Book Review
Acute and chronic wounds: nursing management
Ruth A. Bryant
ISBN: 080 1608 961; 1992; 350 pages; Mosby-Year Book;
Keryln Carville
Silver Chain Nursing Association, Perth WA
There is both an art and a science to wound management. The art has been practised since prehistoric man first attempted to cover wounds with mud and bark in an attempt to staunch bleeding. The art has been refined and developed throughout the centuries, generally as a result of traditional practice rather than according to scientifically founded principles. Two hundred years ago the science of wound healing was appreciated by John Hunter, a British surgeon, who in 1793 described the phenomena of wound granulation, contraction and epithelialisation. For many nurses this knowledge has been a well kept secret until more recent times. Thus, the value of this book is that it clearly defines both the art and science of wound management and healing.
The art of caring for wounds is promoted in the chapters dealing with the development of clinical skills and knowledge related to holistic and local assessment, wound dressing techniques and topical therapies. The science of wound healing is described clearly and concisely by the authors who discuss the many physiological and environmental factors that promote or delay healing. Ruth A Bryant, editor and author of Chapters 1, 5 and 8, has combined the knowledge and experiences of 21 reputable nursing and medical specialists for this book.
It was coordinated with assistance from the International Association for Enterostomal Therapy. The theoretical and clinical wound management modalities presented in this text are current and well supported in the literature. Topics covered include: the skin, principles of wound healing and management, assessment and evaluation of healing, acute surgical wounds, pressure ulcers, lower extremity ulcers, management of percutaneous tubes, drain sites and fistulas, nutrition, and evolving wound care modalities. The anatomy of the integument and the physiology of its repair and regeneration process is well described.
Chapter 3 discusses the schema of non-invasive instruments for clinical evaluation of wound status and healing. Further information is provided in the appendices where three well reputed assessment scales are described in detail. There is also a partial list of wound care products which are categorised according to generic qualities. Not all products are available in Australia, however the generic groups assist the reader to identify the qualities of the more familiar products listed and facilitate appropriate use of these products. Also included in the appendices is a generic list of pressure prevention beds and mattresses and an 'Etiologic (causal) Model of Pressure Sore Prevention' both of which summarize the well written chapter on pressure ulcers. The management of percutaneous tubes as described in Chapter 7 gives excellent yet simple management options for gastrostomy, jejunostomy, nephrostomy and biliary tubes.
All of which, if not managed efficiently, can cause distress to both client and carer. Not only does this book provide a valuable resource on the many facets of wound healing and care for any nursing, medical or allied health practitioner, but it serves as a self-directed learning tool. Each chapter is preceded by a list of clearly defined learning objectives and concludes with a list of questions and answers that allows selfevaluation. The chapters are concise yet comprehensive, extensively referenced and supported with 86 illustrations and 32 colour plates. Acute and chronic wounds: nursing management will prove to be a much used text in any nurses' library for it does much to promote understanding and clinical excellence in the care of persons with wounds.
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