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Høyland SA, Holte KA, Islam K, Øygaarden O, Kjerstad E, Høyland SA, Waernes HR, Gürgen M, Conde KB, Hovland KS, Rødseth E, Carayon P, Fallon M, Ivins N, Bradbury S, Husebø SIE, Harding KG, Ternowitz T. A cross-sector systematic review and synthesis of knowledge on telemedicine interventions in chronic wound management-Implications from a system perspective. Int Wound J 2022; 20:1712-1724. [PMID: 36261052 PMCID: PMC10088836 DOI: 10.1111/iwj.13986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/09/2022] [Accepted: 10/09/2022] [Indexed: 11/29/2022] Open
Abstract
Based on initially identified needs for further telemedicine (TM) and chronic wound management research, the objective of this article is twofold: to conduct a systematic review of existing knowledge on TM interventions in chronic wound management-including barriers and opportunities-across the specialist and primary care sectors, and to incorporate the review findings into a system framework that can be further developed and validated through empirical data. We conclude that there is a pressing need for broader and more comprehensive empirical explorations into quality improvement and integration of TM in chronic wound management, including using system frameworks that can capture cross-sector system perspectives and associated implications. Of practical consideration, we suggest that the design and execution of TM improvement interventions and associated research projects should be conducted in close cooperation with managers and practitioners knowledgeable about barriers and opportunities that can influence the implementation of important interventions within chronic wound management.
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Affiliation(s)
- Sindre Aske Høyland
- Division for Health and Social Sciences, NORCE Norwegian Research Centre, Stavanger, Norway
| | - Kari Anne Holte
- Division for Health and Social Sciences, NORCE Norwegian Research Centre, Stavanger, Norway
| | - Kamrul Islam
- Division for Health and Social Sciences, NORCE Norwegian Research Centre, Stavanger, Norway
| | - Olaug Øygaarden
- Division for Health and Social Sciences, NORCE Norwegian Research Centre, Stavanger, Norway
| | - Egil Kjerstad
- Division for Health and Social Sciences, NORCE Norwegian Research Centre, Stavanger, Norway
| | | | | | - Marcus Gürgen
- Department for Dermatology, Stavanger University Hospital, Stavanger, Norway
| | | | | | - Eirin Rødseth
- Department for Personal E-Health, Norwegian Centre for E-health Research, Tromsø, Norway
| | - Pascale Carayon
- Department for Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Nicola Ivins
- Welsh Wound Innovation Centre WWIC, Ynysmaerdy, Wales
| | | | | | - Keith G Harding
- School of Medicine, Cardiff University, Cardiff, UK.,Skin Research Institute of Singapore (SRIS), Novena, Singapore
| | - Thomas Ternowitz
- Department for Dermatology, Stavanger University Hospital, Stavanger, Norway
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González-de la Torre H, Verdú-Soriano J, Quintana-Lorenzo ML, Berenguer-Pérez M, Lavín RS, Soldevilla-Ágreda J. Specialised wound care clinics in Spain: distribution and characteristics. J Wound Care 2020; 29:764-775. [PMID: 33320747 DOI: 10.12968/jowc.2020.29.12.764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine the number of specialised wound care units/clinics (SWCUs) in Spain, at present, and to describe their most important characteristics. METHOD This was an observational study with a descriptive-analytical, cross-sectional, multicentre approach, where the studied population consisted of SWCUs in Spain. A specific data-collection questionnaire was designed using a modified Delphi method, consisting of four rounds, with the collaboration of 10 wound experts. The final questionnaire included 49 items distributed across four dimensions/areas with a content validity index (CVI-Total for pertinence=0.96 and CVI-Total for relevance=0.94. RESULTS A total of 42 SWCUs were included in the study. Most SWCUs were based in hospitals (n=15, 35.7%) or healthcare centres, covering a specific healthcare area (n=17, 40.5%). SWCU coordinators were primarily nurses (n=33, 78.6%). Staff members' professions in SWCUs included registered nurses (n=38 units, 92.7%), nursing assistants (n=8 units, 19.5%), podiatrists (n=8 units, 19.5%), vascular surgeons (n=7 units, 17%), osteopaths (n=2 units, 4.8%) and medical doctors from different specialties (n=3 units, 7.2%). For wound aetiology, the most prevalent wounds managed were diabetic foot ulcers (n=38 units, 90.5%), followed by venous leg ulcers (n=36 units, 85.7%) and arterial ischaemic ulcers (n=36 units, 85.7%). A statistically significant association was found between the number of staff members in a SWCU and the existence of resistance/opposition barriers when developing a SWCU (Chi-square test, p=0.049; Cramér's V=0.34; 34%), as well as between resistance/opposition barriers when developing a SWCU and a nurse as coordinator of a SWCU (MacNemar test, p=0.007, Cramér's V=0.35; 35%). CONCLUSION The typical SWCU implemented in Spain is located in a hospital or integrated in a healthcare structure that offers coverage to a whole health area and providing services for people with hard-to-heal wounds (wound management and prevention) and health professionals (advice, consultancy and training/education). Despite the growing number of SWCUs in Spain, the future of this new organisational model is uncertain, as there can be barriers to creating them and some deficiencies, such as low staff numbers, which need to be addressed.
