METHOD: Post-basic students (staff nurses and medical assistants) were given real life pictures showing the wound and periwound area. The students were asked to classify all pictures according to the HPSC at zero months (before attachment) and after two months of attachment. The images were the same but the answers were never given or discussed after the first test.
RESULTS: A total of 30 post-basic students participated in the study, assessing wound 30 images. The results showed that there was an increase of 25.42% in accuracy of wound assessment using the HSPC after two months of clinical attachment compared to pre-attachment. The reliability of the HPSC in wound assessment 79.87%.
CONCLUSION: Health professionals have to be able to assess and classify wounds accurately to be able to manage them accordingly. Assessment and classifications of the periwound skin are important and need to be validated and integrated as a part of a full wound assessment. With experience and adequate training, health professionals are able to comprehensively assess wounds using the validated tool, to enable effective wound management and treatment, accelerating wound healing and improving the quality of life for patients.
METHOD: A literature search of PubMed, Cochrane Library and Google Scholar was conducted based on the PICO model (patient/population, intervention, comparison and outcomes) to retrieve publications of different levels of evidence in order to evaluate outcomes of the use of TLC-NOSF dressings.
RESULTS: A total of 21 publications of different levels, ranging from double-blind randomised control trials to case reports, involving over 12,000 patients, were identified through PubMed, with a further eight publications through Google Scholar and two publications through Cochrane Library. A total of seven results were omitted due to the lack of relevance or repetition.
CONCLUSION: All the evidence provided suggest that these dressings provide clinicians with an evidence-based option for the management of chronic wounds; that the TLC-NOSF dressings are beneficial in promoting the healing process, reducing healing times, enhancing patients' HRQoL, and in allowing a more cost-effective procedure.
METHOD: Eligible patients with chronic wounds were enrolled between March and June 2016, from the Wound Care Unit, Hospital Kuala Lumpur in this consecutive case series. Standard wound care was performed with microcurrent as an adjunct therapy. Each patient was treated with an anti-inflammatory frequency, followed by a vasodilation frequency, while having their wounds cleansed during each dressing change. Patients were loaned a home-microcurrent device to treat themselves three times daily using a tissue repair frequency for four weeks.
RESULTS: A total of 100 patients with chronic wounds, such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers, were recruited. During the four-week treatment period, all patients had a reduction in wound size, with 16 having complete wound closure. All 89 of the 100 patients who complained of pain, associated with their wound, experienced reduced pain scores, with 11 being pain-free at the end of the four-week period. There was significant reduction (p<0.001) in both mean pain score and mean wound area during the treatment period, as well as improvements in other parameters, such as reduction in inflammatory symptoms (leg swelling, foot stiffness), increased vasodilation (skin discolouration, leg heaviness, early morning erection, sensation), improvement in sleep quality, gait, and frequency of bowel movement. No adverse events were reported.
CONCLUSION: The results of this study show there was significant reduction in wound area and pain score during the treatment period. The ease of use of microcurrent devices would advocate its use in accelerating wound healing.
METHOD: Patients with DFUs were selected randomly. Wound size, appearance and presence of infection were recorded at each dressing change.
RESULTS: We assessed five patients in this case series. The use of both nano-colloidal silver and chitosan biopolymer dressings aided wound healing. The patients did not require surgical debridement or amputation. All five cases in this study had a slow healing rate at presentation.
CONCLUSION: Applications of nano-colloidal silver in conjunction with chitosan bioactive as primary dressings in managing DFUs cases are safe and help increase wound healing rates, thus, leading to significant cost savings in the hospital setting.
METHOD: Wounds were cleansed and debrided before using the application to photograph, document, measure and analyse the wounds. The smartphone app was oriented parallel to the plane of the wound, where possible, to obtain accurate measurements. A longitudinal study report was generated for each wound and showed the progress of the wound healing until the wound was closed.
RESULTS: A sample size of 60 patients consisting of wounds from different locations, and a total of 203 measurements and analyses were conducted over a period of seven months. The wound monitoring app proved to be effective for wound monitoring and required less than two hours' training. A report summary of wounds recorded could also be generated automatically through the dashboard. All 60 patients' cases were automatically recorded, measured and presented into reports for use in clinical analysis. There was a significant time savings (27 hours per day for a specialised care centre with 10 nurses) increase over manual wound documentation and measuring methods.
CONCLUSION: The app provided a non-contact, easy to use, reliable and accurate smart wound management solution for clinicians and physicians to track wound healing in patients. The app could also be used by patients and caregivers for home monitoring of their wounds.
CASES: Case 1, a 74-year-old diabetic female was treated for bilateral VLUs with micropore dressing for several months, which she noted to be painless and convenient. Case 2, a 49-year-old housewife with a solitary VLU was treated with micropore dressing, leading to good treatment results and high satisfaction.
CONCLUSION: VLUs managed by the micropore dressing resulted in reduced pain and ease of use during dressing changes, as well as noticeable reduction in wound and periwound area maceration. The use of this type of dressing in these cases shows encouraging results and provides a desirable management option. More robust clinical studies are necessary to establish this.
METHOD:: The retrospective study was performed in a referral wound care clinic in Hospital Kuala Lumpur. Data was collected from January 2014 to October 2016 on DFU patients who attended this clinic.
RESULTS:: Of the 340 patients (216 male and 124 female) DFU patients who attended the clinic (mean age: 58.1±10.8 years old), 41.5% presented with infection with a mean cross-sectional ulcer area of 21.5±33.2cm2. Binary logistic regression analysis revealed that patients of Chinese ethnicity (OR: 3.39; 95%CI 1.49 to 7.70), with fasting blood glucose ≥7mmol/l (OR: 3.41; 95%CI 1.57 to 7.39), ulcer size ≥10cm2 (OR: 2.90; 95%CI 1.45 to 5.82) and blood pressure ≥140/90mmHg (OR: 2.52; 95%CI 1.54 to 4.14) were more likely to develop DFI. The median healing time for patients with DFUs was three months. There were six variables identified as significantly associated with prolonged healing time of DFU, namely presence of infection (p<0.001), poor glycaemic control with fasting blood glucose ≥7mmol/l (p<0.001), high blood pressure ≥140/90mmHg (p<0.001), large DFU size ≥2cm2 (p<0.001), history of amputation (p<0.005) and plantar location of the DFU (p<0.05).
CONCLUSION:: Large DFU size, poor glycaemic and blood pressure control are common risk factors for both DFU and DFI. Unexpected high prevalence and ethnicity risk factor for DFI urge more comprehensive primary and secondary preventative strategies to reduce its incidence.