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

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ISBN 978-1-906218-29-4 © Health Service Executive October 2009 Health Service Executive, Dr. Steevens’ Hospital, Dublin 8 Ireland Phone +353 1 6352000 http://www.hse.ie
Foreword The development of HSE national guidelines for wound management are designed to support the standardisation of care and encourage best clinical practice. These guidelines constitute a general guide to be followed, subject to the medical practioners judgement in each individual case. These guidelines are based upon up to date scientific evidence and expert opinion and will serve to support consistency of treatment and contribute to improved patient outcomes. It is estimated that 1.5% of the population are affected by a wound at any one point in time. Wounds have a major personal, social, and economic impact. Wounds not only impact on the individual and their quality of life, they also have a significant impact on our health service and our society as a whole. Studies in the UK indicate that up to 4% of total health care expenditure is spent on the provision of wound management while in Ireland it is estimated that two thirds of community nursing time is spent on the provision of wound management. As part of the HSE efforts to improve healthcare, it is hoped that these national guidelines will assist all clinicians in the decision making process and help to standardise the management of wounds at primary, secondary and tertiary levels. The availability of national guidelines will also provide guidance to policy makers. Healthcare is an ever changing science and advances and new developments in wound care will continue to take place. Thus, revision of these guidelines will be necessary as new knowledge is gained. The HSE wish to sincerely express their gratitude to those who reviewed the guidelines and in particular to the guidelines development group as this work, for some members, was performed on an honorary basis and in addition to their usual work commitments. ________________ Dr Barry White National Director Clinical and Quality Care. 1
Page 1: National best practice and evidence
Page 5 and 6: The management of diabetic foot dis
Page 7 and 8: These guidelines have been endorsed
Page 9 and 10: Section 3 - Clinical Guidelines 25-
Page 11 and 12: Section 4 References and Appendices
Page 13 and 14: SECTION 1: Background and Justifica
Page 15 and 16: anked operations of the skin and su
Page 17 and 18: The number of adults diagnosed with
Page 19 and 20: On Society The loss to society due
Page 21 and 22: 1.3 Terms of Reference ● To ensur
Page 23 and 24: SECTION 2: Methodology 21
Page 25 and 26: 2.2 Outline of the grading method u
Page 27 and 28: SECTION 3: Clinical Guidelines 25
Page 29 and 30: 3.2 Principles of Wound Management
Page 31 and 32: Wound Dressings ● The integrity o
Page 33 and 34: ● Removal of devitalised tissue c
Page 35 and 36: 3.4 Guidelines for management of ar
Page 37 and 38: 3.5 Guidelines for the prevention a
Page 39 and 40: Table 10: Patient Education Inspect
Page 41 and 42: Evaluation ● If one or more pedal
Page 43 and 44: ● Alteration in skin condition in
Page 45 and 46: 3.7 Repositioning for the Preventio
Page 47 and 48: 3.8 Support Surfaces General Statem
Page 49 and 50: SECTION 4: References and Appendice
Page 51 and 52: Graham, I.D., Harrison, M.B., Nelso
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Appendices 1. Glossary of Terms 2.
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● Bulla/Bullae: Another term for
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● Granulation: During the prolife
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● Periwound: The area immediately
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Appendix 2: Examples of Wound Asses
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date odour None on dressing change
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Anatomical chart Please mark the ar
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Date WOUND DIMENSIONS Max. length m
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Date Time THE ADELAIDE & MEATH HOSP
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BRADEN SCALE FOR PREDICTING PRESSUR
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I need permission for: Name: Title:
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BAPEN 'Malnutrition Universal Scree
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BAPEN Weight before weight loss (kg
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BAPEN Advancing Clinical Nutrition
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AUDIT TOOL for NATIONAL WOUND MANAG
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Objective Statement 4 identify shor
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Objective Statement 10 identify sho
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Treatment Statement 16 in persons a
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Objectives Statement 23 the use of
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