Karen Ousey

University of Huddersfield · School of Human and Health Sciences

Objective The aim of this in vitro experimental series was to explore the mode of action of a hydrocellular polyurethane foam dressing (HPFD) and how its advanced features support beneficial interactions with the wound bed to address common barriers to wound healing, thus supporting improved clinical outcomes. Method Multiple in vitro microbiologi...

Wound debridement is commonplace in expediting wound healing in the clinic. Despite this, there are limited resources available for simulation training for practitioners prior to facing real-life patients. Typically, citrus peels or porcine skin are employed in a vain attempt to improve debridement proficiency, yet these fail to provide a realistic...

Objective The effective assessment of wounds, both acute and hard-to-heal, is an important component in the delivery by wound care practitioners of efficacious wound care for patients. Improved wound diagnosis, optimising wound treatment regimens, and enhanced prevention of wounds aid in providing patients with a better quality of life (QoL). There...

Slough is a well‐known feature of non‐healing wounds. This pilot study aims to determine the proteomic and microbiologic components of slough as well as interrogate the associations between wound slough components and wound healing. Ten subjects with slow‐to‐heal wounds and visible slough were enrolled. Aetiologies included venous stasis ulcers, po...

This scoping review aimed to identify and summarise evidence on the comfort and functional performance of police officer personal protective equipment (PPE). The Arksey and O'Malley (2005) five-stage framework for scoping reviews was followed. PubMed, CINAHL, Scopus, and Web of Science were searched, and 35 articles were included in the review. The...

Slough is a well-known feature of non-healing wounds. This study aims to determine the proteomic and microbiologic components of slough as well as interrogate the associations between wound slough components and wound healing. Twenty-three subjects with slow-to-heal wounds and visible slough were enrolled. Etiologies included venous stasis ulcers,...

Objective: To update the evidence in relation to the use of dialkylcarbamoyl chloride (DACC)-coated wound dressings in the prevention, treatment and management of wounds. Method: PubMed and PubMed Central databases were searched to identify articles published since 2020 describing the experimental and clinical evidence for DACC-coated dressings,...

Objective: Most surgical wounds heal by primary or secondary intention. Surgical wounds can present specific and unique challenges including wound dehiscence and surgical site infection (SSI), either of which can increase risk of morbidity and mortality. The use of antimicrobials to treat infection in these wounds is prevalent, but there is now an...

Objective: Antiseptics are widely used in wound management to prevent or treat wound infections, and have been shown to have antibiofilm efficacy. The objective of this study was to assess the effectiveness of a polyhexamethylene biguanide (PHMB)-containing wound cleansing and irrigation solution on model biofilm of pathogens known to cause wound...

Objective: To internationally validate a tool for predicting the risk of delayed healing of venous leg ulcers (VLUs). Method: A 10-item tool including sociodemographic factors, venous history, ulcer and lower limb characteristics, compression and mobility items to determine the risk of delayed healing of VLUs has previously been developed and va...

Background: Evidence has shown an association between obesity and an increased risk of wound infection after caesarean section. This study was designed to examine if abdominal subcutaneous adiposity impacts upon cutaneous perfusion dynamics. Methods: Mild cool challenge, followed by real-time video thermography, was developed to map the appearan...

A wound offers an ideal environment for the growth and proliferation of a variety of microorganisms which, in some cases, may lead to localised or even systemic infections that can be catastrophic for the patient; the development of biofilms exacerbates these infections. Over the past few decades, there has been a progressive development of antimic...

Objectives The aim of this study was to establish an international, interorganisational consensus on wound infection terminology. Methods This project consisted of definition scoping and a Delphi process to produce a consensus glossary for 18 wound infection terms. Recent guidelines/consensus documents were reviewed to identify 2–4 definitions for...

Wound infection is a major challenge for clinicians globally, with accurate and timely identification of wound infection being critical to achieving clinical and cost-effective management, and promotion of healing. This paper presents an overview of the development of the International Wound Infection Institute (IWII)'s 2022 Wound Infection in Clin...

