Wound healing: what is the NICE guidance from the UK?

2021 ◽  
Vol 30 (3) ◽  
pp. 172-182
Author(s):  
Katharine Powell ◽  
Ojas Jyoti Singh Pujji ◽  
Steven Jeffery
Keyword(s):  
Wound Healing ◽  
Wound Care ◽  
Financial Burden ◽  
Productivity Loss ◽  
Standards Of Care ◽  
Index Measurement ◽  
Nice Guidance ◽  
Health Related ◽  
The Uk

Alteration of wound healing increases the risk of a patient's morbidity and mortality. This can lead to scarring, infection, malignant transformation and a reduction in quality of life. Management of wounds costs the UK an estimated £5.3 billion annually which is paid for by the state, with further financial burden due to health related productivity loss. Wound care is managed by a broad spectrum of different health professionals leading to different standards of care. For example, only 16% of lower leg wounds have either an ankle-brachial pressure index measurement or Doppler scan. Due to this variation in wound care, we have summarised all available NICE guidelines and guidance up to February 2021 on the topic of wound healing listed in the National Institute for Health and Care Excellence (NICE) archives. The goal is to provide an easy to access summary of wound care interventions. Our search provided us with 18 technology appraisals related to wound healing which have been summarised.

scholarly journals The effect of intravenous golimumab on health-related quality of life and work productivity in patients with active psoriatic arthritis: results of the Phase 3 GO-VIBRANT trial

2021 ◽  
Author(s):  
Alexis Ogdie ◽  
Jessica A. Walsh ◽  
Soumya D. Chakravarty ◽  
Steven Peterson ◽  
Kim Hung Lo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Productivity Loss ◽  
Health Related Quality ◽  
Functional Capability ◽  
Related Quality ◽  
Health Related ◽  
Eq Vas

Abstract Introduction/objectives To evaluate changes in health-related quality of life (HRQoL) and productivity following treatment with intravenous (IV) golimumab in patients with psoriatic arthritis (PsA). Methods Patients were randomized to IV golimumab 2 mg/kg (n=241) at Weeks 0, 4, then every 8 weeks (q8w) through Week 52 or placebo (n=239) at Weeks 0, 4, then q8w, with crossover to IV golimumab 2 mg/kg at Weeks 24, 28, then q8w through Week 52. Change from baseline in EuroQol-5 dimension-5 level (EQ-5D-5L) index and visual analog scale (EQ-VAS), daily productivity VAS, and the Work Limitations Questionnaire (WLQ) was assessed. Relationships between these outcomes and disease activity and patient functional capability were evaluated post hoc. Results At Week 8, change from baseline in EQ-5D-5L index (0.14 vs 0.04), EQ-VAS (17.16 vs 3.69), daily productivity VAS (−2.91 vs −0.71), and WLQ productivity loss score (−2.92 vs −0.78) was greater in the golimumab group versus the placebo group, respectively. At Week 52, change from baseline was similar in the golimumab and placebo-crossover groups (EQ-5D-5L index: 0.17 and 0.15; EQ-VAS: 21.61 and 20.84; daily productivity VAS: −2.89 and −3.31; WLQ productivity loss: −4.49 and −3.28, respectively). HRQoL and productivity were generally associated with disease activity and functional capability, with continued association from Week 8 through Week 52. Conclusion IV golimumab resulted in early and sustained improvements in HRQoL and productivity from Week 8 through 1 year in patients with PsA. HRQoL and productivity improvements were associated with improvements in disease activity and patient functional capability. Key Points• In patients with active psoriatic arthritis (PsA), intravenous (IV) golimumab improved health-related quality of life (HRQoL) and productivity as early as 8 weeks and maintained improvement through 1 year• Improvements in HRQoL and productivity outcomes in patients with PsA treated with IV golimumab were associated with improvements in disease activity and patient functional capability outcomes• IV golimumab is an effective treatment option for PsA that can mitigate the negative effects of the disease on HRQoL and productivity

scholarly journals A study to improve the quality of writing clinic letters to patients attending the outpatient clinic

