In my own clinical practice I regularly encounter individuals who have leg ulcers whilst concurrently having complex comorbidities. These types of wounds are very prone to polymicrobial infections and biofilms. In the past 6 months I have looked after numerous patients who have benefited from the process
I have come to realise that a chronic wound is skin in organ failure. As with all other organs the key is to determine whether the failure is reversible or not. Once known then the clinician and patient can design an intervention to address the
A recent report on ABC News described a current case of Necrotising Fasciitis in Victoria, Australia. This is a timely reminder to health care clinicians to be mindful of the etiology and presentation of this rare but devastating infection. https://www.cdc.gov/features/necrotizingfasciitis/index.html
http://www.smith-nephew.com/news-and-media/media-releases/news/smith-nephew-signs-exclusive-worldwide-distribution-agreement-for-the-revolutionary-moleculight-ixtm-imaging-device/ Point of care technologies which make a real time difference to clinical decisions are a holy grail which is gradually being realised.
Until recently I had never heard of Podoconiosis. It presents in a very similar fashion to the better known Elephantitis or Filariasis, which produces chronic oedema with its accompanying skin changes and limb deformity. Filariasis is mosquito bourne and involves the habitation of a round
Gary Sibbald and James Elliott eloquently describe their clinical mantra for treating a patient with neuropathic foot ulceration. They refer to the process as the "VIPs of care". V = ensuring an adequate vascular supply. Examine pulses, systolic arterial pressures (including in the great toe) and
Smoking Drugs - opioids, steroids, anticoaggulants, illicit Diabetes Obesity (BMI >40 there is a 51% chance of infection within 6 weeks of the surgery) Pre-eclampsia Prior C-section Poor nutrition Ischaemia (normally intra, peri and post-op) Retained foreign bodies - sutures, clips, drains, dressing materials
A Turkish report states that up to 40% of long term condom catheter (urodome) users will develop a UTI. As many as 15% will experience skin injuries including inflammation, ulceration and necrosis. Ozkan,HS; Irkoren,S; Sivrioglu,N Penile strangulation and necrosis due to condom catheter. Int Wound J 2015;12:248-249
A/Prof Geoff Sussman's excellent presentation at the 2016 Wounds Australia Conference has been reproduced in the December 2016 edition of Wound Practice and Research. Geoff discusses the matter of antimicrobial resistance and he reaffirms the WHO 2014 statement that
Are we back to fighting off microbial communities in wounds using "old time" remedies like salt, sugar, honey, garlic, vinegar and tea-tree oil? Now add some peptides from Tasmanian Devil milk and Nature has given us another string to the antibiotic-resistant bug killing bow. "There is nothing