Background: Incontinence-associated dermatitis (IAD) develops from skin exposure to urine, faeces or both. Previous studies have tested different IAD management practices in critically ill patients in the intensive care unit (ICU); however, actual clinical practices reported for IAD prevention and management remain unknown. This study aimed to understand Australian registered nurses’ current clinical practices to prevent and manage IAD in the ICU.

Method: This study used a cross-sectional exploratory survey design. Members of the Australian College of Critical Care Nurses (ACCCN) Ltd were invited to complete an electronic survey.

Results: Response rates were 5.6% (111/1967) of the total email invitations sent or 10.6% (111/1051) of those who read the invitation. Most participants were female (88.3%, n=98), with 69.4% (n=67) working in a metropolitan hospital, and 91% working in a public hospital. Participant recall of IAD frequency was 10.4%. Various methods were identified to prevent and manage IAD, including skin protection at the patients’ general bed-bath and at episodes of incontinence clean-up. The lack of IAD management policy in ICUs was common across the participant group.

Conclusion: Clinical practices to prevent and manage IAD were found to be the same. Formal IAD management protocols in ICUs were limited in number.

This case study illustrates the importance of collaboration in complex care across the hospital–community continuum to improve the patient experience The team engaged the patient by building rapport and trust, providing education, and implementing evidence-based care. These contributed to better outcomes for this patient, who had severe chronic venous leg ulceration and poor treatment concordance. Our objectives were to promote ulcer healing and increase treatment concordance by engaging the patient. Engagement was achieved by enhanced communication and the use of technology such as digital photography and advanced wound therapies. The provision of support, education and assessment of advanced skills competence of clinicians across the care continuum achieved our objectives.

Introduction: Incontinence-associated dermatitis (IAD) is caused by chemical and physical irritation from excrement in contact with skin. Though IAD is a risk factor for pressure injury development and can occur simultaneously, inconsistencies and gaps within the literature remain.

Background: Psychosocial assessments are essential to holistic assessment of a person with a wound to ensure positive impacts are maximised and the negative influence on wound healing minimised. However, there has been little discussion on the psychosocial impacts of IAD on the patient, hence this literature review.

Methods: A systematic literature search was undertaken using CINAHL, EMBASE, MEDLINE and PubMed databases to explore the link between wellbeing and IAD. A comprehensive search was employed and 12 articles were included in the review.

Results: The IAD literature focused on treatments briefly inferring impact to the patient, whilst omitting psychosocial assessments and patient involvement. The few mentions of IAD impact on patient wellbeing were generalised from the incontinence literature. Two articles recommended the need for patient involvement and exploring the impact of IAD.

Conclusion: Research is needed to investigate the psychosocial factors which impact on patients with IAD wounds, along with the role wellbeing may play in wound healing in adults with IAD.

Necrotising fasciitis is a rapidly progressive, destructive soft tissue infection that mainly involves fascia and subcutaneous tissues. Rapidly spread necrosis in tissues is often caused by systemic sepsis, toxic shock syndrome, multiorgan failure and thrombosis in the subcutaneous vasculature. Necrotising fasciitis can be seen in all the anatomical regions of the body; the extremities and perineum are frequently affected. In this case report, we emphasised the importance of nursing care of a necrotising fasciitis patient who has been treated for a long time with aggressive surgical treatment. Vacuum-assisted closure application is a non-invasive method with controlled and localised negative pressure on the wound to accelerate healing in acute/chronic wounds. Necrotising fasciitis can be successfully treated with early diagnosis, adequate debridement, and appropriate antibiotic therapy. A multidisciplinary approach is necessary for the comprehensive care of these patients.

Introduction: The next generation of wound dressings will actively participate in the wound healing process, helping the body to heal itself. For deep and/or chronic wounds a dermal scaffold is often required prior to the application of a skin graft or other therapy that encourages re-epithelialisation and the restoration of the barrier function. The aim of this study was to determine if electrospinning and plasma polymerisation could be used to generate a scaffold that would support fibroblast growth and extracellular deposition.

Methods: A totally synthetic electrospun dermal replacement was produced coated with an allylamine plasma polymer and its impact upon cellular processes assessed in vitro.

Results: The scaffold encouraged increased adhesion and rapid migration of human dermal fibroblasts into the scaffold. Fibroblasts rapidly proliferated to populate the scaffold and deposited significantly more collagen I on scaffolds coated with the allylamine plasma polymer than the uncoated poly(lactic acid) scaffold or scaffolds coated with other plasma polymers (acrylic acid or 1,7’ octadiene).

Conclusions: Electrospinning and plasma polymerisation are both versatile and widely used techniques that are also suitable for large-scale manufacture of scaffolds. These properties increase the potential of the scaffold to include its use as a cell delivery device for the delivery of fibroblasts, including their associated extracellular matrix and mitogens to chronic wounds.