Search

Chronic wound management remains challenging in clinical practice, especially in the presence of bacterial bioburden and slough. To resolve these clinical challenges, it is essential clinicians implement the TIME framework (tissue, inflammation/infection, moisture, edge of wound) as a model of effective wound bed preparation. As a result of advances in technology and wound care therapies, on the market today are products that can help reduce the wound bed clinical challenges recommended by the TIME framework. This article looks at a wound cleansing solution that reduces the wound bed bioburden by breaking down biofilms and debriding slough.

Over the past two decades a body of evidence has been generated to support the traditional use of water in cleansing wounds, with studies showing that the use of clean water does not increase the risk of infection or delay healing. However, recent advances in the understanding of wound management have encouraged reforms and led to the development of wound cleansing agents that have the potential to improve clinical outcomes. This article draws on in vitro and in vivo evidence including comparative studies of patients with acute and chronic wounds to consider the evidence supporting alternatives to water in wound cleansing.

Human skin in healthy adults is inhospitable to pathogenic organisms. A wound may occur from any accidental or deliberate trauma that breaks the surface of the skin. Once this line of defence is broken there is a risk of infection. All soft tissue injuries, whether chronic, traumatic or surgical, involve the same basic biochemical and cellular processes. This article looks at the risk factors associated with healing of such wounds. The principles of asepsis, wound cleansing agents, choice of dressings and the taking of wound swabs are considered.

After the removal of a dressing from a wound, wound cleansing is often the first action to be taken by the nurse. Saline or tap water is often used to loosen the dressing and therefore help to remove it. It can also be used for the subsequent cleansing of the wound if required. B/Braun Medical has a range of modern wound care products for all healing phases of acute and chronic wounds and this article will look at their saline range.

Patients with skin injuries account for 15% of accident and emergency (A&E) admissions (Leaman, 1991). Although there is evidence to suggest that wound cleansing is not always necessary (Thomlinson, 1987), no diagnostic test exists to allow healthcare practitioners to identify whether the bacterial load in the wound is capable of causing infection (Chrisholm, 1992). For this reason, all wounds in A&E should undergo some form of cleansing to decrease the bacterial inoculum in the wound to levels that can be managed by host defences (Chrisholm, 1992). Heyworth (1997) postulates that sucessful management of the contaminated wound must remove contaminants while inflicting minimal injury to tissue. This article reviews the research on the preparation and cleansing of superficial lacerations. Wound closure and indications for oral antibiotics will not be discussed.

Wound cleansing is performed on a regular basis by many healthcare professionals. However, the modern concept of cleansing has not always been a priority in wound management. There are many questions which challenge those responsible for cleaning wounds such as how often a wound should be cleaned and which techniques should be used. This article begins with a brief guide to wound cleansing and then focuses on the new Steripod normal saline produced by SSL International.

Wound cleansing is a common and often ritualistic process. The nurse has at his/her disposal a variety of techniques, equipment and cleansing solutions. This article will help to highlight myths and areas of good practice in the wound-cleansing process.