Background Lower limb venous disease can cause significant pain, loss of mobility, and can be detrimental to an individual’s quality of life. Manifestations of venous disease often pose a substantially negative impact on patients and place a high demand on finite healthcare resources. Whilst this problem is internationally recognised, most research...

Background Compression therapy is a safe, effective treatment for lower leg conditions such as lymphatic insufficiency and venous hypertension. The most common method of arterial assessment is the calculation of a patient's ankle–brachial pressure index (ABPI). The need for ABPI is highlighted in many best practice statement and local policies. ABP...

The importance of the periwound skin as the ‘organ of healing’ in the skin should not be underestimated. This paper explores the numerous healing processes originating in the periwound skin, without which healing progression would not occur. This paper also explores how damage to the periwound skin is ubiquitous and can occur because of underlying...

An overview of chronic wounds, including their physiology, causes and management options.

Objective: This systematic review assesses the effects of care bundles on the incidence of surgical site infections (SSIs). Data sources: The search was conducted between February and May 2021, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases. Study selection: Studies were included if they used systematic review methodology, were i...

Background Lower limb venous disease can cause significant pain, loss of mobility, and can be detrimental to an individual’s quality of life. Manifestations of venous disease often pose a substantially negative impact on patients and place a high demand on finite healthcare resources. Whilst this problem is internationally recognised, the majority...

Background The long term impacts of experiencing a ‘long lie’ following a fall in the older person are poorly understood. This systematic review explored the impact of a long lie fall on physical and clinical outcomes in older people requiring an ambulance. Methods PRISMA guidelines were followed. Results 70 studies were identified. Nine studies...

Objective This study assesses anonymous patient-level data on the use of sub-epidermal moisture (SEM) assessment technology as a tool in the prevention of pressure ulceration in at-risk hospital patients. Method The relationship between technology-generated prompts for clinical action (patient turning, application of pressure redistributing equipm...

Objective: To assess the effectiveness of sub-epidermal moisture (SEM) assessment technology as an adjunct to visual assessment to reduce pressure ulcer (PU) incidence alongside standard PU care pathways. Method: Data were obtained from wards located within 28 institutions in the UK, Canada, Belgium, Spain and Ireland. At each ward, the proporti...

p>Although great strides have been made to tackle hospital-acquired pressure ulcers (HAPUs), there is a need for greater recognition of device-related pressure ulcers (DRPUs), including their causes, management and prevention. This consensus statement, an updated second edition, aims to continue raising awareness of these largely preventable injuri...

Objective Antimicrobial resistance (AMR) occurs (as a result of misuse, such as over-prescribing) when certain pathogens fail to respond to treatment with antimicrobials. Consequently, patients can become severely ill and possibly die. A strategy referred to as antimicrobial stewardship (AMS) has been introduced which reduces the impact of this ant...

This paper presents an overview of a Journal of Wound Care (JWC) webinar ‘Antimicrobial Stewardship Masterclass’ which took place on 17 June 2021, bringing together international experts in the field of wound care. The webinar was undertaken to provide an educational platform elucidating the basis of an effective antimicrobial strategy in wound car...

A break in skin integrity must be repaired as quickly as possible to avoid excess blood and fluid loss, and to minimise the onset of infection. Hard-to-heal wounds, in which the progression of the wound healing response is compromised, present several challenges to healing (for example, the presence of devitalised tissue acting as a physical barrie...

Objective: To assess the incidence, risk, and associated factors that contribute to an acquired surgical site infection (SSI) after emergency cesarean section (CS). Methods: This retrospective case-control study was conducted in an acute district general hospital in England with 206 patients (101 SSI patients and 105 non-SSI patients) who had an...

Background: Antimicrobial resistance (AMR) is one of the most serious health threats globally. The development of new antimicrobials is not keeping pace with the evolution of resistant microorganisms, and novel ways of tackling this problem are required. One of such initiatives has been the development of antimicrobial stewardship programmes (AMS)...

Objective Episodes of inpatient care-related pressure ulcers (PU) lead to deleterious effects on patient quality of life, and additional costs associated with wound dressings, staff visits and hospitalisation. Accurate prediction of future incidence may be helpful in defining strategies for benchmarking and resource management. Observations of cate...

