Wound Healing Southern Africa

CPD Questionnaire (V17N01)

2024-06-14T09:19:48+00:00

CPD Questionnaire

Superficial partial burns and donor sites are unique wounds: case series of extended wear Cutimed® Sorbact®

2024-05-24T08:56:32+00:00

Background: Superficial partial burns and donor site wounds are unique and do not behave like other wounds, warranting a unique approach. A dressing with an antimicrobial effect to prevent infection and minimise trauma at the wound by extending wear time promotes spontaneous healing by epithelialisation. The properties of Cutimed^® Sorbact^® achieve this goal in its temporary skin-like substitute action. This audit aims to illustrate that our management of superficial partial burns and donor sites is successful.

Methods: A prospective audit was done from January to June 2019 at the Harry Gwala Regional Hospital, where Cutimed^® Sorbact^®was used at the burn surgeon’s discretion. Sorbact^® was typically chosen for acute superficial partial-thickness burns at presentation and donor sites.

Results: A total of 27 patients were included. There were 14 superficial partial-thickness burns (nine children and five adults) treated with a mean wear time of 14 days to healing, with two patients having a wear time of 17 and 22 days, respectively. There were 13 donor sites treated (eight children and five adults), with 12 cases healed by day 17 and one complication of depth conversion.

Conclusion: Frequent removal of the primary Cutimed^® Sorbact^® dressing in the epithelialising wound causes trauma to the wound, leading to delayed healing despite the absence of infection. Leaving the primary Cutimed® Sorbact® in situ while monitoring for complications leads to successful outcomes. This has been adopted as standard management in our service for superficial partial burns and donor sites.

Editorial

2024-06-12T05:46:20+00:00

Every time I write the editorial, we seem to have something exciting happening in our country. Last time, we had just won the rugby world cup…again! This time, for the first time in over 30 years, we appear to have a very different government about to be formulated after our recent elections. We are all hoping that the proposed government of national unity will bring positive changes to our ailing economy. Our economy has deteriorated to levels that have recently necessitated budget cuts in our healthcare sector that have never been seen before, with posts being frozen for all forms of healthcare professionals. This has put enormous strain on those that remain in the system. Let’s hope that the makeup of the new government results in positive changes for the healthcare sector and the country as a whole.

Diabetic foot complications and their management at primary healthcare clinics in Johannesburg

2023-09-19T08:17:37+00:00

Background: Primary healthcare (PHC) in South Africa is predominantly nurse-driven, focusing on illness prevention and treatment of acute and chronic disorders. However, data on diabetic foot complications at PHC clinics is limited, and the role of podiatrists in prevention is underutilised. Diabetic foot complications, particularly ulcers, are a significant cause of amputations, with early identification and treatment crucial for prevention.

Methods: This cross-sectional retrospective study involved 536 diabetic patients with foot complications from three Johannesburg PHC centres. Descriptive statistics were used to analyse patient data.

Results: The study reveals a high prevalence of diabetic foot complications in PHC clinics, emphasising the need for community foot health promotion and podiatrist involvement. Early intervention is crucial, especially in patients with longer diabetes duration. Inadequate management and screening of foot-related complaints by nurses are observed. Lack of guidelines and well-defined referral pathways contribute to inadequate diabetic foot management.

Conclusion: The study reveals significant challenges in managing diabetic foot complications in South Africa’s PHC system, emphasising the need for reform, early intervention, and the inclusion of podiatrists to provide holistic care and prevent amputations. The study concludes that podiatrists should be an integral part of PHC teams to improve diabetic foot care.

The role of continuous topical oxygen therapy as an adjunctive treatment in non-healing chronic wounds: a South African perspective

2024-04-10T12:19:29+00:00

Background: This study aims to investigate the impact of continuous topical oxygen therapy (cTOT) as an adjunct to routine standard of care (SoC) in several patients with chronic, hard-to-heal wounds at the Wound Management Centre in Pretoria, South Africa.

Patients and methods: Patients with non-healing wounds lasting more than 30 days without active, untreated infection or osteomyelitis were included in this study. Following review and informed consent, patient, wound, and pain assessments (numeric rating scale, NRS) were performed. The cTOT system (cTOT, NATROX^® O₂ wound therapy) was applied to the wound and covered with an appropriate secondary dressing. Wound assessments and dressing changes were performed weekly until healing was achieved.

Results: A total of 14 patients received cTOT. Two patients were lost to follow-up, and one failed to return to the clinic after eight weeks of treatment; however, data from that point were included. Six wounds healed within a mean duration of 11.7 weeks. The diabetic foot ulcer (DFU, Texas grade 2B, patient 4) took the longest time to heal (17 weeks), whereas the fastest healing was seen in a venous ulcer (VU) reported to heal in just six weeks, despite a duration of seven months before cTOT. The mean area reduction across the 12 wounds was 78.6%. The NRS pain score was shown to reduce in 5/6 wounds by 3.2 points on average (2–4 range).

Conclusion: cTOT proved to be a valuable adjunct to help improve wound healing and reduce pain in these challenging wounds in South Africa, highlighting the possible benefit of access to this therapy for patients with chronic, non-healing wounds in the region.

Perspectives on wound care in nursing homes: an agenda for knowledge translation in the South African context

2024-05-21T12:54:34+00:00

Background: The high risk of wounds among older people necessitates an evidence-based approach to wound care in nursing homes. This study explores the perspectives of nurse managers on the need to improve wound care in South African nursing homes to inform knowledge translation endeavours.

Methods: Utilising an exploratory, descriptive, qualitative design, 14 nurse managers from diverse nursing homes in the Tshwane District, Gauteng, were interviewed via telephone. The collected data were then thematically analysed.

Findings: Findings reveal improvement needs at the level of the resident and their family, the staff, and the organisation. Key issues include the need for enhanced psychological, emotional, and financial support for residents, capacity building to improve care staff’s knowledge, attitudes, and wound care practices, and organisational support for accessing advanced wound care products and multiple health professionals.

Conclusion: The study emphasises the complexity of wound care in nursing homes and the imperative for a person-centred, integrated, and interprofessional approach to address these challenges on multiple levels. Insights into context-specific problems can inform the development of interventions and strategies, hence, an agenda for knowledge translation. Continuous learning, collaboration, and organisational support are essential to establish evidence-based wound care practices in nursing homes.