Wound Practice and Research

Aims The aim of this pilot randomised controlled trial (RCT) is to evaluate feasibility and acceptability of a personalised medical nutrition therapy (MNT) intervention on wound healing in individuals with diabetes-related foot ulceration (DFU) attending high risk foot clinics in New South Wales. It’s hypothesised that the personalised MNT intervention will be more acceptable and will improve diet quality compared to standard care.

Methods A six week superiority pilot multicentre, parallel-group two arm RCT for individuals (n=40) with type 1 and 2 diabetes, living with active DFU classified as VL or L as per WIfI grading and recruited from two-high risk foot clinics. The primary outcome is feasibility and acceptability, assessed by a process evaluation. The intervention group will receive MNT delivered by a dietitian at baseline, and weeks 2 and 4, with nutrient-dense food boxes provided at MNT consultations. The control group will receive a healthy eating brochure. Both groups received standardised podiatry care.

Discussion The results from this pilot study will enhance understanding of feasibility and acceptabilty of MNT for those with DFU and its potential for impact on wound healing. Results will inform future fully powered RCTs investigating effectiveness of MNT in individuals with DFU.

Aims To present recent evidence for the antimicrobial effect of a non-medicated wound dressing in wounds. Methods: An electronic search of key terms (“HydroClean” and “HRWD”) was undertaken in articles published between 1 January 1990 and 31 March 2024. Results: In all, seven articles met the inclusion criteria. Two articles were related to experimental studies, and the remaining five articles described clinical studies featuring non-medicated wound dressings. Conclusions: Non-medicated wound dressings’ (HydroClean^®) effectiveness in exudate management includes the absorption and sequestration of damaging exudate components such as matrix metalloproteinases. Hydro-responsive wound dressings (HRWD™) promote removal of devitalised tissue which is a focus of microbial growth (such as wound biofilm), and results in a reduction in the clinical signs of infection. Non-medicated wound dressings that contain no active antimicrobial agent may be used to treat infected wounds via the physical characteristics of the dressing.

Introduction The demanding nature of wound care, coupled with increased reports of elevated stress among healthcare staff in Saudi Arabia, warranted the examination of burnout and job satisfaction in this healthcare domain.

Aim The study aimed to assess the prevalence of burnout and the level of job satisfaction among wound care professionals in Saudi Arabia.

Methods A cross-sectional online survey was conducted among wound care staff in Saudi Arabia. Participants provided demographic information and responded to standardised questionnaires measuring burnout and job satisfaction.

Results A total of 118 wound care professionals participated in the study. The results revealed alarming levels of burnout among wound care professionals, with many participants experiencing high disengagement (84.7%), exhaustion (83.1%), and burnout (79.7%). Job satisfaction scores were moderately low overall, highlighting the importance of addressing both burnout and job satisfaction in this workforce. Demographic factors such as age, gender, marital status, and working hours per duty showed no significant associations with burnout. However, differences were observed among professional roles, with nurses exhibiting lower burnout levels compared to other professions.

Conclusion The study findings highlight the urgent need for targeted interventions to mitigate burnout and enhance job satisfaction among wound care professionals in Saudi Arabia.

Ventriculoperitoneal (VP) shunts, used to treat hydrocephalus, can sometimes cause hypersensitivity reactions to silicone, necessitating repeated surgical interventions. Traditional management involves replacing silicone with alternatives like polyurethane, which have limitations. This study presents a novel approach using Teflon (PTFE) sheets to cover the silicone valve surface.

A 22-year-old male with a history of multiple shunt surgeries and wound revisions was admitted for wound dehiscence, suspected to be due to a late hypersensitivity reaction to silicone. The shunt valve and cranial entry point were wrapped in Teflon PTFE felt sheets, and the wound was closed with propylene sutures. The patient was treated with methylprednisolone and discharged after three days.

Follow-up showed complete wound healing within a month, and the patient remained revision-free for ten years. This case suggests that Teflon sheets may offer a promising approach for managing silicone hypersensitivity in VP shunts, though further studies are needed to determine its broader applicability.