Background: Surgical site infection (SSI) is a common postoperative concern. Purpose: To provide an in-depth understanding of the lived experience and quality of life (QoL) of individuals with SSI. Methods: A systematic search for published studies that explored the impact of SSI on QoL among adult patients (older than 18 years) who had underg...

Background Traditionally, infections are treated with antimicrobials (for example, antibiotics, antiseptics, etc), but antimicrobial resistance (AMR) has become one of the most serious health threats of the 21st century (before the emergence of COVID-19). Wounds can be a source of infection by allowing unconstrained entry of microorganisms into the...

Aim To develop and psychometrically evaluate a skin tear knowledge assessment instrument (OASES). Design Prospective psychometric instrument validation study. Method The skin tear knowledge assessment instrument was developed based on a literature review and expert input (N = 19). Face and content validity were assessed in a two‐round Delphi proc...

The 2019 novel coronavirus disease (COVID-19) pandemic has brought the effects of device-related pressure ulcers (DRPU) into sharp focus. With the increased use of personal protective equipment (PPE), including face masks, continuous positive airway pressure (CAPP) masks and other devices, the incidence of DRPUs among health professionals and patie...

It is estimated that surgical wound complications (SWCs) are one of the leading global causes of morbidity following surgery, with mortality affecting 1–4% of patients, in a study focusing on gastrointestinal surgery (Pearse et al, 2012; Collaborative GS, 2017). The Lancet Commission on Global Surgery estimates over half of the 4.2 million post-ope...

Catherine Milne and colleagues present the findings of their review, ccna2@juno.com

Objective The aim of this systematic review was to examine the associations and relationship between commonly cited risk factors and the pathology of pressure ulcer (PU) development. Method Using systematic review methodology, original research studies, prospective design and human studies written in English were included. The search was conducted...

Surgical site infection (SSI) is an unfortunate postoperative complication that affects many surgical patients worldwide and treatment of this type of wound is most likely to occur following discharge from the acute care setting. While there are several guidelines for preventing and managing SSIs in hospitals, there is an absence of guidelines for...

Introduction: Intermittent claudication (IC) is the most common symptom of peripheral arterial disease. Previous research has suggested that cycloidal vibration therapy (CVT) may induce angiogenesis and improvements in circulation. The objective of this feasibility study was to explore trial design and acceptability of the protocol to provide data...

Background: Skin tears are acute wounds that are frequently misdiagnosed and underreported. A standardised and globally adopted skin tear classification system with supporting evidence for diagnostic validity and reliability is required to allow assessment and reporting in a consistent way. Objectives: To measure the validity and reliability of...

Background: Wound assessment and treatment are essential aspects of nursing care. Dressing-associated complications can delay wound healing, causing unnecessary patient distress. Despite evidence suggesting that dressings should be changed infrequently, there still remains a tendency for healthcare professionals to remove dressings regularly, incr...

Doctoral-level study is increasingly popular for clinicians who wish to advance their clinical, research and academic career pathways. A range of alternatives to the traditional PhD are now well-established. This article aims to outline the different approaches and discuss some advantages and drawbacks of doctoral-level postgraduate study. By compa...

The aim of this review was to present the clinical data on the use of the family of bacterial-binding dressings (Sorbact; dialkylcarbamoyl chloride-coated) in the treatment of a variety of acute and chronic wounds. The findings are discussed in terms of the effectiveness of the bacterial-binding dressings on bacterial bioburden reduction, infection...

Pressure ulcers are a common occurrence of damage to skin. Severity ranges from slightly discoloured skin to full thickness tissue damage which can be fatal in some cases. Engineering effort, typically developing computational models had made significant progress in the understanding and demonstration of the formation mechanism of pressure ulcers w...

Objective: To achieve international consensus relating to clinical indicators for a chronic wound, wound infection and biofilm presence to inform the development of international clinical guidance for assessing and managing wound infection. Method: An online Delphi consensus process of international key opinion leaders in infection was undertake...

