Wound infection, dressings and pain, is there a relationship in the chronic wound?

In this really interesting study by Keith Cutting et al, the nature of pain, changes in pain and pain associated with infection are the focal points.

Cutting KF, White RJ, Mahoney P. Wound infection, dressings and pain, is there a relationship in the chronic wound? Int Wound J 2012; doi: 10.1111/j.1742-481X.2012.00947.x http://onlinelibrary.wiley.com

http://www.ncbi.nlm.nih.gov/pubmed   Click on either link to get the full paper.

How long should you leave silver wound dressings in place?

How long should you leave silver wound dressings in place and where does the silver go?
Find the answer in this paper by L.J. Wilkinson, R.J. White & J.K. Chipman.
‘Silver and nanoparticles of silver in wound dressings: a review of efficacy and safety.’
Find the article in the Journal of Wound Care 2011 Nov; 20 (11):543-9.
http://www.journalofwoundcare.com/

or on Pub Med
http://www.ncbi.nlm.nih.gov/

More on Incontinence……..

I could find no publications that reported a statistically significant causal link between incontinence and pressure injury (PI) development. An examination of the literature and the risk factors for incontinence, included in many tools reveals the potential  difficulty screening poses for healthcare workers. Most PI risk screening tools, as well as the studies that have reported on  incontinence as a potential risk factor for PU development, [1] do not differentiate between ‘urinary incontinence’ (UI) and ‘faecal incontinence’ (FI), nor between the different types of UI, stress or functional incontinence.[2]

Many assessment tools have combined urinary incontinence and faecal incontinence, into one risk factor, ‘incontinence.’  It is therefore, difficult to objectively assess ‘incontinence’ as a causal risk factor, or an intervening variable coming after a predictive factor, prior to PI development. However bivariate analysis has shown UI to be associated with a significantly higher rate of PI development.[3] Berlowitz (2001) reported continent residents had a higher rate of PI 90 days after the initial screening than those coded as ‘usually continent’ or ‘incontinent’. This prospective study was carried out on 14,607 nursing home residents who were without a Stage 2 PI, or larger, although these Stages were not defined.

[1] Allman RM, Goode PS, Patrick MM, Burst N. & Bartolucci AA.  Pressure ulcer risk factors among hospitalized patients with activity limitation. JAMA 1995; 273(11): 865- 70; Fisher AR, Wells G. & Harrison MB. Factors Associated with Pressure Ulcers in Adults in Acute Care Hospitals. Advances in Skin & Wound Care 2004; 17(2): 80-90; Papanikolaou P. Lyne PA. & Lycett EJ. Pressure ulcer risk screening: application of logistic analysis. J Adv Nurs 2003; 44(2):128-36; Pase MN. Pressure relief devices, risk factors, and development of pressure ulcers in elderly patients with limited mobility. Adv Wound Care 1994; 7: 38–43;  Maklebust J, Siggreen MY. Pressure Ulcers. Guidelines for Prevention and Nursing Management. Springhouse PA: Springhouse Corporation, 1996, 24; Versluysen M. Pressure sores in elderly patients. The epidemiology related to hip operations. J Bone Joint Surg Br 1985; 67(1): 10-3; Brandeis GH, Morris JN, Nash DJ et al. The epidemiology and natural history of pressure ulcers in elderly nursing home residents. JAMA 1990; 264:2905–2909.

Wound Care Consults for your frail aged.

Incontinence causes pressure ulcers…but does it??