Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
To effectively educate patients on wound care, it is crucial to provide comprehensive and actionable information, promoting self-care and involving them in decision-making NICE CKS.
- General Education Principles:
- Provide both verbal and written education to improve patient knowledge of managing their condition NICE CKS,NICE NG19.
- Enhance education for patients and carers to support a structured approach to surgical wound care NICE NG125.
- Promote self-care and provide educational materials, as this can encourage treatment concordance, improve ulcer healing, and prevent recurrence NICE CKS.
- Key Information to Convey to Patients:
- Understanding the Wound: Offer a clear explanation of the person's specific wound problem, potentially including pictures NICE NG19.
- Recognising Signs of Infection: Educate patients on the clinical symptoms and signs of infection. These include fever or malaise, rigors or tachycardia, wound breakdown, abscess, cellulitis, pocketing in the wound, increased or altered appearance of exudate, increased pain at the site, or the presence of odour NICE CKS. Advise them to report these signs and seek review if infection is suspected or persists NICE CKS,NICE CKS.
- Wound Cleansing:
- For surgical wounds, advise patients that sterile saline should be used for cleansing up to 48 hours after surgery NICE NG125. After 48 hours, tap water can be used if the surgical wound has separated or been surgically opened to drain pus NICE NG125.
- For ulcerated legs, advise that they can be washed normally in tap water and carefully dried NICE CKS.
- When choosing a method of wound cleansing, consider factors such as patient preference and availability of treatments NICE CKS.
- Dressing Management:
- Discuss with patients, and their family or carers if appropriate, what type of dressing should be used, taking into account pain and tolerance, the position of the ulcer, the amount of exudate, and the frequency of dressing change NICE CG179.
- Involve patients in decisions about wound dressings, considering their preference NICE CG179,NICE NG19.
- Advise patients that they may shower safely 48 hours after surgery NICE NG125.
- Managing Bleeding: For mild bleeding from an ulcer, advise applying gentle pressure for 10–15 minutes with a moist, non-adherent dressing NICE CKS. For heavier bleeding, advise applying pressure and seeking urgent advice from their healthcare team NICE CKS.
- Specific Considerations (if applicable):
- Diabetic Foot Problems: Provide information on care of the other foot and leg, foot emergencies and who to contact, footwear advice, and the importance of blood glucose control NICE NG19. Discuss offloading devices and strategies, taking into account the person's preference NICE NG19.
- Pressure Ulcers: Discuss strategies to offload heel pressure as part of an individualized care plan NICE CG179.
- Lacerations: Check and discuss the person's tetanus immunization status NICE CKS.