ABSTRACT
Background - The growing prevalence and incidence of nonhealing acute and chronic wounds is a worrying concern. A major challenge is the lack of united services aimed at addressing the complex needs of individuals with wounds. However, the WHO argues that interprofessional collaboration in education and practice is key to providing the best patient care, enhancing clinical and health-related outcomes and strengthening the health system. It is based on this background that the team approach to wound care project was conceptualised. The project was jointly initiated and realised by the Association for the Advancement of Wound Care (AAWC-USA), the Australian Wound Management Association (AWMA) and the European Wound Management Association (EWMA). Aim - The aim of this project was to develop a universal model for the adoption of a team approach to wound care. Objective The overarching objective of this project was to provide recommendations for implementing a team approach to wound care within all clinical settings and through this to develop a model for advocating the team approach toward decision makers in national government levels. Method An integrative literature review was conducted. Using this knowledge, the authors arrived at a consensus on the most appropriate model to adopt and realise a team approach to wound care. Results - Eighty four articles met the inclusion criteria. Following data extraction, it was evident that none of the articles provided a definition for the terms multidisciplinary, interdisciplinary or transdisciplinary in the context of wound care. Given this lack of clarity within the wound care literature, the authors have here developed a Universal Model for the Team Approach to Wound Care to fill this gap in our current understanding. Conclusion - We advocate that the patient should be at the heart of all decision-making, as working with the Universal Model for the Team Approach to Wound Care begins with the needs of the patient. To facilitate this, we suggest use of a wound navigator who acts as an advocate for the patient. Overall, we feel that the guidance provided within this document serves to illuminate the importance of a team approach to wound care, in addition to providing a clear model on how to achieve such an approach to care. We look forward to gathering evidence of the impact of this model of care on clinical and financial outcomes and will continue to share updates over time.
ABSTRACT
Wound bed preparation is essential for the healing of wounds. The TIME framework (tissue, infection/inflammation, moisture balance, edge of wound) for wound bed preparation shows the importance of debridement in the treatment of chronic wounds. Debridement involves the removal of devitalised tissue from the wound bed. It also facilitates the removal of biofilms-complex microbial communities that are known to contribute to delayed wound healing and chronicity of wounds. Ultrasonic-assisted wound debridement (UAWD) is a lesser known debridement method that uses low-frequency ultrasound waves. There is evidence to show that the three clinical effects of atraumatic selective tissue debridement, wound stimulatory effects and antibacterial activity facilitate early healing of wounds, reducing the cost to the healthcare system and improving the patient's quality of life.
