Newsletter: April 2010 V4, Issue 2

April 1, 2010

Contents

  1. Guest Editorial — By: Marco Romanelli MD. PhD.
  2. Journal Watch
    1. Mortality associated with acute Charcot foot and....
  3. Regional Reports
    1. Western Branch Report
    2. Dublin/Wicklow Branch Report
  4. Notices from WMAI Office

Guest Editorial

Marco Romanelli MD. PhD. – Wound Healing Research Unit University of Pisa

Marco Romanelli

Marco Romanelli

Diagnostic and therapeutic advances are progressing rapidly in the field of wound care. Within the last several years, new advances in wound healing, molecular biology and pharmacology, as well improved understanding of the pathophysiology of diseases, have greatly expanded the diagnostic and therapeutic options available to wound care practitioners. Recently there has been considerable interest in the application of non invasive measurement devices either as diagnostic tools or in research trials. The objective and reproducible measurement of wound healing phases is becoming increasingly important and should provide indispensable assistance to caregivers in the near future. The new diagnostic and therapeutic instruments will be useful in research and clinical practice, providing more information about wound healing processes, bringing major innovations to data collection, storage and recall, and assisting in the comparison of different treatment modalities.

The use of skin imaging techniques to improve the management of wounds remains a novel area for most practitioners, since the traditional approach continues to be used for clinical inspection. The main goal of current research is to create a system that monitors the qualitative and quantitative evolution of wounds with an easy-to-use technological system, which is able to produce an objective evaluation of the wound status and which allows the evolution of the wound to be monitored by means of measurable attributes. Dedicated wound photography, high frequency ultrasound assessment, laser Doppler perfusion imaging, confocal microscopy, transcutaneous oxymetry, pH measurement and magnetic resonance imaging are some of the techniques that are currently available and being used to specifically examine different types of wounds. Collectively, the new developments reviewed will help significantly to guide patient care, increase the practitioner’s therapeutic armamentarium, and have a significant public health implication.

10th National Conference

Wound Management Association of Ireland’s 10th Bi-annual National Conference

10th Nation Conference Committee

On the 6th and 7th of October 2009, the national conference was held in the Hodson Bay Hotel Athlone. Titled "Fundamentals to Best Practice" the conference was a huge success with over 250 delegates. One of the main draws was the launch of the National Wound Management Guidelines. Members of the WMAI were involved in the setting up of the guidelines so it was a fantastic opportunity for the association to launch them at the conference.

Over the two days there was a great variety of speakers and presentations. International speakers included Prof. Raj Mani, University of Southampton, who gave the keynote address and has also contributed to this newsletter previously. Also speaking was Teresa Hurd, Canada, Dr. Amy McNulty, Texas, Dr.Hugo Dowd, Wales, Josh Scholes, Prof.Hugo Partsch, Austria, Ms.Janice Bianchi, Scotland and Prof Jan Apleqvist, Sweden.

Not to be outdone by the international community we were delighted to have our own talent from Ireland as speakers at the conference. Barbara Gilman, Senior Dietician, Mater Hospital, Dr. Caroline McIntosh, Head of School of Podiatry, NUI Galway, and Dr. Zena Moore, Nursing & Midwifery Research Fellow, RCSI. The combination of disciplines and both international and national perspectives gave us plenty of food for thought.

Almost 20 poster presentations were on display. They were both varied and topical and provided delegates with the chance to see what their colleagues were researching.

The committee would like to thank their sponsors and all the delegates who attended the conference.

Journal Watch

Mortality associated with acute Charcot foot and neuroathic foot ulceration.

Van Baal, J., Hubbard, R., Game, F. & Jeffcoate, W. (2010) Diabetes Care, 33(5), 1086-1089.

This study compared five year mortality rates of 136 patients who presented with either an acute Charcot foot or with uninfected neuropathic foot ulcer(NFU). Data was collected between 2001 and 2007 and compared with data from 1980 to 2007.

