Nursing standard (Royal College of Nursing (Great Britain) : 1987)
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Chronic wounds such as leg ulcers and pressure ulcers are often slow to heal. One of the causes of delayed wound healing is the presence of micro-organisms in the wound. A strategy for the prevention and treatment of wound colonisation or infection, which is receiving renewed attention, is the use of silver-based dressings. ⋯ It is effective against a broad range of bacteria (including methicillin and vancomycin-resistant strains), yeast, fungi and viruses. A number of new silver-based dressings, some of which act by the sustained release of silver ions to the wound bed, have recently become available, but there are wide variations in the amount of data supporting the use of individual products. This article reviews the evidence base for silver-containing dressings to help practitioners select the most appropriate product for the type of wound being treated.
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A moist environment provides the optimum conditions for wound healing, but maintaining control of exudate and preventing its contact with the surrounding skin remain a challenge to carers. An essential part of management is identifying the underlying pathology of the wound. Correct diagnosis of the cause of increased exudate production is necessary for the implementation of appropriate interventions. Continual assessment of the wound and surrounding skin, together with evaluation of dressing performance, are integral to manage the different stages of wound healing.
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Surgery causes physiological stress on the body and carries inherent risks such as shock and haemorrhage. This article discusses cardiogenic and hypovolaemic shock and outlines the principles of safe and effective post-operative care, including recognising hypovolaemia, maintaining fluid balance and administering pain control.