Best Practice Recommendations for Preparing the Wound Bed

Sibbald, R. Gary; Orsted, Heather L.; Coutts, Patricia; Keast, David

doi:10.1097/01.asw.0000280200.65883.fd

Cited by 74 publications

(48 citation statements)

References 19 publications

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“…Although it is widely acknowledged that debridement is a key element in wound healing, [11][12][13] there are a few controlled studies showing the benefit of wound debridement. 4,5,10,11,14,[16][17][18][19] Unfortunately, there is no standard tool to assess the surface of different tissue types within wounds, hence, preventing efficient wound debridement and healing monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…Although wound debridement is now established in the best practice recommendations for preparing the wound bed, [11][12][13] the measurement methods are poorly evaluated. 4,5,14 This study aimed at comparing the reproducibility and the repeatability of fibrin measurement using three wound measurement techniques including visual analysis, a computerized planimetry software Canvas s , and a portable wound measurement system (PWMS) Visitrak s .…”

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confidence: 99%

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Wound debridement: Comparative reliability of three methods for measuring fibrin percentage in chronic wounds

Laplaud¹,

Blaizot

Gaillard

et al. 2010

Wound Repair and Regeneration

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The purpose of this study was to examine the intra-and interrater reliability of three methods to measure the percentage of fibrin within a wound, hence reflecting wound debridement. The three methods include visual assessment, a portable wound measurement system (PWMS) Visitrak s , and a computerized planimetry software Canvas s . The main objective was to compare the computerized planimetry with visual analysis. For each wound, a series of two repeated recordings of fibrin percentage based on the same Day 1 photograph at Day 8 and Day 15, respectively, was assessed by four evaluators using the two methods. Additional objectives consisted in the assessment of the inter-rater reliability of computerized planimetry and PWMS to assess fibrin percentage and total surface area. Twenty-four patients were included for a total of 31 wounds. Intraclass correlation coefficient revealed improved reproducibility and repeatability of computerized planimetry. The reproducibility of computerized planimetry was better than PWMS when measuring the percentage of fibrin and total wound area. Because average visual estimations were very close to the computerized planimetry, bedside evaluation of fibrin percentage and wound debridement was considered as reliable, and consequently a valid technique for daily practice. PWMS proved to be less convenient, owing to difficulties in identifying fibrin margins. The higher intra and interrater reliability of computerized planimetry probably reflected the fact that subjective clinical assessment and objective calculation of percentages were mandatory for correct wound evaluation. Therefore, digital image analysis was considered as an accurate method for double-blind and multicentric trials.Chronic wounds are a major problem in developed countries resulting in substantial morbidity and cost to healthcare systems.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Wound debridement: Comparative reliability of three methods for measuring fibrin percentage in chronic wounds

Laplaud¹,

Blaizot

Gaillard

et al. 2010

Wound Repair and Regeneration

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“…Some authors 11 infer that wound healing can be a complex process, and as such, patients with chronic ulcers require a systematic team approach from healthcare professionals. These authors argue that the wound care team members may vary based on the individual patient's requirements.…”

Section: Introductionmentioning

confidence: 99%

Patient Satisfaction with an Interprofessional Approach to Wound Care in Qatar

Al-Qahtani¹,

Critchley²,

Ngwakongnwi³

2017

Public Health Open J

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Background: Patient satisfaction with healthcare services is an important indicator of the patients' confidence in the healthcare system and a significant indicator of the quality of healthcare services delivered. This study assessed the level of patient satisfaction with wound care service delivery at the Hamad General Hospital (HGH) Outpatient Wound Clinic in Doha, Qatar. Methods: To complete this research a cross-sectional study design was conducted to survey patients who received wound care services from an interprofessional team at the HGH in Doha, Qatar from January 2015 to February 2016. Through this data collection method these patients' opinions on the services they received through the interprofessional approach were solicited. A total of 81 respondents completed a client satisfaction questionnaire (CSQ-8), 1 modified to include questions on socio-demographic characteristics. Data collection was completed from December 2015 to March 2016. Results: Overall, results from this study showed that patients were generally satisfied with wound care services delivered by an interprofessional team, as assessed by the CSQ-8. The results revealed favorable ratings of patient satisfaction ranging from 67.9% to 90.1%. Conclusions: Overall, study findings show that patients were mostly satisfied with wound care services and can be improved. A comparison of mean satisfaction scores by subgroups revealed no significant differences worth reporting.

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“…[4][5] When biofilms are suspected to be present, the physical removal of biofilms and suppression of biofilm reformation are a necessary part of wound bed preparation (WBP). [6][7][8] Wound debridement can be considered an integral part of WBP not only to remove dead tissue, debris, and bacteria present in the wound bed but also to expose host defenses that are more intact and better suited to combat bacteria. 9,10 However, there is no evidence-based standardization in the debridement approach with questions remaining unanswered about the frequency of debridement and the extent of peripheral wound tissue removal necessary to promote healing that has been stated in the debridement positioning document of the European Wound Management Association.…”

Section: Introductionmentioning

confidence: 99%

Effective biofilm removal and changes in bacterial biofilm building capacity after wound debridement with low-frequency ultrasound as part of wound bed preparation before skin grafting

Yarets¹

2017

CWCMR

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Abstract:The aim of the study was to evaluate the efficacy of ultrasonic-assisted wound debridement (UAW) used for wound bed preparation of chronic wounds prior to skin grafting. Initially, 140 patients were enrolled into study. Group 1 patients (n=53) with critically colonized wounds underwent a single UAW procedure before skin grafting. Group 2 patients (n=87) with colonized wounds received two UAW sessions, skin grafting followed by the second UAW treatment. Initial wound classification in colonized and critically colonized wounds did not correlate with results from microbiological analysis of wound swab samples. Hence, comparison of efficacy of one or two debridement sessions was conducted solely for a similar group of patients, that is, patients with colonized wounds of group 1 (n=40) and group 2 (n=47). In wounds of group 1 patients, a single debridement session resulted in reduction of bacteria from >10 4 to <10 4 CFU/mL. However, bacteria remaining at wound site showed minor differences in biofilm slime production, with skin graft failure being observed in 25% cases. In wounds of group 2 patients, two debridement sessions significantly reduced bacterial presence up to <10 2 CFU/mL. Bacteria remaining at wound site showed low capacity for biofilm slime production and high accumulation of biomass; a complete graft healing was observed in all patients. We suggest two to three debridement sessions with UAW to be most effective in wound bed preparation before skin grafting of chronic wounds. UAW showed to be effective in cleaning the wound bed, destroying the extracellular substances in biofilms, and influencing biofilm slime building capacity of bacteria left at wound site.

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Best Practice Recommendations for Preparing the Wound Bed

Cited by 74 publications

References 19 publications

Wound debridement: Comparative reliability of three methods for measuring fibrin percentage in chronic wounds

Wound debridement: Comparative reliability of three methods for measuring fibrin percentage in chronic wounds

Patient Satisfaction with an Interprofessional Approach to Wound Care in Qatar

Effective biofilm removal and changes in bacterial biofilm building capacity after wound debridement with low-frequency ultrasound as part of wound bed preparation before skin grafting

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