ABSTRACT
GENERAL PURPOSE: To review a practical and scientifically sound application of the wound bed preparation model for communities without ideal resources. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Summarize issues related to wound assessment.2. Identify a class of drugs for the treatment of type II diabetes mellitus that has been shown to improve glycemia, nephroprotection, and cardiovascular outcomes.3. Synthesize strategies for wound management, including treatment in resource-limited settings.4. Specify the target time for edge advancement in chronic, healable wounds.
Chronic wound management in low-resource settings deserves special attention. Rural or underresourced settings (ie, those with limited basic needs/healthcare supplies and inconsistent availability of interprofessional team members) may not have the capacity to apply or duplicate best practices from urban or abundantly-resourced settings. The authors linked world expertise to develop a practical and scientifically sound application of the wound bed preparation model for communities without ideal resources. A group of 41 wound experts from 15 countries reached a consensus on wound bed preparation in resource-limited settings. Each statement of 10 key concepts (32 substatements) reached more than 88% consensus. The consensus statements and rationales can guide clinical practice and research for practitioners in low-resource settings. These concepts should prompt ongoing innovation to improve patient outcomes and healthcare system efficiency for all persons with foot ulcers, especially persons with diabetes.
Subject(s)
Diabetes Mellitus, Type 2 , Diabetic Foot , Foot Ulcer , Humans , Delphi Technique , Diabetes Mellitus, Type 2/therapy , Diabetic Foot/diagnosis , Diabetic Foot/therapy , Resource-Limited SettingsABSTRACT
Nonhealing wounds (stalled, healable) challenge affected individuals, wound clinicians, and society. Nonhealing may result despite local factors being corrected. The interplay between tissue degradation, increased inflammatory response, and abundant protease activity is a challenging quandary. A modified Delphi process was utilized to investigate a protease activity test and practice implications.
Subject(s)
Diagnostic Tests, Routine/instrumentation , Peptide Hydrolases/analysis , Point-of-Care Systems , Wounds and Injuries/diagnosis , Algorithms , Canada , Consensus , Delphi Technique , Diagnostic Tests, Routine/methods , Humans , Inflammation/diagnosis , Inflammation/enzymology , Inflammation/pathology , Peptide Hydrolases/metabolism , Time Factors , Wound Healing , Wounds and Injuries/metabolism , Wounds and Injuries/pathologyABSTRACT
PURPOSE: To provide the wound care practitioner with a review of the assessment and management of chronic wound infection. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES: After reading this article and taking this test, the reader should be able to: 1. Discuss the etiology of chronic wounds. 2. Describe the agents used for the treatment of chronic wound infections.
