Wound Healing Southern Africa

Custom foot orthosis offloading for the management of a plantar pressure foot ulcer

2024-04-10T12:11:22+00:00

Chronic ulcers carry a high rate of failure to heal. Pressure ulcers are classified as wounds primarily caused by pressure. Foot ulcers typically present with heavy callus formation in response to excessive pressure, hindering the healing process. Apart from wound management, which includes wound dressing and mechanical debridement, eliminating the causative factors is crucial for optimal wound healing. The healing of plantar pressure foot ulcers can be especially stubborn when not adequately offloaded. Amongst various forms of offloading, this case report focuses on using a custom foot orthosis for offloading a plantar pressure foot ulcer.

Soft tissue infection of the scalp complicated by mucormycosis in an immunocompromised patient: a case report

2024-11-08T10:06:22+00:00

Mucormycosis is a rare but life-threatening angioinvasive fungal infection classically presenting in patients with uncontrolled diabetes and ketoacidosis, which results in rapidly progressive soft tissue infection and necrosis. Mucormycosis is commonly associated with rhino-orbital-cerebral infections; however, primary cutaneous mucormycosis, which involves the skin, also occurs. Diagnosis of the infection implies identifying the organism with histopathology and culture confirmation. Treatment consists of radical surgical debridement and antifungal therapy. The disease prognosis remains poor despite these interventions. This case aims to highlight this rare condition and discuss some aspects of managing mucormycosis and its outcomes. The authors present a case of an adult female with uncontrolled diabetes and advanced human immunodeficiency virus (HIV) admitted to intensive care in diabetic ketoacidosis (DKA) after surgical debridement of a necrotising scalp infection. Her condition was further complicated by mucormycosis in the wound area. Despite interventions, the necrosis spread rapidly, and care was ultimately withdrawn.

An unexpected encounter: cutaneous leishmaniasis in wound care

2024-11-25T03:19:01+00:00

Cutaneous leishmaniasis is a parasitic infection caused by the Leishmania species, transmitted by infected sandflies. Patients with cutaneous leishmaniasis present with single or multiple skin lesions at the bite site. This article presents a rare case of cutaneous leishmaniasis in Namibia. The diagnosis was confirmed via histopathology and molecular typing of the Leishmania species. The article highlights the challenges of diagnosing cutaneous leishmaniasis in non-endemic areas. It also emphasises the importance of biopsy and multidisciplinary care when managing chronic wounds. The report connects the case to global trends in leishmaniasis epidemiology and discusses the implications for clinical practice.

Editorial

2024-12-05T08:37:53+00:00

As another year draws to an end, I’m sure we’re all looking forward to some time away from work, with family and friends. Mental health, stress and burnout have been very topical and it is important to give ourselves (and our families) the timeout we deserve. This is particularly true of wound care practitioners, who are typically exceptionally busy and whose careers often encroach on family time.

Copper Dressings as part of the armamentarium in the fight against wounds – much more than an antimicrobial

2024-08-30T07:58:42+00:00

Copper plays a critical role in all wound-healing processes. Examples of these include stimulation of angiogenesis, dermal fibroblasts proliferation, and secretion of extracellular matrix proteins and their cross-linking. Copper furthermore has potent wide-spectrum antimicrobial properties. These two key properties of copper endow this mineral as an excellent active ingredient to be used in the effective treatment of both acute and chronic wounds with or without infection. These dressings directly stimulate wound-healing processes, at all wound healing stages, from skin rupture to skin closure and seem to have endless possibilities within the wound management armamentarium. This review will highlight the mode of action of copper and how it could be utilised as a valuable resource in treating hard-to-heal wounds.

CPD Questionnaire (V17N02)

2024-12-05T10:51:23+00:00

CPD Questionnaire

Negative-pressure wound therapy for hospitalised patients: a paradigm shift

2024-10-25T08:23:38+00:00

Background: Negative-pressure wound therapy (NPWT) is widely available, but due to the high cost of the treatment, it is not used to its full potential. Worldwide, wound care providers are trying to facilitate a more practical and cost-effective way of providing this essential therapy. Thus far, none of the low-cost solutions could solve the “tethered to the bed” problem of the wall suction technique. We designed a tubing (Woundprep^®) that works with Luer connectors, which is well known by nursing staff. The connectors allow the patient or medical staff to easily and electively disconnect and reconnect the tubing for bathroom breaks, special investigations, or daily linen changes. We aimed to determine if NPWT can be provided with Woundprep^® safely and practically in the hospital setting.

Method: A prospective observational study was undertaken that included 16 patients who required NPWT in the hospital. Data was collected prospectively regarding adverse events, pain level, interval of dressing changes, elective disconnection periods, and pressure settings. The tubing pressure was measured daily by a digital manometer in mmHg.

Results: No serious adverse events were recorded. No active bleeding occurred, even though 15 of the 16 patients received low-molecular-weight heparin (LMWH) thromboprophylaxis. No wound sepsis occurred whilst on NPWT with Woundprep^®, and the average pain level was 2 out of 10 during treatment. The median interval of dressing changes was 72 hours (range 42–120 hours). The average pressure measured by the digital manometer was slightly higher (7%) than the regulator setting (112.5 vs. 121 mmHg). All patients actively participated in their wounds being connected or disconnected.

Conclusion: NPWT with wall suction and Woundprep^® tubing is safe and practical in the hospital setting when standard guidelines are followed. This clinical study may stimulate further work on developing a protocol advising on NPWT in hospitalised patients.