Results showed there was no statistically significant difference in survival between the two groups, although significantly more males died in the NFU group (p = 0.027). 13 (18.6%) died in the Charcot foot group with a mean age of 61.7 years, while 22 died in the control group with a mean age of 65.1years. Of the 13 patients with Charcot who died during follow-up, 61.5% had renal dysfunction compared with 63.6% of the 22 who died in the control group. Median survival for the age and sex matched general population was 22.32 years, compared with median survival for Charcot patients and NFU patients of 7.88 years and 8.43 years respectively (p < 0.001).

This is an important study which builds on previous patient outcome data in relation to diabetic foot disease. A reduction in life expectancy for those with Charcot foot or NFU of 13 years from that of the general population warrants continuous efforts to seeks means to improve patient outcomes.

Regional Reports

Reports from the WMAI Regions

Western Branch

Smith & Nephew and Abbott Nutrition held an Evidence based practice meeting in conjunction with the Western Branch in The Clayton Hotel, Ballybrit, Galway, on 12 November last. Speakers included: Dr. Georgina Gethin, who delivered a presentation on Implementing the HSE Wound Management Guidelines. Mary Burke – Smith & Nephew, TIME and the use of Antimicrobials in practice. Marena Burd, Infection Control Implementing Guidelines on the prevention of HAI. Grainne Noone – Abbott Nutrition, Meeting the challenges of nutrition in complex wounds.

This meeting was also repeated in Sligo in the Castlebar Hotel on the 11 Feb, 2010 and in Mayo in the Days Hotel, on the 11 March, 2010. ConvaTec sponsored the “Assessment and Management of the Diabetic Foot Disease” held in Aras Moyola, NUI, Galway over a four week period on Tuesday evenings from 7-9pm.

Agenda:
  • Week 1: Epidemiology, prevalence and managing the complexities of diabetic foot disease – Dr. Seam Dinneen, Consultant Endocrinologist, UCHG of Diabetic Foot Disease.
  • Week 2: Assessment of the diabetic foot – Dr. Caroline McIntosh, Head of Podiatry, NUI Galway.
  • Week 3: Clinical guidelines and best practice in managing the diabetic foot – Dr. Georgina Gethin, President, WMAI.
  • Week 4: Practical session: Assessment and management strategies for the diabetic foot.

This course was very well attended, this is the 2 year this course was delivered and is expected to be an annual event.

Dublin/Wicklow Branch

It was with great regret that we learned that one of our outstanding committee members Lucy Carroll was retiring after many years of dedicated service to WMAI.

Over the years Lucy held executive posts of Chairperson and Treasurer at national and regional level and was an outstanding committee member and excellent support to the rest of the committee for her knowledge and experience. We wish her well and many happy years of retirement.

A Four week Wound Care Course was held in April 08, November 08 and, May 09. There was attendance of 50/60 participants at each course. This course was be repeated every Tuesday this November in lecture theatre of Cherry Orchard Hospital. This course covers all aspects of wound care from introduction, causes, prevention pressure ulcers, leg ulcers and the diabetic foot. The course consists of talk on given subject then related workshop. It is of particular interest to all disciplines involved in wound care and there is a multi-disciplinary team involved in running the course. The course has approval from ABA and EWMA Refreshments are served each evening.

Zena Moore RGN Msc FFNMRCSI has recently completed her research study on the benefits of repositioning and 30 degree turn to prevent pressure ulcers from occurring.

This research was carried out in Care of Elderly Facilities and was found to be very effective from a patients perspective and also very cost effective. Zena has presented her paper on this at EWMA conference in Helsinki.

Zena and Julie Jordan O’Brien also held a workshop on repositioning at EUPAP conference in Amsterdam.

Notices

Messages from WMAI Office

Writing for the newsletter

Would you like to write a short paper for the WMAI newsletter or share your experiences or expertise with others? We would like to invite short papers for inclusion in future issues of the newsletter. Please send your submissions via email or post to the Office.


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