Dressings and Wound Care

Introduction

It is estimated that about 1.5% of the population will have a wound at some point in life. The great majority of the wounds are simple and acute, thus healing without any problem. The remaining are the chronic ulcers, which play a significant impact on patient morbidity and mortality worldwide.

Wound management is very costly to the health system, especially because of the protracted course of the disease and the potential for secondary infections. Although the general annual costs for wound care in the UK have never been quantified, there is an estimative that the NHS expenses with advanced wound dressings alone amounts to £13 million per year. For specific wound groups, it has been reported that the costs associated with leg ulcers range between £300 and £600 million annually, and can reach up to £2.1 billion (or 4% of the annual NHS spend) for pressure ulcers care, with most of the costs related to nursing.

Chronic wound management should be optimised through a comprehensive and individual assessment of both the wound and the patient as a whole. As wound healing is a complex multifactorial sequence of events, primary and secondary health centres are supposed to have trained staff for wounds assessment, ideally composed by a multidisciplinary team (MDT). Each nurse or clinician participating in the wound care team should work within his/her scope of practice.

Aims & objectives

• Help health professionals to approach, evaluate and indicate the initial management for patients with chronic wounds;
• Recognise patients at risk of chronic ulcers in order to implement preventive measures and policies;
• Identify the most common causes of chronic ulcers;
• Recognise and describe the symptoms and clinical signs of chronic wounds of different causes, particularly venous and/or arterial disease, diabetes mellitus and prolonged immobilization;
• Educate patients with chronic wounds on wound care and further preventive measures;
• Indicate the general measures and the most appropriate dressing, when needed, according to the wound clinical features;
• Recognise when to refer a patient with a chronic wound to a specialist.