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Affiliation(s)
- Héctor González-de la Torre
- Complejo Hospitalario Materno-Infantil Insular de Gran Canaria, Servicio Canario de Salud, Las Palmas de Gran Canaria, Spain
| | - José Verdú-Soriano
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante, Spain
| | - María L Quintana-Lorenzo
- Gerencia de Atención Primaria de Gran Canaria, Servicio Canario de Salud, Las Palmas de Gran Canaria, Spain
| | - Miriam Berenguer-Pérez
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante, Spain
| | - Raquel Sarabia Lavín
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Cantabria, Santander, Spain
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General practitioners' knowledge of leg ulcer treatment in primary healthcare: an interview study. Prim Health Care Res Dev 2020; 21:e34. [PMID: 32967749 PMCID: PMC7576540 DOI: 10.1017/s1463423620000274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To describe general practitioners’ (GPs’) knowledge and the development of their knowledge regarding leg ulcer treatment when treating patients with leg ulceration at primary healthcare centers. Background: Earlier research regarding GPs’ knowledge of leg ulcer treatment in a primary healthcare context has focused primarily on the assessment of wounds and knowledge of wound care products. Less is known about GPs’ understandings of their own knowledge and knowledge development regarding leg ulceration in the everyday clinical context. This study, therefore, sets out to highlight these aspects from the GPs’ perspective. Methods: Semi-structured interviews were conducted with 16 individual GPs working at both private and county council run healthcare centers. The data were analyzed inductively using a thematic analysis. Results: Four themes were identified. ‘Education and training’ describe the GPs’ views regarding their knowledge and knowledge development in relation to leg ulcer treatment. ‘Experience’ refers to GPs’ thoughts about the importance of clinical experience when treating leg ulcers. ‘Prioritization’ describes the issues GPs raised around managing the different knowledge areas in their clinical work. ‘Time constraints’ explore the relationship between GPs’ sense of time pressure and their opportunities to participate in professional development courses. Conclusions: The study shows that the GPs working in primary healthcare are aware of the need for ongoing competence development concerning leg ulceration. They describe their current knowledge of leg ulcer treatment as insufficient and point to the lack of relevant courses that are adapted for their level of knowledge and the limited opportunities for clinical training.
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Rendell VR, Esposito TJ, Gibson A. Survey of Surgeons’ Perspectives of Wound Care Centers and Chronic Wound Care. Am Surg 2020. [DOI: 10.1177/000313481908501231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Multidisciplinary management of chronic wounds using comprehensive wound centers improves outcomes. With an increasing need for wound providers, little is known about surgeons’ roles in wound centers. An online survey of two national surgical organization members covered demographics, wound center characterization, and surgeons’ perspectives of wound centers and wound care. Surgeon perspectives were compared by age, gender, and relationship status. Three hundred sixty-four surgeons responded. Respondents were mostly older than 50 years, male, in practice older than 10 years, and used wound centers. Most respondents reported favorable experiences with wound centers but uncertainty about financial details. Most respondents were interested in formal wound care certification and participation in a wound practice, particularly as a transition to the retirement option for older surgeons. Surgeons are interested in pursuing a career focus in wound care. Further efforts are needed to educate surgeons and create a pathway for surgeons to become wound center directors. In a nationwide survey, surgeon perspectives on wound centers and wound specialization were positive, although financial understanding was limited. The importance of this finding is the support of wound care pathways for surgeons.
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Affiliation(s)
- Victoria R. Rendell
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; and
| | | | - Angela Gibson
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; and
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Astrada A, Nakagami G, Jais S, Sanada H. Successful treatment of a diabetic foot ulcer with exposed bone using Trigona honey: a case study. J Wound Care 2019; 28:S4-S8. [DOI: 10.12968/jowc.2019.28.sup12.s4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Many studies have shown that honey might improve wound healing. However, its efficacy for large wounds which may be followed by a systemic effect remains unclear. The effectiveness of honey-based dressings in treating large diabetic foot ulcers (DFU) is still unknown. This study presents the case of a 38-year-old female patient presenting with an extensive infected DFU with exposed bone. The DFU was treated with propolis-enriched Trigona honey, used as a single treatment, in a home visit setting. After two months' follow-up, the wound exhibited complete re-epithelialisation despite the patient's initial poor condition.
