Aim To determine the number and type of wounds and their treatment costs (consumables and labour) in Australian hospitals, residential aged care facilities (RACFs), general practices (GPs) and community, and to provide evidence to inform reimbursement of wound treatment costs for all Australians.

Method Data from 21,189 clients with 49,234 wounds treated by a community care provider in Western Australia, Queensland and South Australia during the financial year 2020/2021 were used to determine the mean and median costs (consumables and labour) to treat wounds. Surveys involving skin inspections and medical record audits were conducted amongst consenting adults over 18 years old in a sample of Australian hospitals, RACFs and GPs. A sample of community clients’ data for wounds treated on one day in June 2021 comprised the fourth cohort used in this analysis. The costs to treat all wounds surveyed between 14 December 2020 and 17 October 2021 in the four cohorts were modelled against the community care provider’s data for 2020/2021 (49,234 wounds).

Results There were 2,505 individuals with 3,096 wounds. The estimated cost to treat all wounds was A$1,621,768 using the mean costs of the community care provider as a basis, and A$692,144 using the median costs of the community care provider as a basis. Costs for all wound types were determined.

Conclusion The cost of treating wounds in Australia was determined and is anticipated to inform a review of equitable reimbursement of wound treatment costs for Australians with wounds.

Wound bed preparation is essential for treatment of chronic and hard to heal wounds and clinicians have several options depending on skill and availability of equipment. There is growing evidence of benefit and usage of low frequency ultrasound contact debridement (LFUCD) across the globe but few studies that explore what the best sonotrode, technique using that sonotrode, intensity of ultrasound, or level of flow of irrigation have on the outcome of treatment or the patient experience. This observational case series study of 114 treatments of a convivence sample of 45 patients explored the use of three different sonotrodes / handpieces and five different techniques – mainly 100% ultrasound intensity and irrigation flow greater than 40% – to determine any variation in outcome or patient experience. The minimum data set (MDS) captured information regarding percent of tissue type and size of the wound before and after treatment, level of pain before, during and after treatment, technique(s), analgesia, length of treatment, aetiology and demographics. The results indicate LFUCD assisted in removing non-viable tissue and fibrin within minutes, while sparing granulation tissue, and was well tolerated regarding pain. This study did not find any significant difference in the type of techniques, but the type of sonotrode did.

Purpose Exposed bone and periosteal damage promote the adherence of pathogens to bone matrix components. Damage to the periosteum adversely affects bone perfusion and creates a more suitable environment for pathogens. The purpose of this study was to determine the prevalence of osteomyelitis among patients with diabetic foot ulcers with bone exposure and to identify the role of simple serological markers in the diagnosis of osteomyelitis in this patient group.

Methods Patients who underwent amputation and debridement due to diabetes-related foot wound were included in the study. The pathology results were evaluated according to presence of osteomyelitis. C‑reactive protein (CRP), erythrocyte sedimentation rate (ESR), complete blood count (CBC), platelet/lymphocyte ratio, neutrophil/lymphocyte ratio (NLR) and microbial growth were analysed.

Results Patients with ESR of 79mm/h or lower had a 3.046-fold higher risk of osteomyelitis. The risk of osteomyelitis was 2.901-fold higher at lymphocyte percentages of 12.3% or higher. Patients with a neutrophil percentage of 78% or lower had a 3.010-fold higher risk of osteomyelitis. Patients with NLR of 6.02 or lower had a 2.901-fold risk of osteomyelitis. When ESR was evaluated with neutrophil percentage, lymphocyte percentage and NLR, the sensitivity was calculated as 86.76% for osteomyelitis.

Conclusion We believe that the immune response caused by bone exposure to the environment is different than the immune response caused by soft tissue infection in the classical diabetic foot. The combined evaluation of multiple diagnostic parameters increases the sensitivity of osteomyelitis diagnosis.

Aims This review aimed to examine the effect of using topical antimicrobial preparations on antimicrobial resistance (AMR) by critically evaluating the currently available evidence.

Method Using systematic review methodology, we considered original research studies employing a prospective design and written in English. The search was conducted in July 2022 using Ovid MEDLINE, Ovid EMBASE Medline and CINAHL databases. Data were extracted using a pre-designed extraction tool and all included studies were quality appraised using the Evidence Based Literature (EBL) appraisal checklist.

Results A total of 375 studies were identified, with 25 meeting the inclusion criteria. Studies were conducted between 1998 and 2021. Half of the studies included explored the use of silver in dressings as an antimicrobial. Two studies were performed in a hospital setting, one study employed an in vitro and in vivo design, with all remaining studies employing an in vitro approach.

Conclusion There was limited evidence of the effect of topical antimicrobial preparations on AMR, with most included studies exploring the effectiveness of topical antimicrobials on infection and wound healing. AMR remains an important issue for exploration and understanding to clearly determine whether topical antimicrobials contribute to AMR.