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S211-S211
Author(s):  
Irangani Mudiyanselage ◽  
Madhvi Belgamwar
Keyword(s):  
Outpatient Clinic ◽  
Standards Of Care ◽  
Multidisciplinary Teams ◽  
Patient Centered ◽  
Second Person ◽  
County Mental Health ◽  
Hospital Doctors ◽  
The Uk ◽  
To Receive

AimsIn many countries (including the UK and Australia) it is still common practice for hospital doctors to write letters to patients’ general practitioners (GPs) following outpatient consultations, and for patients to receive copies of these letters. However, experience suggests that hospital doctors who have changed their practice to include writing letters directly to patients have more patient centred consultations and experience smoother handovers with other members of their multidisciplinary teams. (Rayner et al, BMJ 2020)The aim of the study was to obtain patient's views to improve the quality of clinical letters sent to them, hence the level of communication and standards of care.MethodAn anonymous questionnaire was designed and posted to collect information from patients attending one of the South County Mental Health outpatient clinic in Derbyshire. 50 random patients were selected between March to November 2020. Patients were asked to provide suggestions to improve the quality of their clinic letters written directly to them and copies sent to their GPs.ResultOut of 50 patients 48% (n = 24) responded. Majority of patients (92%) expressed their wish to receive their clinic letters written directly to them and 79% preferred to be addressed as a second person in the letters. More than half (54%, N = 13) of them would like to have letter by post. Majority of them (92%, N = 22) wished to have their letter within a week of their consultations.Patients attending clinics felt that the communication could be better improved through writing clearly: a) reflection of what was discussed during the consultation b) updated diagnosis c) a clear follow-up plan d) current level of support e) medication change f) emergency contact numbers g) actions to be carried out by their GP and further referrals should there be any.ConclusionPatients in community prefer to have their clinic letters directly addressing them in second person. It was noted that the letters needed to reflect accurately on what was discussed during the consultation in order to have patient centered consultations. This in turn would improve communication and thus rapport, trust and overall therapeutic relationship.

scholarly journals Ca-Zn-Ag Alginate Aerogels for Wound Healing Applications: Swelling Behavior in Simulated Human Body Fluids and Effect on Macrophages

Polymers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 2741
Author(s):  
Claudia Keil ◽  
Christopher Hübner ◽  
Constanze Richter ◽  
Sandy Lier ◽  
Lars Barthel ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Care ◽  
Developed Countries ◽  
Swelling Behavior ◽  
Wound Dressings ◽  
Regulatory Function ◽  
Wound Fluid ◽  
Healing Wounds ◽  
Injury Models

Chronic non-healing wounds represent a substantial economic burden to healthcare systems and cause a considerable reduction in quality of life for those affected. Approximately 0.5–2% of the population in developed countries are projected to experience a chronic wound in their lifetime, necessitating further developments in the area of wound care materials. The use of aerogels for wound healing applications has increased due to their high exudate absorbency and ability to incorporate therapeutic substances, amongst them trace metals, to promote wound-healing. This study evaluates the swelling behavior of Ca-Zn-Ag-loaded alginate aerogels and their metal release upon incubation in human sweat or wound fluid substitutes. All aerogels show excellent liquid uptake from any of the formulas and high liquid holding capacities. Calcium is only marginally released into the swelling solvents, thus remaining as alginate bridging component aiding the absorption and fast transfer of liquids into the aerogel network. The zinc transfer quota is similar to those observed for common wound dressings in human and animal injury models. With respect to the immune regulatory function of zinc, cell culture studies show a high availability and anti-inflammatory activity of aerogel released Zn-species in RAW 264.7 macrophages. For silver, the balance between antibacterial effectiveness versus cytotoxicity remains a significant challenge for which the alginate aerogels need to be improved in the future. An increased knowledge of the transformations that alginate aerogels undergo in the course of the fabrication as well as during wound fluid exposure is necessary when aiming to create advanced, tissue-compatible aerogel products.

scholarly journals The patient’s experience of primary ciliary dyskinesia: a systematic review

2017 ◽  
Vol 26 (9) ◽  
pp. 2265-2285 ◽  
Author(s):  
Laura Behan ◽  
Bruna Rubbo ◽  
Jane S. Lucas ◽  
Audrey Dunn Galvin
Keyword(s):  
Quality Of Life ◽  
Primary Ciliary Dyskinesia ◽  
Age Groups ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Uk ◽  
The Impact ◽  
Ciliary Dyskinesia

