Almost 1-1.5% of the population constantly has a problem wound, which counts for 2-4% of the health care budget. However, evidence for which type of intervention, technology and dressing materials to use is still weak. Recent reviews have shown little or no difference in time to healing or percent healing between patients treated with traditional and modern dressings. Consequently traditional products like gauze may be reimbursed, while not the modern dressings. Why has wound care research not been able to establish evidence on level IA of the Cochrane system, 25 years after the first modern wound product was introduced? The main problem has been the comparability of the patients, because most are old, fragile and suffering from several competing diseases. This results in inadequate sample size, short follow up, non-random allocation to treatment arms, non-blinded assessment of outcomes, poor description of control and concurrent intervention etc. This has raised a discussion on level of evidence and perhaps evidence-based medicine may not only be restricted to randomised trials and meta-analysis as pointed out by Sackett et al
The Midlands Branch recently ran a very successful short course in wound care titled, Wound Care—Your Responsibility. It was held on four Tuesday evenings throughout September 2007. Each evening was very well attended and we obtained Category 1 An Bord Altranais approval. Zena Moore opened the first night with an excellent talk DAn Introduction to Wound Care.
The second night was facilitated by Catherine Benn who spoke on DLeg Ulcers—Assessment and Management, which was followed with a very popular bandage workshop with a profore and proguide demonstration. All were invited to participate. Mary Stokes a podiatrist spoke on the third night on Diabetic Foot”, followed by a demonstration on vac therapy.
Finishing the course, Georgina Gethin gave an excellent talk on DPressure Ulcers. A demonstration on pressure relieving devices followed. Acting Director of Nursing, Midland Regional Hospital.
Writing for the newsletter
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