Only 6 days to go!

Only 6 days to go before we have our final Holistic Wound Management Course for 2011.  This year is certainly closing fast. Remember to register for the upcoming Eloquent Breakfast on the 23rd of November 2011.

Pressure Ulcers still are a major problem world wide and in South Africa we are not the exception.  A pressure ulcer has been defined by the National Pressure Ulcer Advisory Panel (NPUAP) as any lesion caused by unrelieved pressure that result in damage to underlying tissue.  Even though pressure as external force may be a key causative factor other contributing forces such as moisture, shear, friction, immobility, sensory loss and certain underlying medical conditions cannot be excluded (www.npuap.org).  Below is a table that relates the general principles of pressure ulcer care to the Wound Bed Preparation Recommendation/Guideline that was launched at the Wounds International Conference in February 2011. Always remember to first TREAT THE CAUSE as well as PATIENT CENTRED CONCERNS before you focus on the loca wound care.

GENERAL PRINCIPLES OF PRESSURE ULCER THERAPY	WOUND BED PREPARATION RECOMMENDATIONS
1.       Relieve pressure	Identify & Treat the Cause -          Diagnose and correct or modify treatable cause of tissue damage (No. 2 – Level of Evidence IV)
2.       Eliminate reversible predisposing conditions	Identify & Treat the Cause -           Assess the patient’s ability to heal.  Adequate blood supply must be present as well as the correction of other important host factors to support healing (No.1 – Level of Evidence IV)
3.       Avoid Friction, Shearing & Maceration	Patient Centered Concern -          Assess and support management of patient centered concerns to enable healing (Pain & Quality of life) (No. 3 – Level of Evidence IV)
4.       Debride Devitalized Tissue	Local Wound Care -          Debride healable wounds, removing non-viable, contaminated or infected tissue (No. 6 – Level of Evidence IB)
5.       Provide optimal wound dressing care	Local Wound Care -          Select a dressing that is appropriate for the needs of the wound, the patient and the caregiver or Clinical Setting. (No. 9 – Level of Evidence IV)
6.       Diagnose and treat soft tissue and bone infection	Local Wound Care -          Assess and treat the wound for increased bacterial burden or infection. (No. 8 – Level of Evidence IIa)
7.        Provide appropriate rehabilitation efforts	Patient Centered Concern -          Provide patient education and support to increase adherence to treatment plan (No. 4 – Level of Evidence IV) Provide Organizational Support -          For improved outcomes, education and evidence base must be tied to interprofessional teams with the cooperation of health care systems (No. 12 – Level of Evidence IV)
8.       Perform operative closure, as appropriate	Local Wound Care -          Use active therapies (biological agents, skin grafts, adjunctive therapies) when other factors have been corrected and healing still does not progress. (No. 8 – Level of Evidence IIa)