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Affiliation(s)
- Adam Astrada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan
- BantuMelangkah.com
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, the University of Tokyo, Japan
| | - Suriadi Jais
- Kitamura Clinic, Indonesia
- Muhammadiyah Institute of Nursing Science, Pontianak, Indonesia
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, the University of Tokyo, Japan
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Ennis WJ, Hoffman RA, Gurtner GC, Kirsner RS, Gordon HM. Wound healing outcomes: Using big data and a modified intent-to-treat method as a metric for reporting healing rates. Wound Repair Regen 2017; 25:665-672. [DOI: 10.1111/wrr.12575] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 07/18/2017] [Indexed: 11/30/2022]
Affiliation(s)
- William J. Ennis
- University of Illinois Hospital and Health Sciences System; Chicago Illinois
- Healogics Inc.; Jacksonville Florida
| | | | | | - Robert S. Kirsner
- Department of Dermatology; University of Miami Miller School of Medicine; Miami Florida
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Chandra V, Glebova NO, Salvo NL, Wu T. Partnerships between podiatrists and vascular surgeons in building effective wound care centers. J Vasc Surg 2017; 66:902-905. [PMID: 28842074 DOI: 10.1016/j.jvs.2017.06.071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This practice memo, a collaborative effort between the Young Physicians' Program of the American Podiatric Medical Association and the Young Surgeons Committee of the Society for Vascular Surgery, is intended to aid podiatrists and vascular surgeons in the early years of their respective careers, especially those involved in the care of patients with chronic wounds. During these formative years, learning how to successfully establish an interprofessional partnership is crucial to provide the best possible care to this important population of patients.
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Affiliation(s)
- Venita Chandra
- Division of Vascular Surgery, Stanford University, Stanford, Calif
| | - Natalia O Glebova
- Division of Vascular Surgery & Endovascular Therapy, University of Colorado, Aurora, Colo
| | - Nichol L Salvo
- Podiatry Section, Atlanta VA Medical Center, Decatur, Ga
| | - Timothy Wu
- Division of Vascular Surgery, Rutgers New Jersey Medical School, Newark, NJ.
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Li W, Ma Y, Yang Q, Pan Y, Meng Q. Moist exposed burn ointment for treating pressure ulcers: A multicenter randomized controlled trial. Medicine (Baltimore) 2017; 96:e7582. [PMID: 28723796 PMCID: PMC5521936 DOI: 10.1097/md.0000000000007582] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Pressure ulcers often seriously affect the quality of life of patients. Moist Exposed Burn Ointment (MEBO) has been developed to treat patients with pressure ulcers. The present study aimed to evaluate the efficacy and safety of MEBO in the treatment of pressure ulcers in Chinese patients. METHODS Seventy-two patients with pressure ulcers were randomly assigned to 2 groups who received a placebo or MEBO for 2 months. The primary outcomes included the wound surface area (WSA) and pressure ulcer scale for healing (PUSH) tool. The secondary outcomes included a visual analog scale (VAS), questionnaire of ulcer status, and adverse effects. RESULTS Sixty-seven patients completed the study. After 2 months of treatment, the difference of mean change from the baseline was greater for MEBO (vs placebo) for WSA mean (SD) -6.0 (-8.8, -3.3), PUSH Tool -2.6 (-4.7, -1.5), and VAS score -2.9 (-4.4, -1.7). On the basis of the questionnaire, the pressure ulcers were "completely healed" (50.0% vs 16.7%) (P < .05) in patients after 2 months of treatment with MEBO versus placebo. No major adverse effects were found in the 2 groups. CONCLUSION We showed that MEBO is effective and well tolerated for improving wound healing in Chinese patients with pressure ulcers.
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Affiliation(s)
- Wei Li
- Department of Medical Science Institute of Harbin, the First Hospital of Harbin, Harbin Medical University, Harbin
| | - Yubo Ma
- Department of Orthopedics, Hongqi Hospital of Mudanjiang Medical College, Mudanjiang
| | - Qi Yang
- Department of Medical Science Institute of Harbin, the First Hospital of Harbin, Harbin Medical University, Harbin
| | - Yu Pan
- Department of Study Center, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qinggang Meng
- Department of Medical Science Institute of Harbin, the First Hospital of Harbin, Harbin Medical University, Harbin
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