Wound Healing Southern Africa - Volume 2, Issue 1, 2009
Volume 2, Issue 1, 2009
Author Alan WidgerowSource: Wound Healing Southern Africa 2 (2009)More Less
I recently participated in a symposium / workshop entitled "Wound Care - striving for the balance" where I delivered a lecture with the same title. The topic related to the balance of wound 'preparers' (MMPs) and the wound 'finishers' (growth factors). Much of that talk is included in one of the articles in this edition of WHSA entitled 'Deconstructing the Chronic Wound'.
Author H. RobinsSource: Wound Healing Southern Africa 2, pp 6 –7 (2009)More Less
All too often we are faced with the issues surrounding culture and wounds. Many wound care specialists find that cultural beliefs are almost a barrier to effective management of the wound and interfere with treatment programmes. This article seeks to address some of the issues faced in a multicultural society and discusses possibilities of collaboration and coherence in wound care management.
Author A.D. WidgerowSource: Wound Healing Southern Africa 2, pp 9 –11 (2009)More Less
Chronic wounds have traditionally been defined as those that fail to progress through an orderly and timely sequence of repair, such that healing does not take place in a predictable time frame. More objective definitions of chronic wounds are 'those that have failed to heal within three months'; 'a wound that has not decreased by 30% of its size within four weeks'; 'if a wound is not 30% smaller by week four, it will not heal by week twelve'; and so on. The crux of the matter is that these wounds reach an impasse in their healing progression which is not easily explained and has remained a mystery for decades. On 'deconstructing' the chronic wound phenomenon in recent years, two factors appear to play an increasingly important role in the evolution of chronicity - exaggerated inflammation and allied to that, infection, particularly involving biofilm.
Source: Wound Healing Southern Africa 2, pp 13 –15 (2009)More Less
The wound dressing interface represents the zone of contact between the wound surface and the material applied to it. Professionals choose the right dressing after a clinical wound assessment bearing in mind that the interface is of great importance. Pain management, silver ions or nanodelivered particles, control of exudates and bacteriological balance using antimicrobial materials are all factors impacting on the dressing surface. The dressing interface is so important that some medical materials are specifically designed to relieve pain at dressing change, others to deliver medication continuously, or to increase granulation tissue and enhance the stimulation of fibroblasts. The shape of the dressing, the chemical content and adherence to the tissue are important. Mechanical forces imposed on the wound by the dressing are also relevant, like the foam used in negative pressure therapy.
Author M. MulderSource: Wound Healing Southern Africa 2, pp 17 –20 (2009)More Less
One of the most important principles in the management of wounds is to carry out a comprehensive assessment of a patient with a wound. The following aspects must be taken into account when doing a comprehensive assessment: the general health of the patient as well as social, economic and psychological aspects that may influence wound healing. Naturally the wound must also be thoroughly assessed.
During the assessment all factors that may compromise wound healing must be taken into account and recorded as baseline data. Also assess the patient's ability to heal. It would be ideal to use a standardised assessment instrument that will ensure the systematic collection of data.
Source: Wound Healing Southern Africa 2, pp 22 –26 (2009)More Less
Source: Wound Healing Southern Africa 2, pp 28 –30 (2009)More Less
This case accentuates the need for a multidisciplinary approach to many wound care problems. The diagnosis and treatment of our patients is facilitated by this approach and even then, in some cases the entire team may be stumped - it is therefore wise to include all the relevant team members to aid in the brainstorming process and the ultimate management of the patient. Additionally we need to remember to include the patient as part of the team, as the patient's compliance is essential.
Billing / tariff strategies : managing workman's compensation claims : injury on duty : practice managementSource: Wound Healing Southern Africa 2, pp 31 –32 (2009)More Less
In line with previous articles in this 'billing / tariff strategy' section we highlight the process of billing and discuss the current problems in the South African context. Workman's compensation claims are amongst the most notorious and problematic accounts for timely remuneration. Most service providers have resorted to employing professional agencies to collect funds on their behalf at an enormous cost burden to their practices.