Q813

An ABPI of over 1.2 may be pathological, e.g. patients with diabetes may show a falsely high ABPI as a result of medicinal calcinosis, with vessels being difficult to compress. Compression bandages should not be applied to people with diabetes except under close medical supervision (Morison and Moffatt 1994) (see Q8.18). If there is any doubt about the significance of an ABPI, a doctor should be consulted for advice. No one who has not been trained to do Doppler readings should attempt this...

Dressings

Many types of wound dressings are now available and it can be difficult to choose the one most appropriate to the wound. This chapter attempts to place the dressings into broad categories with some suggestions for their appropriate use. The dressings mentioned are not the only ones available and for further information it would be appropriate to refer to a text such as the Formulary of Wound Management Products (Morgan 1994). Your primary care group, or trust, may have a wound care formulary...

Factors affecting wound healing

It is not only the dressing that is chosen which affects the way wounds heal. This chapter examines other issues that may impact on wound healing, and explains why it is important to look at the patient's lifestyle and health status when assessing the patient and planning his or her wound management. Q3.1 What should be included in a general assessment of the patient As well as assessing the wound itself, it is important to look at the patient holistically. Many factors influence wound healing....

Wound infection

This chapter discusses the care of infected wounds, how to recognise wound infection and how it should be treated. The principles of cross-infections and asepsis are addressed and the precautions that are necessary to deal with patients who have MRSA. For further information about infection control the reader is referred to Duggal, Beaumont and Jenkinson, Infection Control A Handbookfor Community Nurses - in this series. Q10.1 How is wound infection recognised Infected tissue within a wound...

Miscellaneous

This chapter deals with other frequently asked questions that do not fit into any of the other chapters in the book. These include care of fungating wounds, dressing difficult areas, maceration and the use of maggots larval therapy . Fungating describes a condition of ulceration and proliferation that arises when malignant tumour cells infiltrate and erode through the skin Mortimer 1993 , or malignant cells spread along pathways of least resistance, e.g. between tissue planes and lymph...