Background Prophylactic antibiotics are commonly prescribed intra-operatively after caesarean section birth, often at high doses. Even so, wound infections are not uncommon and obesity increases the risk. Currently, no independent wound assessment technology is available to stratify women to low or high risk of surgical site infection (SSI). Study...

This article discusses how an integrated physical, psychological and social approach to wound care can help improve the quality of life for people who self-injure. The health professional should demonstrate compassion while teaching the person who self-injures how to provide their own wound care. Compassionate care may help the patient improve thei...

Chronic wounds are associated with a significant patient, healthcare and financial burden and can have extensive implications for healthcare. Age is a significant risk factor for developing chronic wounds, due to physical changes in skin integrity and several age-related complex comorbidities, including poor nutrition and mobility. Pressure ulcers...

The use of atmospheric low‐temperature plasma (AP) on chronic wounds and its effect on microbial bioburden in open wounds has not been explored with a systematic review and meta‐analysis. PRISMA guidelines were followed and PubMed, Embase, CENTRAL, and CINAHL databases searched for randomised controlled trials (RCTs), which compared AP with no AP f...

Background The risk of SSI increases in the presence of foreign materials and may be caused by organisms with low pathogenicity, such as skin flora derived from hands of surgical team members in the event of a glove breach. Previously, we were able to demonstrate that a novel antimicrobial surgical glove coated chlorhexidine-digluconate as the acti...

Background: Effective communication between healthcare providers and patients represents an important caveat in healthcare, both nationally and internationally. Providing information to patients about their care and condition can be challenging, particularly in demanding, time-pressured environments such as the Emergency Department (ED). Understan...

Objective: Venous leg ulcers (VLUs) cause significant pain and suffering for patients. Additionally, they place considerable financial and service burden on the National Health Service (NHS). A large proportion of VLUs do not heal within the standard time frame of 16-24 weeks, resulting in static wounds which commonly have issues with increasing e...

Disinfection of gloved hands is increasingly advocated in situations where visibly not soiled gloves are used during multiple clinical activities on the same patient. Since there is no data demonstrating that such practice attributes to lower bacterial transfer during clinical care, a standardised experimental study was conducted. Gloved hands touc...

Objective: Surgical site infection (SSI) is a common cause of postoperative morbidity. Perioperative hypothermia may contribute to surgical complications including increased risk of SSI. In this systematic review and meta-analysis, the effectiveness of active and passive perioperative warming interventions to prevent SSI was compared with standard...

This article is based on a focus group meeting that was held in London on 29th June 2017 and sponsored by 3M. The focus group was convened so that an expert multidisciplinary panel could discuss the underreported issue of MARSI. The aims and objectives of the meeting were to: gain an understanding of MARSI in practice, identify gaps in knowledge ba...

Malodorous wounds can be distressing for patients and their families, negatively impacting on quality-of-life outcomes. For health professionals malodorous wounds can also cause distress manifesting in feelings of disgust when faced with a wound emitting an unpleasant or repulsive odour. There has been investigation into the management of controlli...

Objective: To assess the relationship in healthy adults and critically ill patients between: patient position, body mass index (BMI), patient body temperature, interface pressure (IP) and tissue reperfusion (TR). Also to determine the relationship in critically ill patients between: Sequential Organ Failure Assessment (SOFA) score, Braden Scale sco...

Pressure ulcers are a common injury of the skin which leads to pain and potential infection for patients and financial burden to the healthcare providers across the global due to treatment costs, litigation and extended hospital stays. The current study focuses on one of the causes of pressure ulcer formation, ischemia. Blood vessels are deemed to...

Individuals living with an ostomy may suffer from a variety of peri-stomal skin complications related to the use of their stoma appliance or accessories. These conditions can be serious enough to significantly impact on a patient's quality of life and may result in severe clinical complications (such as infection). This article is a review of the l...

The aim of this integrative systematic review was to systematically search, critically appraise, and summarise reported research related to readiness to practice and types of clinical support offered to newly registered nurses and preregistration nurses (such as, mentoring, preceptorship, or clinical facilitation). The review was undertaken in Febr...

