Improving wound prevention and healing

The Tissue Viability Society (TVS) conference focuses on the science behind wound prevention and healing along with the clinical skills required to achieve good outcomes in wound care. The event provides an opportunity for the hundreds of specialist nurses and other health professionals involved in the prevention and healing of wounds to improve the care received by the thousands of people who experience a wound each year. The Tissue Viability Society is the oldest specialist organisation worldwide dedicated to preventing and treating all forms of wounding. It was formed in 1981 as a multi-professional organisation and has been a registered charity since 1994. The society exists to share information to healthcare professionals, academic colleagues, members of the public, policy makers, bioscience industries and other stakeholders related to the development of tissue viability, as well as raising awareness of research and best clinical practice.

Why are wounds important?
Wounds cost the NHS large sums of money each year. Each year the NHS may spend between £2.3 billion to £3.1 billion only on the treatment of three forms of non-healing wound – diabetic foot ulcers, leg ulcers and pressure ulcers (Posnett and Franks 2007). These costs do not take into account efforts to prevent these wounds which, in the case of pressure ulcers, may at least match the cost of treatment (£1.76 billion to £2.64 billion). Nor do these costs cover the treatment of acute wounds which are far more common than chronic nonhealing wounds (Vowden and Vowden 2009). On economic grounds improved wound prevention and healing are vital if the NHS is to reduce its current spending which may reach 3% of the total NHS expenditure on healthcare in the UK.

Campaigns and awareness raising
Dr Michael Clark, professional adviser to the Tissue Viability Society and an internationally recognised expert on pressure ulcer prevention notes that the Tissue Viability Society “works on a number of levels to improve the awareness of health professionals and the public of the significance of wounds to the general health and wealth of the UK”. Reaching the public can be challenging as this is an issue that is often clouded by embarrassment and surrounded by ignorance regarding the serious health consequences that wounds can bring. The TVS has been working with other organisations through the Skin Care Campaign and, in particular, the “Your Turn” campaign which is focused on pressure ulcer prevention. The “Your Turn” campaign can be seen at: www.your-turn.org.uk and offers practical information and support for people who may be vulnerable to developing pressure ulcers. The campaign is supported by the successful stage and screen actress, Miriam Margolyes, who commented: “It makes me frustrated and incredulous to think that in a society where we have made such wonderful strides with medical technology, that an entirely avoidable condition such as a pressure ulcer is being completely overlooked. Helpless people need to be taken care of – it’s our human responsibility.” The Tissue Viability Society has also been working closely with the European Pressure Ulcer Advisory Panel and the Royal College of Nursing to develop an audit showing the readiness of healthcare organisations in the UK to manage pressure ulcer prevention. The initial results of this audit will be presented at the TVS conference and will show, for the first time the strategic and managerial steps taken across the NHS to tackle pressure ulcer prevention. The TVS also works closely with the European Wound Management Association (EWMA) and the conference will showcase the EWMA Leg Ulcer Project – EWMA has been working in conjunction with the wound management associations of the Czech Republic, Poland and Slovenia to develop, implement and evaluate an appropriate model of care for patients with leg ulceration. The TVS conference will provide the first opportunity for a UK audience to hear the progress of this European collaboration and contribute to the next stages of the project through open discussion in the conference sessions. One major highlight of the Tissue Viability Society conference will be the European launch of new international pressure ulcer prevention and treatment guidelines issued jointly by the European Pressure Ulcer Advisory Panel and the US National Pressure Ulcer Advisory Panel. These international guidelines were launched in the United States in late February 2009 and the TVS is proud to have been selected as the event at which these important documents on improving pressure ulcer care are shown for the first time in Europe. The development of the new guidelines has been a massive undertaking involving over 70 academics and clinicians throughout North America and Europe with comments on draft versions from over 150 individuals and organisations located all around the world. The development process and latest drafts of guideline documents can be viewed at: www.pressureulcerguidelines.org The current president of the European Pressure Ulcer Advisory Panel, Dr Carol Dealey, will also present a fascinating overview of the history of manual repositioning of people to prevent pressure ulcer development. For many years the standard approach to pressure ulcer prevention was to change the position of immobile people at two-hour intervals. The source of this guidance has been shrouded in mystery and myth, with a common perception that this stemmed from Florence Nightingale in the Crimean War. It was believed to take her and her nurses two hours to move through each ward, changing the position of the wounded soldiers. Dr Dealey will provide a historical narrative of the likely sources and development of the ritual of two-hourly repositioning and hopefully shed light on the initial development of this practice.