Nurses specialised in wound, ostomy and continence (NSWOCs) who are working during a pandemic require engagement in self-care. Nurses across all sectors – clinical practice, education, leadership, policy, research and service – are each deeply aware of the burden of COVID-19, and provide the best care when they engage in self-care activities. Recent COVID-19 studies evaluating the mental health and well-being of staff working in the pandemic are of concern as staff are burdened by pandemic demands. Mental health and well-being, as well as skin and eye care, are essential. This paper talks about the Canadian perspective.

Background The face is the area central to a person’s identity that provides our most expressive means of communication. Facial burns are extremely serious medical problems. Topical interventions are currently the cornerstone of treatment of facial burns.

Case The authors report a 45-year-old woman who presented with a 1-hour old, 90% total body surface area (TBSA), including a mixture of deep II° and III° burns to her face. A silver impregnated dressing was used to care for the facial burn wounds.

Conclusion The silver impregnated dressing AQUACEL^® Ag Hydrofiber^® was found to be useful in nursing the facial burn wounds in this case.

Objective This systematic integrative review aims to identify, appraise, analyze, and synthesize evidence regarding nonhealable and maintenance wound management to guide clinical practice. An interprofessional referral pathway for wound management is proposed.

Data sources An electronic search of Scopus, Web of Science, PubMed, Academic Search Ultimate, Africa-Wide Information, Cumulative Index of Nursing and Allied Health Literature database with Full Text, Health Source: Consumer Edition, Health Source: Nursing/Academic Edition, and MEDLINE was conducted for publications from 2011 to 2019. Search terms included (nonhealable/nonhealing, chronic, stalled, recurring, delayed healing, hard-to-heal) and wound types most associated with nonhealable or maintenance wounds. Published studies were hand searched by the authors.

Study selection Studies were appraised using two quality appraisal tools. Thirteen reviews, six best-practice guidelines, three consensus studies, and six original nonexperimental studies were selected.

Data extraction Data were extracted using a coding framework including treatment of underlying causes, patient-centered concerns, local wound care, alternative outcomes, health dialogue needs, challenges within resource restricted contexts, and prevention.

Data synthesis Data were clustered by five wound types and local wound bed factors; further, commonalities were identified and reported as themes and subthemes. 

Conclusions Strong evidence on the clinical management of nonhealable wounds is limited. Few studies describe outcomes specific to maintenance care. Patient-centered care, timely intervention by skilled healthcare providers, and involvement of the interprofessional team emerged as the central themes of effective management of maintenance and nonhealable wounds. 

This paper examines the challenges faced by ostomates with cognitive impairment or dementia. Cognitive impairment is the sixth most common comorbidity in ostomates over the age of 70¹. A desire to remove the pouch at inappropriate times, inability to communicate and agitation, often caused by underlying peristomal skin problems, are all issues commonly experienced by ostomates suffering from dementia. To prescribe the most appropriate pouch option there are four areas to consider – increased pouch wear time, skin friendliness, easy but controlled pouch changes, and security. Ostomates with cognitive impairment or severe dementia can be amongst the most challenging patients. It requires considerable skill and judgement by the stoma care nurse (SCN) to provide a holistic assessment and ensure the most appropriate product selection for this group of vulnerable patients.