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Aim: In this article, we aim to raise awareness of some of the clinical concerns surrounding the management of oncology wounds, particularly malignant fungating wounds. We will also provide practical wound management recommendations for healthcare professionals to consider when managing this wound type. We aim to assess the potential of a 100% chitosan with bioactive microfibre gelling (BMG™) dressing (MaxioCel®), to support wound management and work in partnership with industry to deliver clinical education on the management of oncology wounds, including malignant fungating wounds.

Method: A case study series was undertaken over four weeks, using the chitosan BMG dressing.

Results: We recruited 10 patients during the study. The chitosan BMG dressing facilitated a significant improvement in wound tissue type, exudate levels, and periwound skin, as well as reduced malodour. A reduction in patient-reported pain levels was also noted throughout the evaluation process. 

Conclusion: The introduction of BMG fibre technology demonstrated good outcomes in this patient group, in a short period of time. Importantly for this patient group, the BMG dressing was able to remain in situ during radiotherapy treatment, allowing uninterrupted management of the wounds.

KEY WORDS

Bioburden

Case studies

Malignant fungating wounds

Odour reduction

Oncology wounds

Pathways

SUSY PRAMOD

Lead Nurse Tissue Viability, The Christie NHS Foundation Trust, Manchester

SUE RICE

National Clinical Development Manager, CD Medical, Bolton, Lancashire

Nicola Milne

Audit within Brooklands and Northenden Primary Care Network revealed that people with type 2 diabetes under the age of 50 years were an underserved population and were less likely to receive the recommended eight care processes than other age groups locally. This article outlines the initiatives carried out to address this inequality. The  work involved a Diabetes Support Team (DiaST) model of care and embedded an array of actions to overcome barriers to engagement among this hardly reached group. The initiative has resulted in more than a doubling of the rate of care process achievement in this population, although disparities with other age groups remain. The article should serve as inspiration for services looking to make the most of NHS England’s T2Day (Type 2 Diabetes in the Young) programme to fund extended health checks for people aged 18–39 years living with type 2 diabetes.

Citation: Milne N (2023) Engaging with and optimising care for people under age 50 years with type 2 diabetes: The DiaST model of care. Diabetes & Primary Care 25: [Early view publication]

Key words

– Audit

– DiaST

– Early-onset type 2 diabetes

– Service delivery

Author

Nicola Milne, DiaST Lead, Brooklands and Northenden PCN.

Background: The management of leg ulceration through compression has predominately been considered a community care need. In 2021, Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust, in partnership with the Doncaster Wound Care Alliance, developed and launched a framework of interventions including education, a joint wound care formulary and clinical pathways, all aimed at standardising care. Additionally, they introduced the UrgoKTwo multicomponent compression system to provide seamless care across community, primary and secondary care using the National Wound Care Strategy Programme's (NWCSP) 2020 lower limb recommendations. As a result of changes implemented by the Skin Integrity Team at Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust,within secondary care, the knowledge of hospital staff increased by an average of 34% following attendance at structured education programmes, with 99% of staff being assessed as competent in the practical application of UrgoKTwo multicomponent compression bandage system. These improvements allowed the Skin Integrity Team to perform timely assessments, diagnoses and treatments for venous leg ulcers (VLUs), resulting in 89% of VLUs commencing UrgoKTwo multicomponent compression bandage system while patients were in the hospital and achieved healing within 12 months.

 

KEY WORDS

Education Healing rates Leg ulcers Lower limb UrgoKTwo

KELLY PHILLIPS Lead Nurse, Skin Integrity Team, Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust, FRAN MCNAB Skin Integrity Team, Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust.

KATIE PHILLIPS Acting Clinical Nurse Specialist, Skin Integrity Team, Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust.

TONI PLUMB Specialist Sister, Skin Integrity Team, Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust.

LOUISE WALL Specialist Sister, Skin Integrity Team, Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust.

VICTORIA DODD Specialist Sister, Skin Integrity Team, Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust.

GEMMA LONG Specialist Support Worker, Skin Integrity Team, Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust.

ENIKKA BARNES Specialist Support Worker, Skin Integrity Team, Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust.

胡志成 张逸 唐冰 王鹏 黄韶斌 董云先 徐海琳 温日妮 荣燕超 朱家源 作者及单位信息 
    ·DOI: 10.3760/cma.j.cn115668-20201104-00302
摘要

目的: 观察自体细胞再生技术治疗深度烧伤削痂后植皮的效果。

方法: 分析2014年3月至2018年3月我科住院的深度烧伤患者54例,其中27例患者术中应用自体细胞再生技术(细胞分选仪,广州市麦施缔医疗科技有限公司,粤穗械备:20201238号)结合游离皮片移植,27例患者常规使用游离皮片移植修复创面。于术后对比两组创面的愈合时间和愈合效果。

结果: 应用自体细胞再生技术结合植皮后,与对照组相比,实验组愈合时间更短愈合后远期效果更佳,两组差异有统计学意义(P<0.05)。在术后首次换药时疼痛程度,术后植皮并发症方面,两组之间差异无统计学意义。

结论: 自体细胞再生技术可有效促进烧伤创面愈合,缩短愈合时间,并且安全性高。

 

深度烧伤;临床研究;皮片移植

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