Undertaking a structured assessment of a hard-to-heal wound.

A thorough, holistic wound assessment is essential to identify the aetiology of a hard-to-heal wound and formulate a diagnosis, which will underpin the treatment plan. This article describes the fundamental elements of assessing a patient with a hard-to-heal wound holistically, including taking a patient history, performing a clinical examination and investigations, and considering the patient's physical, psychological, spiritual and social needs. The author also outlines the aspects of the TIMERS (tissue, infection/inflammation, moisture, edge, regeneration and social factors) wound assessment tool in detail, and explains some of the challenges associated with accurately assessing a wound.

Application of Novosorb biodegradable temporising matrix in wounds of different aetiologies: a case series.

The authors have no conflicts of interest to declare.

Necrotising fasciitis in the COVID-19 era: A consequence of caution - A case series.

Necrotising fasciitis (NF) is a severe soft tissue infection that is associated with a high risk of morbidity and mortality. During the coronavirus disease 19 (COVID-19) pandemic, the population has been actively discouraged from presenting to emergency medical services unless absolutely necessary. While this was an important step in allowing for preservation of limited resources in a time of crisis, it may have resulted in immeasurable 'secondary victims' of the pandemic as patients with time-critical conditions delay hospital presentation.

A Clinical Program for Transgender and Gender-Diverse Neurodiverse/Autistic Adolescents Developed through Community-Based Participatory Design.

: A series of studies report elevated rates of autism and autistic characteristics among gender-diverse youth seeking gender services. Although youth with the co-occurrence present with complex care needs, existing studies have focused on co-occurrence rates. Further, clinical commentaries have emphasized provider-centered interpretations of clinical needs rather than key stakeholder-driven clinical approaches.

Initial Clinical Guidelines for Co-Occurring Autism Spectrum Disorder and Gender Dysphoria or Incongruence in Adolescents.

Evidence indicates an overrepresentation of youth with co-occurring autism spectrum disorders (ASD) and gender dysphoria (GD). The clinical assessment and treatment of adolescents with this co-occurrence is often complex, related to the developmental aspects of ASD. There are no guidelines for clinical care when ASD and GD co-occur; however, there are clinicians and researchers experienced in this co-occurrence.

A VLU complicated by severe group a streptococcal infection resulting in necrotising fasciitis and septic shock: a case report.

This case study outlines the management of a patient with a venous leg ulcer whose swabs cultured Staphylococcus aureus and beta-haemolytic streptococcus group A while in hospital with cellulitis, which was treated with antibiotics as per sensitivities. However, the patient presented at the emergency department five weeks later with a diagnosis of invasive group A streptococcal disease resulting in necrotising fasciitis and streptococcal toxic shock syndrome. This paper describes the holistic care and wound management that the patient received.

Increased gender variance in autism spectrum disorders and attention deficit hyperactivity disorder.

Evidence suggests over-representation of autism spectrum disorders (ASDs) and behavioral difficulties among people referred for gender issues, but rates of the wish to be the other gender (gender variance) among different neurodevelopmental disorders are unknown. This chart review study explored rates of gender variance as reported by parents on the Child Behavior Checklist (CBCL) in children with different neurodevelopmental disorders: ASD (N = 147, 24 females and 123 males), attention deficit hyperactivity disorder (ADHD; N = 126, 38 females and 88 males), or a medical neurodevelopmental disorder (N = 116, 57 females and 59 males), were compared with two non-referred groups [control sample (N = 165, 61 females and 104 males) and non-referred participants in the CBCL standardization sample (N = 1,605, 754 females and 851 males)]. Significantly greater proportions of participants with ASD (5.

Conservative management of mesh-site infection in hernia repair surgery: a case series.

Purpose: The aim of this study is to assess the outcome of conservative management of infected mesh grafts following abdominal wall hernia repair.

Methods: This study retrospectively examined the charts of patients who developed mesh-site infection following surgery for abdominal hernia repair to determine how effective conservative management in the form of antibiotics and wound management was on the resolution of infection and wound healing.

Results: Over a period of 30 months, 13 patients developed infected mesh grafts post-hernia repair surgery.

Randomised controlled trial comparing European standard class 1 to class 2 compression stockings for ulcer recurrence and patient compliance.

The aim of this study was to determine the rate of venous ulcer recurrence and the level of compliance in patients wearing European class 1 or class 2 compression stockings. A total of 100 patients with healed venous leg ulcers were recruited, and were randomised to either class 1 (n = 50) or class 2 (n = 50) compression stockings. Follow-up was at 1 week, 3, 6, 9 and 12 months to monitor ulcer recurrence and compliance.

An experimental study of prescribed walking in the management of venous leg ulcers.

Objective: To determine the relationship between the level of patient activity in the form of walking and the rate of venous leg ulcer (VLU) healing.

Method: Forty patients with newly diagnosed VLUs were recruited to the study a nd randomly allocated to either control or exercise groups. All patients were treated with multilayer compression bandaging for 12 weeks, or until their ulcer had fully healed.

Mobility in patients with venous leg ulceration.

Objectives: To compare mobility in patients with venous leg ulcers to matched controls and determine the influence of mobility, age and ulcer size on ulcer healing.

Methods: 25 leg ulcer patients, and 25 matched controls wore a mobility monitor (ActivPAL, PAL Technologies Ltd, Glasgow, Scotland)) which recorded the number of steps and amount of time spent walking, standing, sitting or lying for a one-week period. A walking index was calculated.