Wound Prevention and Management
The team’s priority research area is wound prevention and management. In 2006 a research partnership was established with the School of Nursing and Midwifery and Silver Chain. This partnership led to the development of the STAR Skin Tear Classification, which has been widely adopted nationally and internationally, with translations in Japanese, Portuguese and Chinese. This was followed by a case control study that identified clinical predictors for skin tears. These predictors have since undergone testing in two other studies and it is anticipated that they will result in a skin tear risk assessment tool for clinical practice. Studies that investigate skin tear prevention rank high on our priority list. A cluster randomised control study (CRCT) conducted across 14 aged care facilities (980 beds) found that the twice daily application of a perfume free, pH neutral moisturising lotion to the extremities of elderly residents reduced skin tear incidence by 50%. A Master of Philosophy study conducted in conjunction with this CRCT confirmed that the reduced skin tear incidence was attributed to the intervention. A costing study was conducted and demonstrated the financial benefits of such an intervention. Currently two CRCTs are being conducted across 28 aged care facilities to investigate the effectiveness of moisturising cleansers when used during routine bathing of residents, and when used alone or in combination with twice daily application of moisturiser, for further reduction of skin tear incidence.
Another priority focus is surgical wound dehiscence (SWD). A PhD project employed a case control study to examine a cohort of patients referred to a community nursing service with SWD. Controls were matched for referring hospital, surgical procedure and date (or as close to) of procedure. Statistical validation of the identified risk factors has led to a risk assessment tool which will be used for clinical evaluation of pre-operative risk for SWD and will be used to conduct a RCT prevention study. Risk factors for post-caesarean wound dehiscence are also being investigated.
The Wound Healing and Management Node (WHAM) which is a JBI project in partnership with Curtin and the CRC involves the development of evidence summaries on a taxonomy of wound management topics. The aim of these summaries is to accurately inform clinicians, patients and policy makers of the best available evidence on wound management for application in a variety of clinical settings. To achieve this aim a systematic and rigorous process of review is followed and involves national and international experts within the domain. All evidence summaries are published on the JBI site and in the Journal of Wound Practice & Research.
Future planned projects involve leg ulcer studies.