National best practice and evidence based guidelines for wound ...

On Society
The loss to society due to individuals being unable to engage in their normal activities is hard to quantify.
Loss of time from work for the individual and their carer can have financial implications. Feelings of
social isolation, anxiety and depression have potential to reduce the contribution the individual makes to
society, whether is at a local or national level. It has been reported that problematic wounds frequently
result in a loss of productivity; extended hospital stays and increased expenditure (Zhan and Miller, 2003;
Tennevall et al., 2005).
The need for guidelines
Clinical practice guidelines have been broadly defined as ”providing guidance in decision making at
each level of interaction; between health professional and consumer, between purchaser and provider, and
between ‘funder’ and ‘purchaser’’. (http://www.nzgg.org.nz). There are five different types of guidelines
but those related to best practice are defined as ‘systematically developed statements to assist practitioner
and consumer decisions about appropriate health or disability care for specific circumstances, taking into
account evidence for effectiveness and competing claims, and form a fundamental basis for planning’ (NZGG
2001). The HSE hopes that these National wound management guidelines will assist professionals in the
decision making process as they are based on the most current and best available evidence and aim to
bring consistency to the provision of wound care in Ireland.
The provision of wound care falls within the remit of a wide range of disciplines. The knowledge, skills,
and understanding of each of these disciplines can vary, and may depend on the type and frequency
of the wound aetiology encountered and the level of expertise available. There is a growing body of
evidence that a structured, organised and planned approach to wound management whether for
specific wound aetiologies or for wounds in general improves patient outcomes and is cost effective for
the health service.
It is anticipated that these guidelines will promote and enhance evidence based practice in wound care
in Ireland. In addition, the provision of an audit tool should help to provide evidence to support the
use of the guidelines as services and professionals can assess wound care management practices and
patient outcomes against defined standards of care.
Limitations of these guidelines
These guidelines have been developed following systematic search of the literature together with a
review of current published guidelines using the AGREE guidelines review tool. They represent best
practice as it relates to current knowledge. It is anticipated that as new information becomes available
that some aspects of these guidelines will no longer be valid and will require updating.
Some specific wound aetiologies such as burns and malignant wounds are frequently managed in
specialist centres and thus are not included here.
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