Open Wound ◽

Injection Injury ◽

Pressure Injection ◽

High Pressure Injection ◽

Benign Course

We present a case of recurrent cutaneous nocardiosis following a high pressure air injection injury which was treated conservatively. The patient subsequently developed multiple chronic granulomatous nodules in the palm and dorsum of the hand requiring repeated surgical debridements and long term antibiotics for complete resolution. Some reports suggest that high pressure injection injuries of air or water run a benign course and may be treated conservatively. However, inoculation by high pressure injection injury of air or water may result in chronic infections, which cause significant morbidity and are a therapeutic challenge. Although uncommon, they may be avoided by adherence to established treatment principles which include prompt recognition, realisation of its severity and aggressive treatment by open wound management, even for seemingly innocuous trauma or inoculum.

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Wound dressings. A comparison of classes and their principles of use

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-84-9-463 ◽

1994 ◽

Vol 84 (9) ◽

pp. 463-469 ◽

Cited By ~ 22

Author(s):

CS Choate

Keyword(s):

Health Care Providers ◽

Wound Dressing ◽

Wound Dressings ◽

Wound Management ◽

Care Providers ◽

Management Guidelines ◽

Sodium Calcium ◽

Individual Product ◽

Selection Of

Selection of an appropriate wound dressing, to potentiate healing, demands knowledge about varying classes of dressings. With the growing number of wound dressings available, health care providers must understand both the principles of dressing development as well as the qualities of each individual product. The author compares five classes of wound dressings: hydrocolloids, hydrogels, films, foams, and sodium/calcium alginates. Also, principles of dressing selection and long-term wound management guidelines are presented.

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The chronic wound management decision tree: A tool for long-term care nurses

Journal of Wound Ostomy and Continence Nursing ◽

10.1016/s1071-5754(96)90068-6 ◽

1996 ◽

Vol 23 (2) ◽

pp. 92-99

Author(s):

C KNIGHT

Keyword(s):

Decision Tree ◽

Long Term Care ◽

Chronic Wound ◽

Wound Management ◽

Management Decision ◽

Term Care ◽

Chronic Wound Management

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Wound dressings

10.1093/med/9780199682874.003.0013 ◽

2021 ◽

pp. 91-94

Author(s):

David Stewart

Keyword(s):

Wound Dressing ◽

Chronic Wound ◽

Individual Preference ◽

Plastic Surgeon ◽

Surgical Debridement ◽

Wound Dressings ◽

Wound Management ◽

Algorithmic Approach ◽

Surgical Practice ◽

Surgical Aspects

The plastic surgeon is often called upon to manage the complex or chronic wound. While an understanding of the principles of surgical debridement and reconstruction is naturally required for plastic surgical practice, it behoves the surgeon to also have a thorough understanding of the non-surgical aspects of wound management. The choice of dressings should be based on an understanding of what one is trying to achieve. Dressings can be indicated to aid in closure, prevent contamination, maintain hydration, debride, temporize while waiting for surgery, treat infection, and reduce swelling and inflammation. Often the choice will be based on individual preference and local availability, but understanding the varied properties of available dressings will allow the plastic surgeon to have an algorithmic approach to wound dressing.

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Wearable Sensors and Systems for Wound Healing-Related pH and Temperature Detection

Micromachines ◽

10.3390/mi12040430 ◽

2021 ◽

Vol 12 (4) ◽

pp. 430

Author(s):

Ning Tang ◽

Youbin Zheng ◽

Xue Jiang ◽

Cheng Zhou ◽

Han Jin ◽

...

Keyword(s):

Wound Healing ◽

Wearable Sensors ◽

Wound Dressings ◽

Wound Management ◽

Large Area ◽

3 Dimensional ◽

Temperature Detection ◽

Reliable Monitoring ◽

Identification Threshold

Wound healing is a complex tissue regeneration process involving many changes in multiple physiological parameters. The pH and temperature of a wound site have long been recognized as important biomarkers for assessing wound healing status. For effective wound management, wound dressings integrated with wearable sensors and systems used for continuous monitoring of pH and temperature have received much attention in recent years. Herein, recent advances in the development of wearable pH and temperature sensors and systems based on different sensing mechanisms for wound status monitoring and treatment are comprehensively summarized. Challenges in the areas of sensing performance, infection identification threshold, large-area 3-dimensional detection, and long-term reliable monitoring in current wearable sensors/systems and emerging solutions are emphasized, providing critical insights into the development of wearable sensors and systems for wound healing monitoring and management.

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The use of wound dressings as a means to alter the composition of biofilms in a chronic wound model

Access Microbiology ◽

10.1099/acmi.ac2020.po0013 ◽

2020 ◽

Vol 2 (7A) ◽

Author(s):

Gabriela Nedelea ◽

Sarah Maddocks

Keyword(s):

Chronic Wounds ◽

Chronic Wound ◽

Low Ph ◽

Wound Dressings ◽

Wound Management ◽

Chronic Infections ◽

Gram Negative ◽

Negative Shift ◽

Wound Model ◽

Chronic Wound Management

It is estimated that £5 billion are invested yearly into chronic wound management by the NHS. Whilst the demand for treatment rises every year, it has become harder to treat wounds given the burden of antimicrobial resistance. Chronic wounds can easily become harbouring grounds for polymicrobial biofilms in which species interact in specific ways. This study assessed the interactions between two commonly co-isolated chronic wound pathogens: Pseudomonas aeruginosa (ATCC 9027) and Staphylococcus aureus (EMRSA 15), whose biofilm relation initiates a Gram-negative shift. During this phenomenon, P. aeruginosa takes over the majority of the bacterial community, at the detriment of S. aureus. The Gram-negative shift marks the turning point from an acute to a chronic wound. The pH of a chronic wound is typically alkaline, and it was hypothesised that topical dressings with an acidic pH could disrupt the onset of the Gram negative shift, and therefore chronicity. Six different topical dressings with low pH were used in achronic wound model to assess their ability to reverse or delay the Gram-negative shift. It was found that they did not have an impact on the onset of the Gram-negative shift, despite their low pH values. However, the lower the pH of the dressings, the more frequently small colony variant (SCV) bacteria were observed in the biofilm. SCVs are known for causing persistent or chronic infections. It was therefore concluded that low pH dressings alone may not be favourable for managing chronic wound infection.

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Fluorescent Imaging and Precise Suppression of Bacterial Infection in Chronic Wounds by Porphyrin-Based Metal-Organic Framework Nanorod

Journal of Materials Chemistry B ◽

10.1039/d1tb01649k ◽

2021 ◽

Author(s):

zhen zou ◽

Lihua Zhang ◽

Minzhi Ouyang ◽

Yufei Zhang ◽

Huanxiang Wang ◽

...

Keyword(s):

Bacterial Infection ◽

Antibacterial Agents ◽

Chronic Wounds ◽

Chronic Wound ◽

Metal Organic Framework ◽

Critical Role ◽

Fluorescent Imaging ◽

Wound Management ◽

Metal Organic ◽

Chronic Wound Management

Nano-antibacterial agents play a critical role in chronic wound management. However, an intelligent nanosystem that can provide both visual warning of infection and precise sterilization remains a hurdle. Herein, a...

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