The management of surgical wounds in a community setting

Constipation, treatment and biofeedback therapy

Constipation is commonly encountered by the community nurse, particularly in older people. A comprehensive assessment is required prior to treatment, to exclude potential pathologies such as a bowel cancer. There are many potential causes of constipation, such as poor diet or use of opioid analgesia. This can guide the nurse to a potential treatment, for example to include more fibre in the diet or to possibly change the analgesia used. However if these and/or other therapies fail, biofeedback therapy offers a non-surgical option. Biofeedback therapy includes patient education, retraining of the bowels and muscles, behavioural therapies and psychological support.

Innovations in district nursing: the use of a first dressing starter box

Since the advent of nurse prescribing many district nurses have raised concerns about having only a simple non-adherent dressing available to apply to a wound while waiting for a prescription to be dispensed. This type of product does not meet the criteria for an ideal wound dressing. Using dressing products acquired from other sources, for example surplus dressings prescribed for another patient, is considered unacceptable clinical practice. This article describes a pilot study carried out to determine the feasibility of providing a 'starter box' filled with a selection of dressing products for use at the first dressing consultation. The results of the pilot study show that the availability of such a starter box could lead to a better wound care service for patients, and that cost savings could be made from avoiding unnecessary additional return visits or clinic appointments.