Wound Healing Southern Africa - Volume 6, Issue 1, 2013
Volume 6, Issue 1, 2013
Source: Wound Healing Southern Africa 6, pp 8 –11 (2013)More Less
Breaching the skin surface causes pain. Pain evolves via central interpretation of signalling mediators released following a peripheral stimulus. Short-term release of these mediators may aid in wound healing, but extended release may well have detrimental effects thereon. The longer the pain is endured, the more sensitive the patient becomes to the pain stimuli. Additionally, inflammation is increased which delays healing, and fibrosis can result in exaggerated scarring. Thus, while pain control is obviously sought based on compassionate grounds, its impact on healing and scarring may be added reasons to avoid protraction of its occurrence.
Author Bronwyn GreenSource: Wound Healing Southern Africa 6, pp 12 –20 (2013)More Less
Over the last few years, the wound care market has exploded. Numerous technologically advanced dressings have been introduced. In addition, dressings have been designed to treat specific wound aetiologies, e.g. skin substitutes for burns and non-healing recalcitrant ulcers, and protease-modulating dressings to manage the chronic pro-inflammatory wound environment. However, within certain dressing categories there has been a proliferation and duplication of products.
Source: Wound Healing Southern Africa 6, pp 21 –24 (2013)More Less
Objective: The goal of the selective was to gather information on the training received by medical professionals on wound management and treatment during their formal tertiary studies towards the MBChB/MBBCh degree.
Design: A qualitative study was conducted from March 2011 to November 2011.
Setting and subjects: Thirty participants were either interviewed, or asked to complete a questionnaire. Some of the data were quantified to make it more readable.
Results: Eighty-eight per cent of participants stated that "no", "very little" or "minimal'' time is being spent on wound management education during their training. Seventy-seven per cent of medical practitioners felt uncertain about what wound care treatment should be prescribed, and 97% of medical practitioners said that wound care education was very important and that more training should be provided in this field.
Conclusion: The care of wounds is often a nursing staff responsibility. According to the scope of practice of nurses, the medical practitioner's prescription should be followed. If the incorrect prescription is given, the nurses will not provide the correct wound care treatment. Therefore, it is imperative that medical professionals are educated in available scientific wound assessment and treatment options to be able to correctly prescribe a wound care regime to a given patient. Future medical practitioners should be equipped, through education, with the scientific knowledge and art of advanced wound care practices in order to provide the best treatment recommendations and care for patients.
Dog bites and human rabies in the Uthungulu District of KwaZulu-Natal province, 2008-2010 : a review of surveillance data : original researchAuthor Lazarus R. KuonzaSource: Wound Healing Southern Africa 6, pp 33 –40 (2013)More Less
The Uthungulu District in KwaZulu-Natal province is the area that is most affected by rabies in South Africa. Usually, the transmission of rabies to humans occurs through the bites of infected dogs. In 2008, Uthungulu commenced a programme to eliminate human rabies in the district. This paper describes the epidemiology of dog bites and human rabies in the Uthungulu District from 2008-2010, and the extent of adherence to rabies post-exposure prophylaxis (PEP). The method was a retrospective analysis of dog-bite and human rabies surveillance data that were collected in Uthungulu from January 2008-December 2010. Dog-bite injuries in Uthungulu increased from 1 176 in 2008 to 2 365 in 2009, and decreased to 1 598 in 2010. Of 2 601 patients who were offered rabies PEP in 2009 and 2010, 83.7% [95% confidence interval (CI): 82.4-85.2] completed the treatment. Logistic regression analysis found that investigation of the report by an environmental healthcare practitioner [odds ratio (OR) = 3.95; 95% CI: 2.43-6.43, p-value = 0 .0001], the availability of patient telephone contact details in the healthcare facility's records (OR = 1.76; 95% CI: 1.02-3.03, p-value = 0.041), and bite wounds that were classified as Category 3 exposure injuries (OR = 2.96; 95% CI: 1.39-6.29, p-value = 0.004), were independently associated with completion of rabies PEP. Seven human rabies cases were reported (four in 2008, two in 2009 and one in 2010). Annualised human rabies incidence rates decreased from four cases per million in 2008 to one case per million in 2010. The findings suggest that the rabies elimination initiative is having an impact on the reduction of the incidence of human rabies in Uthungulu. The district should strengthen the follow-up of people who are exposed to rabies to ensure PEP completion.
Source: Wound Healing Southern Africa 6, pp 36 –38 (2013)More Less
Dog bites are a poorly understood and complex public health problem. Children are most frequently the victims of dog bites and the face is often the favoured target. A review of dog bite wounds in small children presenting to the Red Cross War Memorial Children's Hospital was carried out over a period of 13.5 years (1991-2004). One thousand eight hundred and seventy-one dog bite wounds were admitted from a total of 125,677 patients treated. From 1,871 patients presenting with dog bite injuries, we identified 596 children who sustained injuries to the head, face or neck. Dog bites to the head, face or neck were responsible for 0.5% of all trauma unit presentations and 32% of all dog bite injuries. The mean age of the children was 5.1 years. Male children accounted for 68% of the patients. The peak incidence was noted in children aged 2 to 4 years old. One hundred and seventy-two (29%) bites occurred between the summer months of December and February. Two hundred and forty-nine (42%) patients presented to hospital between the hours of 12:00 and 18:00 hours and 275 (46%) children presented between 18:00 and 0:00 hours. A large proportion of all attacks occurred either inside or outside the victim's own home and at the home of friends or family. Superficial injuries were treated with wound cleaning, suturing and dressing. There were no fatalities. Dog bites are relatively common in small children, but do not represent a major cause of morbidity and mortality.
Source: Wound Healing Southern Africa 6, pp 37 –40 (2013)More Less
A dialkylcarbamoylchloride-coated dressing was assessed for its ability to manage or prevent infection - and promote healing - in a case series of diabetic foot ulcers. Target ulcers were treated with good traditional wound care and dressed with the test dressing for a period of up to 4 weeks. Reductions in the number and severity of the symptoms and signs of infection were seen in the large majority of ulcers, and wound size decreased in all, during the study period. A larger clinical trial is required to confirm these findings.