Background For years, silver has been used for the treatment of skin injuries.

Objective The effect of the oral administration of silver nanoparticles on the wound healing process in male rats was studied.

Materials and methods In this experimental study, 30 Wistar male rats were randomly allocated to three groups – the control and two silver nanoparticles treatment groups (30ppm and 60ppm AgNPs concentration). In all rats, the full- thickness wound was induced under general anesthesia. At 12 days post-wounding, microscopic evaluation of wound healing – for example inflammatory cells, fibroblasts, angiogenesis and collagen density – was completed.

Results The percentage of wound healing between the control and the treatment groups on the 12th day was significant (p<0.001). Moreover, the number of inflammatory cells was significantly higher in the control than in the treatment groups (p<0.001). The difference between the fibroblast number and collagen density was more in the treatment groups than in the control (p<0.001). Also, a considerable difference was observed between the number of inflammatory cells and fibroblasts in the 60ppm compared to the 30ppm concentration.

Conclusion By inducing anti-inflammatory effects and increasing the proliferation of fibroblasts and the expression of collagen, silver nanoparticles at a concentration of 30ppm accelerated the wound healing process.

Objective To identify the priorities and challenges related to surgical wound care from the perspectives of clinicians and health consumers / patients at a private hospital in Australia.

Methods Twenty-five clinical questions related to five surgical wound management topics were developed a priori and presented to four clinicians at a workshop. Questions were ranked by participating clinicians using a consensus building approach to identify the top two research priorities. One health consumer who had experience with a surgical wound was interviewed. Transcripts from the workshop and the consumer interview were analysed using a deductive approach.

Results The clinicians’ top priority questions focused on the importance of the consumer in their postoperative wound management, and the role of the wound care team in providing evidence-based care. The patient highlighted the vital role collaboration with clinicians played in the successful management of their surgical wound and continuity of care.

Conclusion Strategies to partner with consumers in the prevention of surgical wound complications can be successfully incorporated into clinical practice.

Key points

What is known about the topic? While there are clear gaps in current surgical wound care practices, there is also increasing evidence that suggests wound care outcomes can improve when patients partner with clinicians.

What does this paper add? Surgical wound care outcomes improved when clinicians prepared and worked with consumers using frequent education, support and assessment approaches.

What are the implications for practitioners? Partnership approaches between clinicians and consumers in the prevention of surgical wound complications can be successfully incorporated into clinical practice.

Pressure injuries are a significant problem across the healthcare system. Historically, the focus of prevention programs has been in acute care settings, but skin vulnerability has been recognised in other settings, in particular where consumers are older and frail. In our health district, we sought to extend a model of care for wound prevention and management into the mental health and drug and alcohol (MHDA) services where many consumers are not necessarily in the older age group but are frail due to their mental and physical morbidities. The model was a district-wide program which relied on front line clinicians in each unit taking on the role of a ‘skin integrity champion’. Champions were recruited, inducted and supported to drive practice change in their units. The need for change was derived from an auditing framework developed specifically for measuring pressure injury prevention bundles of care in mental health and drug and alcohol settings. Baseline data demonstrated the need to improve pressure injury risk assessment and risk reduction. Additional strategies to support the model of care were refined by a focus group with the skin integrity champions which determined what the model needed to provide in these unique settings. Serial data demonstrated improvement in identifying consumers at risk and implementing pressure injury prevention strategies.

Background Iodine-impregnated surgical drapes aim to protect the wound from bacterial re-colonisation and therefore prevent surgical site infection (SSI). Studies have produced conflicting results regarding the efficacy of this intervention.

Methods Ovid EMBASE, Ovid MEDLINE, Scopus and PubMed were searched for randomised control trials (RCTs) and cohort studies in which iodine-impregnated drapes were used to reduce SSI. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool for RCTs and the ROBINS-I tool for cohort studies. RevMan was used for meta-analysis. Additional sub-group analysis was performed for incision type.

Results Two RCTs and seven cohort studies inclusive of 4119 patients were included. The RCTs demonstrate a risk ratio (RR) for SSI in the intervention group of 0.92 (p=0.70), whereas the RR in the cohort studies is 0.45 (p=0.01). The number needed to prevent SSI in the cohort studies is 19.5. There is also a statistically significant reduction in SSI in the intervention group for clean-contaminated incisions, with SSI occurring in 3.8% of surgeries with an iodophor drape and 9.2% of surgeries without (RR 0.45, p=0.02).

Conclusion Our review suggests that iodine-impregnated drapes are beneficial in reducing postoperative SSI, particularly in clean-contaminated surgeries; however, the grade of evidence is poor.