Managing ulceration and lymphorrhea in chronic oedema.

This clinical review article on the combined use of JOBST FarrowWrap and Cutimed® Sorbion® Sachet XL uses a case study methodology to demonstrate how effective this approach is in managing superficial ulceration and/or lymphorrhea in the presence of chronic oedema and lymphoedema. The blend of these symptoms causes significant physical and psychosocial issues for patients and is highly labour and resource intensive. However, there is often inadequate treatment choice leading to protracted input by nurses and delayed or failed healing.

Venous leg ulceration and graduated compression.

Venous leg ulceration is the most common type of ulceration. Incompetency of the valves in the leg results in raised venous pressure which gives rise to the signs and symptoms of venous hypertension. The application of compression bandage therapy remains the cornerstone of treatment in the healing of venous leg ulceration.

Use of compression hosiery in chronic oedema and lymphoedema.

The management of chronic oedema is a continuing partnership between patient and practitioner and accurate diagnosis and treatment planning are essential to control the condition in order to prevent complications and optimise the patient's quality of life. A paucity of funding, lack of knowledge and confidence on the part of practitioners and widely varying access to services means that many patients face barriers to gaining appropriate treatment. Nurses in many spheres will come across patients with some form of chronic oedema.

Honey in wound care: effects, clinical application and patient benefit.

The use of honey in wound management has enjoyed a resurgence. This is largely due to the growing clinical problem of antibiotic-resistant bacteria and the combined difficulties for the practitioner in managing chronic wound types, such as burns, leg ulcers or surgical wounds, that may become infected, for example, with methicillin-resistant Staphylococcus aureus or Pseudomonas. The associated costs of treating such wounds are escalating as a result.

Assessment and good technique are key to effective compression therapy.

Compression therapy is the standard treatment for patients with uncomplicated venous leg ulcers. It is crucial, however, to undertake a full clinical assessment before initiating treatment, as inappropriate application can be dangerous. The properties and uses of compression are examined alongside its application in clinical practice.

Wound management to encourage granulation and epithelialisation.

Practitioners working in a variety of clinical areas encounter patients with granulating and epithelialising wounds. Successful management relies on an understanding of the underlying physiology of wound healing, comprehensive assessment and appropriate choice of dressing. This paper looks at wound care in epithelialising wounds.

The properties of hydrogel dressings and their impact on wound healing.

In recent decades, the management of difficult wounds has been enhanced by the introduction of amorphous hydrogels. This paper examines reports in the literature on the outcomes of studies into the efficacy of this group of dressings, discusses the types of wounds that are most suitable for hydrogel application and poses questions that merit further investigation.

The impact of prescribing in wound care on nurses and patients.

The extension of independent nurse prescribing has paved the way not only for extending the Nurse Prescribers' Formulary, but also for the expansion of prescribing rights to other groups of practitioners, including tissue viability nurses. Initial evidence suggests that the changes have been a success, but this paper will discuss the implications for nurses and for patients.