Abstract Background Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterised by progressive sinopulmonary disease, with symptoms starting soon after birth. The aim of this study is to critically review, analyse, and synthesise the literature in order to understand the experiences of patients with primary ciliary dyskinesia (PCD) and the impact on health-related quality of life. Method MEDLINE, EBSCO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and EMBASE were searched according to the inclusion criteria. A qualitative analysis of 14 studies was conducted. Results Fourteen studies were included in the review, five with qualitative methodologies. Studies originated from the UK, USA, Italy, Denmark and Belgium, one study included a survey distributed internationally. Significant relationships were found between age and worsening of respiratory symptoms, physical, and mental domains of health-related quality of life, with a greater decline compared with reference populations. Variations between the UK and Italy were found for health-related quality of life and its correlation with time since diagnosis. PCD was found to have a physical impact in all age groups: patients found it difficult to keep up with others, and found energy levels were easily depleted compared to family or peers. In terms of social impact, symptoms lead to embarrassment and a sense of isolation, with patients concealing symptoms and/or their diagnosis. In turn, isolation was also linked with the lack of public and medical knowledge. In relation to emotional impact, anxiety was reported in a number of qualitative studies; patients were anxious about getting sick or when thinking about their future health. The burden of treatment and factors influencing adherence were also discussed in depth. Conclusion Health-related quality of life decreases with age in patients with PCD. For all age groups, PCD was found to greatly impact physical, emotional, social functioning, and treatment burden. More research is needed on the psychosocial impact of the illness, disease burden and its effect on quality of life.

scholarly journals An update review of stem cell applications in burns and wound care

2012 ◽  
Vol 45 (02) ◽  
pp. 229-236 ◽  
Author(s):  
Lin Huang ◽  
Andrew Burd
Keyword(s):  
Stem Cells ◽  
Wound Healing ◽  
Stem Cell ◽  
Cell Therapy ◽  
Stem Cell Therapy ◽  
Medical Technology ◽  
Wound Care ◽  
Therapeutic Strategies ◽  
Wound Management

ABSTRACTThe ultimate goal of the treatment of cutaneous burns and wounds is to restore the damaged skin both structurally and functionally to its original state. Recent research advances have shown the great potential of stem cells in improving the rate and quality of wound healing and regenerating the skin and its appendages. Stem cell-based therapeutic strategies offer new prospects in the medical technology for burns and wounds care. This review seeks to give an updated overview of the applications of stem cell therapy in burns and wound management since our previous review of the "stem cell strategies in burns care".

Financial support systems: the student experience in England and France

2005 ◽  
Vol 32 (1/2) ◽  
pp. 121-132 ◽  
Author(s):  
Susan Curtis ◽  
Rita Klapper
Keyword(s):  
Design Methodology ◽  
Financial Burden ◽  
Content Type ◽  
Financial Status ◽  
Financial Difficulties ◽  
University Life ◽  
The Uk ◽  
English Students ◽  
Practical Implications

PurposeTo investigate how the financial status of students in England and France affects their experience of university life.Design/methodology/approachA questionnaire survey was carried out among undergraduates in two countries. There were 168 responses from students studying at a French university and 325 responses from students studying at an English university.FindingsThe financial burden in France rests with parents, while in England students are largely responsible for their own funding. Indicators suggest that English students may be suffering from financial difficulties. Students continue the tradition of enjoying themselves and socialising, whatever their nationality and financial status.Research limitations/implicationsThe comparison made was not between institutions of equal status. The Institut de Formation Internationale in Rouen is part of a Grande Ecole group which is private, and may attract students from higher income families. The students at Manchester Metropolitan University Cheshire study in a rural locale (the towns of Crewe and Alsager in south Cheshire), which is unusual for a UK university and it may well be that a lower proportion of these undergraduates come from higher income families than the French students.Practical implicationsWhile it would seem to be more equitable and economically efficient for individuals to pay directly for services they receive, rather than those services being funded by higher tax, this study highlights certain problems. The quality of the educational experience for English students may be reduced by their continuing to live at home with parents and carrying out low level work while studying.Originality/valueNo other research appears to have been carried out in the UK or in France on this topic.

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