23 March 2023

There is currently a barrier in our wound care service provision that doesn’t allow accessible wound care services to all. People that live a challenging lifestyle find it hard to engage with the rigidness of a mainstream service. To combat this I proposed that the Tissue Viability (TV) team offer a six-month pilot study working closely with the health improvement nurses. The clinic operates as a drop-in system, no appointment needed, to encourage better engagement and a chance to build a workable rapport. In July 2022 we commenced our clinics in two localities across Derbyshire.

23 March 2023

• Increasing number of referrals made to the Lancashire & South Cumbria NHS Foundation Trust ( LSCFT tissue viability team for patients with, or at risk of, pressure damage, who choose to smoke in bed. 
• Smoking cessation advice is offered as part of making every contact count 1 , however some patients choose to continue to smoke. 
• Due to significant fire risk, dynamic, alternating cell mattresses are not appropriate for use as the fire from cigarettes can potentially breach the outer cover and ignite the pumped air source.
• A fatal incident within the Trust in 2013 and subsequent MHRA alert highlighted the danger of this.
• Prior to this trial, a static air overlay was used on top of a foam mattress.

23 March 2023

• 3.8 million patients had a wound managed by the NHS in 2017/18.
• The cost to the NHS associated with wound management was £8.3 billion, with two thirds of this spend incurred in the community setting. 1
• In December 2021, the five Tissue Viability (TV) teams from within the Lancashire & South Cumbria Integrated Care Board (ICB) were approached to undertake a pilot project with NHS Supply Chain, in partnership with procurement colleagues.

23 March 2023

Negative pressure wound therapy has seen many new advances within the last few years. One of these being the use of single use NPWT units using disposable AA batteries. The impact of the disposable units upon our carbon footprint is affected by plastic waste and single use batteries, used by many of these units. Typically, the units are disposed of after 7/14/30 days use, through the clinical waste route, with components e.g. dressings being disposed of more frequently. Extended sustainability commitments laid out in the NHS Long Term Plan, range from reducing plastics and water consumption, through to improving air quality and a net zero carbon commitment. Medical waste disposal is costly and impacts upon the annual budgets of health care providers and has an environmental impact, any initiative to reduce waste within the NHS is aligned with the NHS plan. Disposing of batteries poses a particular challenge as these cannot be burned and should be disposed of by specialist companies. 
Most single use disposable NPWT units contain large amounts of plastic, which take centuries to break down. AA batteries are often found in land fill, and this leads to leaching of multiple chemicals into the ground causing catastrophic damage to the environment. 

23 March 2023

The National Wound Care strategy has recommended the use of digital technology to support clinicians working directly with patients and their wounds. As a trust we were eager to implement these recommendations alongside implementing the best practice pathways and began with exploring the use of an application on a mobile phone that the community  nursing teams could use to assess monitor and track wounds trajectory.

23 March 2023

End stage kidney disease (ESKD) is a total or near-permanent failure in renal function. It is irreversible, progressive and ultimately fatal without peritoneal dialysis (PD), haemodialysis (HD) or kidney transplantation.
Dialysis treatments can create new and additional problems for patients, one of which is foot amputation, as a result of non-healing wounds and vascular complications.

23 March 2023

Actively involving patients in their own care is a key aim of healthcare provision [Coulter, 2008]. The SARSCoV-2 pandemic increased the need for many patients to become
more actively involved in their own management, including wound care. A significant decrease in community nursing visits, limited outpatient appointments and few face-toface
appointments accelerated this change, [Blackburn, 2021].

23 March 2023

The mode of action for commercial wound dressings may aim to physically remove bacterial load from a wound through attachment to a dressing surface. Analysing transcription of key genes involved with the attachment process alongside bacterial quantification can aid in the understanding of dressing mode of action.

23 March 2023

In order to reduce Surgical Site Infections (SSI) and SSI readmission rates, improve the patient experience and reduce costs in accordance with the value-based healthcare principle1, Barking, Havering & Redbridge University Hospitals NHS Trust (BHRUT) maternity unit adopted the National Institute for Health and Care Excellence (NICE) guidance MTG55. We replaced an inert wound dressing with Leukomed® Sorbact® (Essity) a single-use, bacteria-binding dressing for all patients with closed caesarean wounds.

23 March 2023

Mr C is a 50 year old gentleman who sustained trauma to his right calcanium when falling off a ladder in 2017. This injury resulted in extensive surgery to his left foot, by the orthopaedic and plastic surgeons, resultant in muscle bulking which is planned for future surgery. The devastating effects of this injury were not only physical but psychological as the strain on both him and his family left a feeling of low mood and the inability to work. Mr C had been referred to a number of speciality consultants where no communication between these specialities had occurred, causing him both frustration and a feeling of little hope that his wound would heal.