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Dedicated followers of fashion

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VOL: 97, ISSUE: 09, PAGE NO: 1

Madeleine Flanagan, MA, BSc, DipN, Cert Ed (HE), RGN, is principal lecturer, tissue viability, University of Hertfordshire, Hatfield

Advanced wound-healing therapies mean different things to different people. First one needs to consider what is understood by the term advanced therapy. Interactive dressings are still regarded by some to be advanced treatments, while others consider laser therapy and tissue engineering to be passe. The word 'advanced' is associated with improvement, complexity, innovation and sophistication. In some circles, it is associated with increased costs. In short, the term advanced wound-healing therapy is a relative and poorly defined concept.

Advanced wound-healing therapies mean different things to different people. First one needs to consider what is understood by the term advanced therapy. Interactive dressings are still regarded by some to be advanced treatments, while others consider laser therapy and tissue engineering to be passe. The word 'advanced' is associated with improvement, complexity, innovation and sophistication. In some circles, it is associated with increased costs. In short, the term advanced wound-healing therapy is a relative and poorly defined concept.

In an attempt to improve healing rates we are often guilty of rushing to implement new treatment approaches without stopping to review the supporting evidence. This sometimes results in the emergence of a wound management trend that spreads like wildfire without careful consideration of patient benefits.

Provision of comprehensive wound management services is, at best, inconsistent. Before using advanced wound-healing therapies, careful consideration must be given to the infrastructure supporting service delivery. There is little point in implementing such therapies if interdisciplinary team-working, integrated care pathways and effective documentation are not standard practice. Before using any advanced wound- healing therapy, such as ultrasound or hyperbaric oxygen, the following questions should be considered:

- Has the patient been thoroughly assessed?

- Is the treatment specifically indicated?

- What potential benefits will use of this therapy bring?

- Have all other alternatives been considered?

All too often advanced wound-healing therapies are indiscriminately used by enthusiastic practitioners who have failed to identify the basic wound aetiology or to ensure that the patient is adequately nourished. The use of such therapies does not negate the need for good assessment skills and in practice should always involve an integrated interdisciplinary approach.

Professional practitioners must keep up to date with new technologies and review local and regional availability so that patients can be appropriately advised. Practitioners also have a responsibility to consult each other and share good practice. For many patients with non-healing wounds advanced wound management therapies offer significant improvements in both healing rates and quality of life. However, patients must be appropriately monitored, otherwise the latest wound therapy fashion may prove to be an unnecessary expense.

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