Resources

In order to reduce Surgical Site Infections (SSI) and SSI readmission rates, improve the patient experience and reduce costs in accordance with the value-based healthcare principle1, Barking, Havering & Redbridge University Hospitals NHS Trust (BHRUT) maternity unit adopted the National Institute for Health and Care Excellence (NICE) guidance MTG55. We replaced an inert wound dressing with Leukomed® Sorbact® (Essity) a single-use, bacteria-binding dressing for all patients with closed caesarean wounds.

Mr C is a 50 year old gentleman who sustained trauma to his right calcanium when falling off a ladder in 2017. This injury resulted in extensive surgery to his left foot, by the orthopaedic and plastic surgeons, resultant in muscle bulking which is planned for future surgery. The devastating effects of this injury were not only physical but psychological as the strain on both him and his family left a feeling of low mood and the inability to work. Mr C had been referred to a number of speciality consultants where no communication between these specialities had occurred, causing him both frustration and a feeling of little hope that his wound would heal.

The delivery of Safe, Effective, Harm Free care has been a focus for healthcare providers and regulators for many years.
Avoidable or preventable harms have a negative impact on the patient and the provider with potentially far-reaching consequences for both parties. See Table 1.
One well-recognised, long standing patient harm is pressure related tissue injury (pressure ulceration). Pressure ulcers (PU) often act as a key indicator of care quality, and these preventable wounds consistently represent an important target for harm reduction by healthcare providers.

National Database of Nursing Quality Indicators (NDNQI) had estimated that the average HAPI costs about $50,000 to $150,000 per injury, & mortality increase by 12%. 2.5 Million HAPI patients are treated in US healthcare facilities annually 60,000 US Hospital Patients die each year from complications related to HAPI
322,946 reported cases of CMS patients with HAPU/HAPI as secondary diagnosis each case. Average charge of $40,381/case Annual total cost of $13 billion. Variability / Case Mix / Level of Cares: 62% of HAPI are surgical patients, 76% ICU patients, 81% admitted patients
Centers for Medicare & Medicaid Services (CMS) none reimbursement for HAPI. Considerable fines & litigation for development of HAPI Patient safety, comfort, morbidity and mortality at risk.

Driving improvements through harm reduction
To help Great Western Hospitals NHS Foundation Trust (GWH) achieve its vision, the senior management team has set out the four ‘strategic pillars’ detailed in Figure 1, with the goal of driving improvements across the Trust.
A key metric within the ‘outstanding patient care and quality improvement’ pillar is Total Harms, and the Trust target is to achieve zero avoidable harm within 5-10 years. The Trust’s calculation for ‘total avoidable harms’ aggregates monthly incidences of; pressure ulcers/harms; Falls; Hospital acquired infections (including COVID-19); Medication incidents; Serious incidents; Never Events.

Venous leg ulcers (VLU) pose significant challenges to patients and healthcare systems and can persist for months and even years1. The annual cost of managing venous leg ulcers in the UK is £941.6 million2. It is estimated that 1-2% of the population worldwide suffer from hard-to-heal ulcers affecting patients’ quality of life (QOL) and negatively impacting wound healing3,4.
A pilot study undertaken by Schwartz et al.5, treated nine VLUs with sNPWT for 4 weeks alongside compression bandaging and showed a decrease in the size of VLUs by 32%. Graduated compression therapy is first-line treatment for patients with VLU as it is an effective treatment and results in a low risk of recurrence3. Despite this, many VLUs remain hard to heal, however the PICO 7 sNPWT can help facilitate a positive wound healing trajectory for these types of wounds6.

Various guidelines on managing hidradenitis suppurativa have been published since 2015 all recognising the importance of wound care for managing HS, however evidence supporting effective dressings for use in HS is lacking1 There are just a few articles examining dressings for HS, which include the recommendation of items such as
sanitary napkins and adult nappies 2 These recommendations highlight the lack of products being developed by industry specifically for patients with HS, that address the difficulties facing patients on a day to day basis Many research articles on HS wound care focus on post surgical care, and for many patients, the day to day management of exudate and odour imposes a significant burden and impacts quality of life 3
HS patients experience many challenges in the day to day management of their HS lesions and wounds A recent study found that the majority of patients use dressings regularly to manage their HS, with over half of patients needing dressings for more than 6 months out of every year 3 Over 80 of patients believe that tending to their wound care has a negative impact on their quality of life A staggering 93 %%( 845 s have experienced a dressing leak or fall off 3 Over 80 of patients experience dressing related pain, with 43 describing dressings changes as “very painful”, while the majority of the patients reported adhesive sensitivity 3 Adhesive dressings and tapes are known to damage the integrity of the skin, causing pain, irritation and skin stripping

The burden of hard to heal wounds on both patient outcomes and the local health economy has been widely documented.1,2 Effective management of these wounds has become a focus due to the increase in the prevalence of such wounds year on year.3 A survey undertaken to quantify the challenges within wound care services in Sweden, highlighted the importance of diagnosing and selecting treatments to reduce the burden and improve patient and wound outcomes.4 Failure to address the burden of hard to heal wounds will have a detrimental effect on services and associated resources in the future. Furthermore, a lack of understanding around recognising when a wound is clinically hard to heal, and the importance of intervening early means that the problem is further compounded.5 This poster presents evidence collated from Aalborg community in Denmark. The aim was to identify wounds that are impacting services and commence sNPWT as an early intervention to enhance the time it takes to heal a wound and prevent
wounds from becoming hard to heal and a burden on healthcare systems.

This poster aims to illustrate the clinical experience of using a new foam silicone adhesive dressing with hydrofiber We are both specialist podiatrists working in large community Trusts within Birmingham and Solihull.
We each completed our own evaluations and brought them together This allowed us to gain a balanced view and also adhere to trust processes as the product evaluation was completed at more than one site

Implementing SEM assessment technology* is being recognized as a routine practice in pressure ulcer (PU) prevention care. Clinical data and real-world evidence support the implementation of SEM assessment technology to achieve consistent PU incidence reductions in multiple care settings.^1,2