For Surgeons


The Wound Care Clinic Concept

Every practice has them. Cases of indolent wounds treated over weeks, sometimes months and occasionally even years. Wounds such as bedsores, venous ulcers, chronic burn wounds, and simply those inadequately managed, may tax the skill of the practitioner and drain society of valuable man-hours and accrue unnecessary expense. As health care expenditure and accountability come under the spotlight, it has become apparent that major amounts of money are spent on protracted wound management. It has also become clear that the subject of wound care, taken so often for granted in teaching and in practice, has evolved into a highly sophisticated scientifically researched area with major exciting advances taking place on a continual basis.

In this light, certain new initiatives have been undertaken as joint projects with wound care companies, academic institutions, private clinics, practitioners and nursing staff. The concept of wound care clinics was spearheaded by Convatec based on various models abroad, in particular those in Peru. In conjunction with a few practitioners, these clinics were established in Academic institutions (Medunsa) and private clinics (Linksfield Park, Pretoria etc). The clinics provide a facility where fully trained nursing staff, familiar with the latest theory and practice of wound healing attend to dressings and care of presenting wounds. This is done in consultation with a specialist in wound care, whether he\she be a plastic surgeon, general surgeon or any practitioner with the necessary experience, training and expertise.

The clinics are run on a multidisciplinary basis with the input of neurologists, orthopaedic surgeons, vascular surgeons or whichever specialty may be needed for additional input. In most cases, the wound care nurse is adequately trained to deal with the usual wound problems and most commonly referrals are from medical practitioners who are involved in the treatment decision making or request the input of a wound care specialist. Ongoing dressings are then carried out without encroaching on the practitioners time. As time goes on, the wound care nurse gains unique experience and is often very capable in handling these wounds independently. This allows discharge of patients from hospital and more efficient utilisation of time and expense in the management of these wounds. Recognising the need for standardised wound-care personnel training as well as maintaining contact with the latest academic developments in the field, Smith and Nephew initiated and still co-ordinates the formation of the Wound Healing Association of South Africa (WHASA). Initial meetings saw the nomination of specialists from various fields interested in wound healing. This steering committee then established frameworks for the standardisation of training courses for nursing staff and recommended the formation of committees in each regional centre with representatives from the trade, nursing and medical practitioners from the public and private sectors. Training courses are already offered by companies such as Smith and Nephew, Convatec and others. It is envisaged that all these courses will be amalgamated into one standardised course for training of nursing personnel. A major certified course is due to be run in August.

From the United Kingdom, University of Hertfordshire, the course consists of an intensive week’s program followed by an examination. Successful candidates will be issued with certificates. This course was researched and sponsored by Smith and Nephew – 20 nursing professionals have been selected (from over 120 applications) for training. Once all the courses have been assessed, a standardised program will be designed for wound care nurses in South Africa.

Knowing full well that the Nursing Societies have their own wound care divisions, this Association is aimed at working with the various nursing bodies and amalgamating all our efforts and experience for the betterment of wound.

31 October 2002
Professor Alan D Widgerow