Journal of Community Nursing

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COMMUNITY WOUND CARE
process, which can be managed
effectively within this care setting.
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Top tips:
` The choice of wound care product must follow comprehensive holistic
wound assessment that involves examining the patients themselves as
well as their wounds.
` Wound assessment must review all aspects of the wound, whether it is a
linear surgical wound, a dehisced open cavity, leg ulcer or pressure ulcer.
` Before a wound can be successfully healed, any infection must
be identified.
` Moisture balance is crucial to healing the wound — poorly managed
exudate can increase the risk of infection and lead to the potential
‘knock-on’ effect of delayed wound healing.
` The role of patients in wound assessment is important — no one will
understand a wound better than the patient themselves and in many
cases they can provide an in-depth history.
` Debridement is essential in moving the wound along the healing
continuum — tissue type should be identified and any devitalised
tissue removed.
` Look out for comorbidities — previously diagnosed health issues such as
diabetes are known to mask problems such as wound infection.
` The edges of cavity wounds must be protected, and dressings used to
assist healing from the base of the wound upwards.
8 JCN supplement 2015,Vol 29 No 5
appropriate for the acute setting,
once the cost of nursing time and
patient wellbeing have been taken
into account, the cost of TNP is
outweighed by health gains. Thus,
it is now widely used in community
patients. Modern technology means
that there are now smaller portable
TNP machines that can deliver the
negative pressure to the wound
while allowing patients to continue
with their rehabilitation.
CONCLUSION
Community hospitals are a growing
service with staff working with
colleagues in district general
hospitals and treatment centres to
provide a link between secondary
and primary care.
With the support of visiting
clinical staff from the acute sector
and specialist nurses, community
hospitals can offer a patient-centred
approach to all aspects of care. As
the age of the general population
grows, so too will the pressure
on services.
Community hospitals are ideally
situated to ensure care needs are
met and that discharge home is
both safe and timely. Wound healing
is a complex and at times lengthy
JCN