(精选)NHS临床指南 Plymouth Health Community NICE Guidance Implementation Group教学课件.pptVIP

Plymouth Health Community NICE Guidance Implementation Group Workshop Two: Debriding agents and specialist wound care clinics. Pressure ulcer risk assessment prevention 5th December 2002 Randomised Controlled Trial (RCT) A trial in which subjects are randomly assigned to either a group receiving an intervention that is being tested or control group receiving an alternative or no intervention. The results compare the outcomes of the different groups. Systematic Reviews A review of research-based evidence on a topic in which the evidence has been systematically identified, appraised and summarised according to pre-determined criteria . Plymouth Health CommunityNICE Guidance Implementation Group Use of debriding agents specialist wound care clinics for difficult to heal surgical wounds. Technology Appraisal Guidance (TGA 24). Issue date: April 2001 Review date: March 2004 Background Delays to healing caused by several intrinsic extrinsic factors - including debris within wound No reliable figures for wounds that become difficult to heal - 21,000 per year Trend towards community care High levels of knowledge, skill advice Expert services for most intractable Debridement Removal of devitalised necrotic or infected tissue or fibrin (‘debris’) from a wound Different methods of debridement, e.g. surgical, mechanical or autolytic Range of wound care products thought to promote autolytic healing: ‘modern dressings’ Frequency of dressing change and patient acceptability important factors in choice of dressing Cost to the NHS Actual costs of treating difficult to heal surgical wounds not been measured Health care costs not only unit costs of dressing used, but the frequency of dressing changes needed, over period of time. Nursing costs No. of patients affected not known, clinical practice varies. Difficult to estimate the cost and service impact on the NHS of changes in debriding agents or specialist wound care services. Systematic review on