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Background: Diabetes-related foot disease (DFD) is a leading cause of the Australian disease burden. The 2011 Australian DFD guidelines were outdated. We aimed to develop methodology for systematically adapting suitable international guidelines to the Australian context to become the new Australian evidence-based guidelines for DFD. Methods: We followed the Australian National Health Medical Research Council (NHMRC) guidelines for adapting guidelines. We systematically searched for all international DFD guideline records. All identified records were independently screened and assessed for eligibility. Those deemed eligible were further assessed and included if scoring at least moderate quality, suitability and currency using AGREE II and NHMRC instruments. The included international guidelines had all recommendations extracted into six sub-fields: prevention, wound classification, peripheral artery disease, infection, offloading and wound healing. Six national panels, each comprising 6–8 multidisciplinary national experts, screened all recommendations within their sub-field for acceptability and applicability in Australia using an ADAPTE form. Where panels were unsure of any acceptability and applicability items, full assessments were undertaken using a GRADE Evidence to Decision tool. Recommendations were adopted, adapted, or excluded, based on the agreement between the panel's and international guideline's judgements. Each panel drafted a guideline that included all their recommendations, rationale, justifications, and implementation considerations. All underwent public consultation, final revision, and approval by national peak bodies. Results: We screened 182 identified records, assessed 24 full text records, and after further quality, suitability, and currency assessment, one record was deemed a suitable international guideline, the International Working Group Diabetic Foot Guidelines (IWGDF guidelines). The six panels collectively assessed 100 IWGDF recommendations, with 71 being adopted, 27 adapted, and two excluded for the Australian context. We received 47 public consultation responses with > 80% (strongly) agreeing that the guidelines should be approved, and ten national peak bodies endorsed the final six guidelines. The six guidelines and this protocol can be found at: https://www.diabetesfeetaustralia.org/new-guidelines/ Conclusion: New Australian evidence-based guidelines for DFD have been developed for the first time in a decade by adapting suitable international guidelines. The methodology developed for adaptation may be useful for other foot-related conditions. These new guidelines will now serve as the national multidisciplinary best practice standards of DFD care in Australia. [ABSTRACT FROM AUTHOR]

Epidermolysis Bullosa (EB) is a rare genetic skin disorder characterised by fragility and blistering of skin and mucous membranes. Skin can blister and shear away from minimal friction, trauma and every day activities. The disease causes a wide range of complications but wound care is the major challenge to severe EB, and good wound care is an essential part of wound management. The goal of wound care was to choose a product that protects the fragile skin, limits friction, decreases pain and promotes healing. However, access to wound dressings for those people living with EB is challenging. This article discusses the availability of EB dressings in a number of countries around the world and also describes an innovative National Epidermolysis Bullosa Dressings Scheme (NEBDS) in Australia, which aims to improve the quality of life of people with EB, by reducing the financial burden associated with the provision of dressings accordingly. [ABSTRACT FROM AUTHOR]

Background: Trauma patients infected with human immunodeficiency virus (HIV) or hepatitis C (HCV) pose specific problems to health-care workers due to the risk of exposure to these agents in blood and other body fluids. Studies of patients with penetrating trauma in the USA have shown a higher prevalence of HIV and HCV infection than the general population. No studies have examined the prevalence of these infections in Australian trauma patients. Methods: The medical records of all patients presenting to St Vincent’s Hospital, Sydney, from January 1994 to December 1998, with a stab wound to the neck, chest or abdomen, or with a gunshot wound to any anatomical site, were retrospectively reviewed. The number of patients with a history of HIV or HCV infection, or with risk factors for these such as male-to-male sexual intercourse and intravenous drug use, were recorded. Results: The medical records of 148 patients with stab wounds to the neck, chest or abdomen, or with gunshot wounds were examined. Risk factors for HIV or HCV infection were recorded in 31 patients (21%). Two patients (1.3%) had a history of HIV infection and a further eight patients (5.4%) were known to have HCV. Conclusions: There was a high prevalence of risk factors for HIV and HCV in patients with major penetrating wounds at St Vincent’s Hospital. The prevalence of documented HIV and HCV infection was subsequently greater than that expected in the general population, highlighting the risks to health-care workers managing these patients. [ABSTRACT FROM AUTHOR]

The article presents developments in the Australian and New Zealand Hyperbaric Medicine Group (ANZHMG). The author announces the submission of reports to the Australian Federal Government Medical Services Authority Committee (MSAC) which seeks subsidy from Medicare for hyperbaric oxygen treatment of soft-tissue radiation injury and necrosis and non-diabetic problem wounds caused by hypoxia. He stresses that the reports are supported by the Australian Society of Anaesthetists and Australian Medical Association. A brief outline of the reports is provided.