Background: There is a continued focus in health care that NHS Trusts must make cost savings while ensuring quality and productivity is not adversely affected. It is essential that healthcare professionals have access to pressure reduction/redistributing equipment that is evidence based and can promote skin integrity via adequate reduction of exces...

Nurses and patients can have extreme feelings based on wound malodour, and understanding how to deal with these is essential for good patient care, write Karen Ousey and Debbie Roberts

The use of silver as an antibacterial has been known for centuries, but its topical use in antimicrobial dressings to prevent or treat infection in a wide range of acute and chronic wounds is relatively new. Extensive laboratory and clinical evaluations have shown the antibacterial value of silver dressings, although efficacy may be dependent on th...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the effects and safety of active and passive perioperative warming interventions for the prevention of SSI, when compared with standard care and other interventions. © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

The development of wound management protocols and guidelines such as the T.I.M.E. acronym are useful tools to aid wound care practitioners deliver effective wound care. The tissue, infection/inflammation, moisture balance and edge of wound (T.I.M.E.) framework provides a systematic approach for the assessment and management of the majority of acute...

Wounds that fail to heal quickly are often encountered by community nursing staff. An important step in assisting these chronic or stalled wounds progress through healing is debridement to remove devitalised tissue, including slough and eschar, that can prevent the wound from healing. A unique wound treatment called HydroTherapy aims to provide an...

Background: Surgical site infection (SSI) is a serious potential complication of spinal surgery. SSI may impact significantly on inpatient hospitalization and the costs associated with extra care. Aim: To investigate the management of patients experiencing SSI following surgery for spinal metastatic tumours, and to estimate the costs associated...

This paper presents analysis from a 6-week prospective product evaluation of the Trezzo range of mattresses, compared to standard foam mattresses, in use on two clinical areas within Pennine Acute NHS Trust. Data were collected via distribution of three questionnaires. A patient experience questionnaire was completed by patients after using their m...

This paper presents the results of an online survey that investigated healthcare professionals' knowledge of wound debridement and the techniques used. The survey, using purposive sampling, was distributed to healthcare professionals working within tissue viability services (n=252) via Survey Monkey across the UK to investigate healthcare professio...

Medical adhesive-related skin injury (MARSI) is a prevalent, under-recognised and preventable complication that occurs across all care settings, age groups and patient types. Use of medical adhesives may affect skin integrity, cause pain, increase risk of infection, potentially increase wound size and delay healing, all of which reduce patient qual...

Incontinence-associated dermatitis (IAD) is a common problem in patients with faecal and/or urinary incontinence. Urine alters the normal skin flora and increases permeability of the stratum corneum and faecal enzymes on the skin contribute to skin damage. Faecal bacteria can then penetrate the skin, increasing the risk of secondary infection. Howe...

The aim of this commentary is to discuss potential clinical implications of introducing resilience-building interventions into care for veterans who are living with a war wound. Some war veterans are expected to live with a wound upon discharge from an active military role and also to fit into civilian life. These lifestyle adjustments can tax the...

Earlier this year the University of Huddersfield's Institute of Skin Integrity and Infection Prevention in association with the Journal of Wound Care (JWC) held the first International Skin Integrity and Infection Prevention Conference. The 2-day event consisted of a mix of keynotes, symposia and short presentations from key opinion leaders and pos...

Objective: This study aimed to determine the rate of surgical site infection (SSI) in patients undergoing surgery for spinal metastases, and identify key risk factors for SSI among this patient group. Method: A retrospective case note review was undertaken in adult patients being treated at a single specialist centre for spinal surgery. Results:...

Background: Few studies have explored the microbial contamination of glove boxes in clinical settings. The objective of this observational study was to investigate whether a new glove packaging system in which single gloves are dispensed vertically, cuff end first, has lower levels of contamination on the gloves and on the surface around the box a...

This article provides an explanation and visual demonstration of the differences between the pathology and presentation of hydration versus maceration in wounds. This is described in order that the clinician can distinguish between the two and optimise wound treatment.