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Wound Healing and Skin Integrity Principles and Practice

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Title: Wound Healing and Skin Integrity Principles and Practice

Edited by: Madeleine Flanagan

Publisher: Wiley Blackwell

Reviewer: Anne Duell, registered general nurse, Birmingham Community NHS Trust

What was it like?

Flanagan’s book is one that is extremely prevalent within the healthcare setting.  With strong emphasis being placed upon patient care and the avoidance of causing one of the four harms this book is a critical resource to be employed. This book can easily be used within an interdisciplinary setting.

At face value this concise book works on several levels supporting non registered health care workers in understanding the basics of skin integrity and skin care and progresses to support registered professionals in understanding the need for evidence based decision making when supporting individualised patient care. 

Through this book the reader learns the basics of skin integrity and how to care for individuals who have vulnerable skin while teaching readers about the physiology of wound healing.  What is interesting is the debate around terminology and the move to use the terms “non-healing” and “healing” in preference to “chronic” and “acute” when defining wounds. Good evidence base of resources are used in each section of this book and are referenced at the end of each chapter, which facilitates easier study and follow through by the reader.

A hierarchical approach is advocated for assessing skin integrity, ensuring an accurate history is taken regarding wound history and subsequent wound management. The mid-section discusses wound infections, biofilms and bacterial loads and management principles to consider when working to reduce the bio burden. Following this consideration is put on the psychological impact that wounds have on patients. Flanagan clearly puts this on the agenda for consideration and asks us to consider the impact that stress and anxiety has on the individual and the need to encourage and develop positive coping strategies.

Section two discusses more complex and challenges wounds including pressure, shear and friction. The author discusses the area of unstageable wounds and deep tissue injury. With the increase in diabetes there is a good section relation to diabetic foot disease, how to review and manage this, in conjunction with how to identify wound and bone infections.

Then the author touches on lower limb ulcers and other causes of skin damage such as lymphedema, surgery, malignancy and dermatological causes.

What were the highlights? 

There are numerous highlights within this book including discussion surrounding the holistic impact of wounds for our patients, while addressing less covered areas such as lymphedema. 

Strengths & weaknesses:

The book is laid out to provide clear evidence base within each section with a recap section at the beginning explaining how to undertake an evidence based piece of work and the structure of evidence with what is classed as weaker and stronger evidence sources.

Who should read it?

This book has capacity for a broad readership. Any professional worker who comes into contact with skin and is subsequently required to make an assessment should read this book including podiatrists and physiotherapists. Nurses at any stage of practice could benefit from this book as it provides good evidence based data when considering tissue viability and holistic assessment. Specialist nurses - tissue viability, diabetes, lymphedema could benefit from this book and is a vital resource to have in any clinical setting.

Wound healing and skin integrity principles

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