Resources

Welcome to our June/July issue, although as I am writing I am wondering just how we have arrived at June already! As always, there are lots of informative and interesting features, all of which we hope will support your learning and practice, leading to enhanced patient care. The ‘Community matters’ piece focuses on the delays our patients are encountering for dermatological services. Please take some time to read this article, which will give you an oversight into why the delays exist and the potential physical and mental effects these are causing. With the summer months upon us, it is particularly relevant that skin cancer is a focus — information is given around the rising rates and possible reasons for this. The feature discusses a variety of skin conditions and offers strategies and advice to support your patients — an interesting and informative read.

Somebody once said that good things come to those who wait, a neat little piece of advice but one that seems over-ambitious given the parlous state of our health services, as anyone who has recently tried to book a GP appointment or find an NHS dentist willing to see them in the next decade will tell you.

But, it’s not just GPs and dentists who are in short supply. A recent BBC report highlighted how pressure on dermatology services is causing long delays for people with inflammatory skin conditions such as severe eczema, psoriasis and acne, with waiting times for NHS dermatology clinics in England even longer than before the Covid-19 pandemic (‘Living hell for “forgotten” skin patients’ — www.bbc.co.uk).

But what is driving these delays and how might it affect your patients?

The QICN has raised serious concerns about the recent government announcement about the apprenticeship scheme. At the heart of the issue is the proposed discontinuation of level 7 apprenticeships, which currently fund specialist postgraduate training for nurses, including district nursing, adult social care nursing, inclusion health nursing, community children’s nursing, and general practice nursing. These programmes are considered essential for delivering complex care in community settings.

Leg ulcers are a common, painful debilitating condition, characterised by long periods of ulceration and a high incidence of recurrence. Despite this, little attention tends to be given to prevention and education regarding the wide-ranging effects that leg ulceration has on a person’s quality of life.

In the past decade, radical changes have occurred within the provider healthcare setting. GPs are looking into the cost-effectiveness of treatments for their patients and the provision of services available for purchase from an NHS provider organisation. The restructuring of clinical services and a new pattern of provision organised around the concept of lower limb care could result in service provision being further fragmented within the category of long-term conditions that require specialist management by an appropriately trained clinician.

Summer has arrived and many of us are daring to get our legs out! That prospect isn’t an option for some people, however.

Across the UK, millions live with lower limb wounds and swelling that is preventable, and treatable — yet too often are given suboptimal care. These conditions can have a huge impact on a patient’s quality of life (Franks et al, 2006; GonzálezConsuegra and Verdu, 2011) and a significant burden on the NHS (Guest et al, 2020)

Guts UK is the national charity for the digestive system, helping the UK get to grips with guts for over 50 years. The charity’s vision is a world where digestive conditions are better understood, better treated and everyone who lives with one gets the support they need. Its mission is to improve the lives of millions of people affected by digestive conditions through three main areas of work: information and support, awareness and public education, and research.

Viscopaste and Ichthopaste Bandages and Zipzoc Medicated Stocking have a heritage to be proud of and have been trusted by clinicians for decades to treat patients successfully. But despite their longevity in the armoury of many healthcare professionals, there is often still some uncertainty around product selection, with clinicians asking, ‘how do I know which product to choose for my patient?’ Despite using the products for many years, clinicians and patients are often unable to explain the specific modes of action of zinc oxide and ichthammol. This can result in a knowledge gap in relation to product choice and the healing success that they observe. This feature provides the reader with a better understanding of when it might be desirable to choose one of these products over another. But first, let’s look at the main raw ingredients of zinc oxide and ichthammol.

This article provides an overview of venous leg ulcers, the current landscape and an evaluation of an intervention strategy implemented in York. The authors’ lower limb specialist wound clinic was set up to reduce variations in management and improve standardisation of care when treating venous leg ulcers. The purpose of the evaluation was to demonstrate the impact of a specialist wound clinic implementing evidence-based strategies and early interventions in line with national guidance for venous leg ulceration. The results demonstrate how this approach can improve outcomes and deliver value-based healthcare.

Debridement is vital in wound bed preparation, creating a clean, moist environment that supports effective healing (Burnett et al, 2021). It facilitates the removal of devitalised tissue, bacteria, and debris, reducing infection risk and promoting healthy tissue growth (Mayer et al, 2024). Multiple debridement techniques exist such as sharp, larval, enzymatic, ultrasound, and surgical, however their use may be limited by required expertise or clinical setting. This article introduces an updated definition of debridement and traces its evolution from traditional methods to modern, patient-friendly technologies, exemplified by the innovative dual-sided monofilament pad, Debrisoft® Duo. It also includes some case series evaluating the effectiveness and practicality of Debrisoft Duo, particularly in managing wounds with persistent fibrous devitalised tissue where conventional sharp debridement is unsuitable.

Moisture-associated skin damage (MASD), particularly incontinence-associated dermatitis (IAD), is a significant challenge in acute care settings. It affects patient comfort, increases the risk of infection, and contributes to prolonged hospital stays (Gray et al, 2021). Effective skin protection strategies, including structured care protocols and barrier products, are essential to mitigate these complications. This case evaluation examines the use of Medi Derma-PRO Ointment to enhance skin integrity and reduce MASDrelated harm across a healthcare trust. An evidence-based approach was employed to evaluate patient and broader organisational outcomes following the implementation of this intervention.