1. Jeannie Randles RN Grad cert wound care PG Cert & PG Dip Primary Health

3.  Patient outcomes  Wound outcomes  Cleansing  Products  On going assessment  documentation

4.  Work in partnership  Expectations  General health  Palliative wound care  Curative wound care

5.  To heal  palliative  To treat infection  To reduce exudates  To protect  Remove Escher  To create wound healing environment  To control odour  To control pain

6.  Devitalised tissue  Slough  Escher  Dry/wet  Granulation  Epithelial islands  Bacterial burden

8.  Moisture balance  Too wet? (macerated)  Too dry? (desiccated)  Moist healing required?

9.  What is happening at the margins  Rolled  Epethelialising  Granulating  Punched out  undermining

10.  Consider why cleansing is required  How to cleanse i.e. aseptic or clean  Products used to cleanse  Temperature of cleansing fluid  Environment patient is in

11.  Think about goal  Debriding  Protection  Pressure  Pressure relief  Moisture control  Bacterial control

12.  Example above is allevyn non adhesive  Variety of dressings available for use with low to heavily exudating wounds  Available with antimicrobial additives  Check absorption of dressing

13.  Inadine  Iodosorb  AG dressings  Honey  Polyhexamethylene biguanide

14.  Used to protect  Waterproof  Avoid multiple layers  Used to secure primary dressings  Monitor for folliculitis  Damaged skin easy to monitor

15.  Vertical wicking  Moderate to heavy exudating wounds  Protects periwound  Available added to waterproof backings  Available as antimicrobial

16.  Seaweed dressing  Haemostatic  Available in sheets or ropes  Available with antimicrobial addition  Moderate to heavy exudating wounds  Horizontal wicking properties

17.  Occlusive dressing creating bacterial and viral barrier  Maintains moisture preventing desiccation  Patient can shower  Pain reduction due to moist environment

18.  Comfort  Absorption  Compression  Cosmetic appearance  Compliance  Hygiene

19.  Compression  Pressure relief  Medication  Psychological support  Education  Financial support

20.  73 year old female  Congestive heart failure  COPD  Diabetic  Venous hypertension  Ulcer present 6 weeks  Now necrotic

21.  63 year old male  Dementia  Smoker 10/day  Dietary intake poor  #patella after fall  Developed pressure ulcer to heal whilst in hospital

22.  34 year old female  Depression  Lichen planus (inflammatory condition)  Oedema to lower limb

23.  Think about goal of care  Tissue  Infection or inflammation  Moisture control  Edges or epithelialisation  Document

24.  Hard-to-heal wounds: a holistic approach (May 2008) Hard-to-heal wounds: a holistic approach (May 2008)  Topical negative pressure in wound management (May 2007) Topical negative pressure in wound management (May 2007)  Management of wound infection (spring 2006) Management of wound infection (spring 2006)  Identifying criteria for wound infection (fall 2005) Identifying criteria for wound infection (fall 2005)  Focus Document: Lymphoedema bandaging in practice (fall 2005) Focus Document: Lymphoedema bandaging in practice (fall 2005)  Wound bed preparation in practice (spring 2004) Wound bed preparation in practice (spring 2004)  Understanding compression therapy (spring 2003) Understanding compression therapy (spring 2003)  Pain at wound dressing changes (spring 2002) Pain at wound dressing changes (spring 2002)

25.  ewma.org/english/ position - documents.html  www.awma.com.au www.awma.com.au  www.worldwide wounds.com www.worldwide wounds.com  www. wounds international.com  Wound care education resources  Also remember courses at CPIT include wound assessment and management courses!  www. wounds -uk.com/pdf/content_9364.pdf