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Re: Wound Field Concept

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#68691
Marija Juraja
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Marija Juraja

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Hi Fiona,

Apologise for taking awhile to respond to this but I needed to get some clarification. I asked my colleagues at University SA what they actually teach students in their course and Terry-Renette Friebe, one of the Uni SA Course lecturers has commented back with this:

“I have recently been upgrading the literature on the wound program and must be honest didn’t see much about the wound field concept. My understanding of the wound field concept is that the wound and the dressing field are one entity, meaning that the microorganisms on the wound are the same as the dressing tray unless contamination from another source occurs. In regards to Infection control the concept of aseptic technique should still be the same regardless of the wound concept practiced. That is,

1. good hand washing
2. if not wearing sterile gloves practicing a non touch technique, and ensuring the part of the forceps and scissors touched by the hands should not be touching the sterile component of the wound field
3. if wearing sterile gloves than able to touch all components of the wound field but not able to touch non wound field environment
4. non sterile gloves are treated the same as bare hands.

To be honest, I would be suggesting the students haven’t understood the concepts and the difference – the wound field concept doesn’t negate the necessity for aseptic technique. I have attached links to a number of sources I found when researching this topic.”

http://search.informit.com.au/fullText;dn983658278629274;resIELHEA

http://download.journals.elsevierhealth.com/pdfs/journals/1322-7696/PIIS1322769608604655.pdf

http://www.sawma.org.au/documents/2007_sawma_wound_cleansing_and_dressing_procedure_nov_07.pdf

Kind Regards

Marija
Mrs Marija Juraja
Clinical Service Coordinator, CICP

Infection Prevention and Control Unit
8th Floor
T: +61 8 8222 7588
F: +61 8 8222 6461
P: 47757
E: marija juraja@health.sa.gov.au

—–Original Message—–

Hi Fiona

I recall the work of Tal Ellis from the Uni of SA which proposed this concept for the management of long term, chronic wounds. My understanding was that is was not really suited to acute trauma or surgical wounds. I don’t have any sources to cite for this, sorry, just what I recall of previous discussions.

I must admit I am surprised to hear universities teaching this concept for all wound care. Would be interested to hear if this is a widespread component of university training programs now.

Cheers
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

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Hi All,

I was recently introduced to the wound field concept by a new graduate nurse who had failed her aseptic non touch technique competency as she was using the wound field concept that she was taught at her university.

Although I can find theoretical information on this concept I have not found any research to show that this is a clinically better practice than using an ANTT. It does not appear to be included in the latest Australian Infection Control Guidelines or the new national standards either.

Does anyone have any references to support the wound field concept especially in relation to reduction in HAI rates?
Does anyone use this concept in their facility?

Kind Regards,

Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
Fiona.Desousa@sah.org.au
185 Fox Valley Road, Wahroonga, NSW, 2076

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