It is widely acknowledged that compression therapy is an effective treatment option for the management of lower limb conditions; however, it is not always applied appropriately by clinicians. A lack of knowledge and clinical uncertainty, coupled with increased workload and reduced time with patients, can contribute to inappropriate decisions being made in regard to compression. This article investigates the adoption of the Hosiery Hunter® app (medi UK) and its role in guiding decision-making within clinical practice. The Hosiery Hunter® app is a novel mobile application designed to simplify the selection of medical compression hosiery for patients with lower limb conditions. Based on qualitative data from a user feedback survey, it was found that the Hosiery Hunter® app helped simplify the process of selecting the most appropriate compression therapy, saved time and provided quick and timely access to codes for prescription. All nurses surveyed agreed that they would continue using the app and would recommend it to a colleague. This article sheds light on the challenges clinicians face in the selection of compression therapy, and explores the effectiveness of adopting the Hosiery Hunter® app in support of providing appropriate, safe and effective care for all patients.

KEY WORDS

Chronic oedema

Compression

Mobile application

Venous insufficiency

GEORGINA RITCHIE Director of Education, Accelerate CIC

HAYLEY TURNER-DOBBIN Clinical Delivery Lead Wound Care, Research and Development, Accelerate CIC

Background: Chronic wounds have a significant impact on patients’ lives and are challenging for healthcare professionals to treat. Failure to implement evidencebased practice can prolong patient suffering and lead to wound complications such as infection. Effective dressing selection is important to ensure wound bed preparation (WBP) and removal of the barriers to healing, such as devitalised tissue, infection, and excess exudate. Multidimensional products such as UrgoClean Ag have a combined action of continuous cleansing, debridement, and treatment of infection, and can effectively prepare the wound bed and advance wound healing. This paper discusses the importance of WBP, with a focus on infection and biofilm management using a multidimensional product (UrgoClean Ag), with clinical practice examples.

KEY WORDS

Biofilm

Infection

Multidimensional

products

UrgoClean Ag

Wound bed preparation

CAROLINE DOWSETT Clinical Nurse Specialist, Tissue Viability, East London NHS Foundation Trust.

ABSTRACT: This service evaluation demonstrates how data from a digital wound management system could be used to improve healing rate trajectories for people with deteriorating wounds. Data entered by clinicians at the point of care was used to identify people who may have a deteriorating wound, enabling senior clinicians to provide a remote treatment plan without undertaking a face-to-face visit. This report provides a service-evaluation data from a Wound Management Digital System (WMDS) used to determine if wounds were improving or not. A formal ‘senior review’ process in the Podiatry Service was evaluated. We identified that 56% of people saw a reduction in their wound area following the review. This was compared with wounds that had been identified as deteriorating by the WMDS, but not formally reviewed, where 50% of wounds improved. This paper provides some early evidence on the effectiveness of a Senior Review process based on data output from a WMDS.

KEY WORDS

ehealth

Senior review

Telehealth

Wound management

Wound management digital system

MICHAEL OLIVER MSc, BSc (Hons) Podiatry, Programme Manager, Livewell Southwest

.JAYMIE STEPHENS, BSc (Hons) Podiatry, Foot Protection Lead Podiatrist, Livewell Southwest HANNAH BLAKE,

MDip, BSc (Hons), Tissue Viability Specialist Nurse, Livewell Southwest VIVIENNE TURTLE-SAVAGE, Digital and Data Lead for Wounds, Livewell Southwest

Zibotentan, a developmental endothelin A receptor antagonist, in combination with dapagliflozin in SGLT2 inhibitor-naïve patients, was effective in reducing albuminuria in people with chronic kidney disease (CKD) already on optimised RAAS blockade in the XENITH-CKD trial published in the Lancet. In this randomised, active-controlled, phase 2b clinical trial, adults with CKD, an eGFR of ≥20 mL/min/1.73 m2 and a uACR of 150–5000 mg/g (approximately 17–565 mg/mmol) were randomised to 12 weeks of treatment with zibotentan 1.5 mg daily (high dose; N=179), zibotentan 0.25 mg (low dose; N=91) or placebo (N=177), all in combination with dapagliflozin 10 mg daily, and in addition to full doses of an ACE inhibitor or ARB if tolerated. At 12 weeks, compared with placebo, there was a significant 33.7% reduction in uACR in the high-dose zibotentan group and a 27% reduction in the low-dose group. Fluid retention had been identified in previous studies of endothelin A antagonists; therefore, weight and B-type natriuretic peptide were monitored during the study and demonstrated fluid retention event rates of 18% with high-dose zibotentan and dapagliflozin, 9% with low-dose zibotentan and dapagliflozin, and 8% with dapagliflozin alone.

Citation: Brown P (2023) Diabetes Distilled: Reaching a XENITH in cardiorenal protection. Diabetes & Primary Care 25: [Early view publication]