This is the current release of the guideline.

This guideline updates a previous version: ConvaTec. SOLUTIONS wound care algorithm. Princeton (NJ): ConvaTec; 2005. 8 p.

Acute and chronic wounds including arterial, diabetic, pressure, venous, or mixed arterial-venous ulcers

Patients with acute and chronic wounds

The development of the initial algorithms, and their subsequent content validation in 2001, is based on evidence obtained from Medline and CINHAL literature searches for the time period between 1992 and 2001. The Medline search was updated again in 2005, covering the period 2001-2005. No further changes to the algorithm were required as a result of that search.

For the most recent update, MEDLINE® and Cochrane databases were searched systematically for all relevant subject terms in each covering the period 2006-2008. Up to 3 of the best available references were used for each relevant recommendation.

86

Evidence Criteria and Definitions for Solutions® Algorithms Recommendations Evidence Base

1. Results of two or more randomized controlled trials (RCTs) in humans or a literature review (LR) or meta‐analysis (MA) containing same provide support of efficacy. For assessment and diagnosis recommendations or risk analysis of likely outcomes: two or more prospective cohort (CO) studies
2. Results of two or more historically controlled trials (HCTs) or case controlled trials (CCTs) or a HCT or CCT provide support of efficacy plus:
   1. One RCT in humans or a LR or MA containing same
   2. For assessment and diagnosis recommendations or risk analysis of likely outcomes: two or more prospective CO studies
   3. Or when appropriate, results of two or more RCTs in an animal model validated as clinically relevant to the acute or chronic wound discussed and/or retrospective case series (RCS) provide indirect support
3. This rating requires one or more of the following:
   • C1: Results of one controlled trial (e.g., RCT, CCT or HCT) (or for assessment and diagnosis recommendations or risk prediction one prospective CO study)
   • C2: Results of at least two case series (CS) or descriptive studies or a retrospective cohort study in humans
   • C3: Expert opinion (EO)

Adapted from AHRQ (Formerly AHCPR) Pressure Ulcer (PU) Treatment Guidelines Levels of Evidence‐‐modified for generality to all chronic wounds

Not stated

These recommendations were adapted from existing validated wound care algorithms, refined and validated by 21 of 37 invited global wound care experts from academic and/or clinical settings, using a standardized judgment quantification content validation process rating clinical relevance of each recommendation. Subsequently, using a standardized content validation process and photographs of acute and chronic wounds, content validity of algorithm components and the ability of non-wound care experts to correctly, validly and reliably select the most appropriate algorithm and treatment (construct validity and reliability) was established in a study involving 204 registered nurses.

Not applicable

Published cost analyses were reviewed from the literature. Kerstein et al (2001) was identified as an appropriate model for conducting the economic analysis. Telemedicine costs (the most costly format for Solutions® algorithms in the cohort study) were added to 12-week healing costs reported in the model. Using the most common wound dressing applied during the prospective cohort study (i.e., the hydrocolloid dressing DuoDERM) would save U.S. $969 for every pressure ulcer healed during 12 weeks or $766 for every venous ulcer healed, as compared to gauze.

Each step in the Solutions® algorithms was formally content validated by wound care professionals (44 wound care nurses in 1998–1999). The final version was again content validated by a multidisciplinary group of 21 invited global opinion leaders in wound care, including physicians of varying specialties, nurses, and other wound care specialists. Subsequently, using a standardized content validation process and photographs of acute and chronic wounds, content validity of algorithm components and the ability of non-wound care experts to correctly, validly, and reliably select the most appropriate algorithm and treatment (construct validity and reliability) was established in a study involving 204 registered nurses.

This process also measured clinical healing outcomes during real-world use of the algorithms.

See the "Availability of Companion Documents" field.

Levels of evidence (A-C) are defined at the end of the "Major Recommendations" field.

The recommendations for wound care are presented in the form of 8 algorithms provided at the ConvaTec Web site. Each algorithm corresponds to one of the following observed wound assessments:

• Dry wound, minimal moisture: <25% necrotic tissue/fibrin slough
• Dry wound, minimal moisture: >25% necrotic tissue/fibrin slough 
• Moist-lightly exuding: <25% necrotic tissue/fibrin slough
• Moist-lightly exuding: >25% necrotic tissue/fibrin slough 
• Moist-moderately exuding: <25% necrotic tissue/fibrin slough
• Moist-moderately exuding: >25% necrotic tissue/fibrin slough 
• Wet-heavily exuding: <25% necrotic tissue/fibrin slough
• Wet-heavily exuding: >25% necrotic tissue/fibrin slough 

The following recommendations support the goal of Solutions Algorithms to facilitate health care professionals' decision making by providing stepwise management and evaluation strategies for acute and chronic would care.

Goals, Guideline, and Outcomes of Patient Care

1. For all chronic or acute wound care patients goals of patient care include reducing risk factors for ulcer development and delayed healing and preventing wound complications and promoting healing in addition to providing local wound care. (Adam et al., 2003; Alexanderhouse Group, 1992: Kerstein, 1996; de Laat, Scholte op Reimer, & van Achterberg, 2005) [Level A]
2. For all chronic or acute wounds, re‐evaluate plan of care or address underlying etiology if the wound has not decreased in area during 2 to 4 weeks of care. (Arnold et al., 1994; Kantor & Margolis, 1998, 2000; Phillips et al., 2000; Sheehan et al., 2003; van Rijswijk & the Multi-Center Leg Ulcer Study Group, 1993; van Rijswijk & Polansky, 1994) [Level A]
3. Include the following as goals of pressure ulcer patient care
   1. Reduce risk factors identified by individual items on Braden Risk Scale (Bolton, 2007) [Level A]
   2. Prevent complications (AHCPR, 1992; Lyder et al., 2002) and promote healing (Bergstrom et al., 1994; Kerstein et al. 2001; Kobza & Scheurich, 2000) [Level A]
4. Include the following as goals of acute wound patient care:
   1. Prevent complications and promote healing (Franz, Steed, & Robson, 2007; Langemo & Brown, 2006; McIsaac, 2005) [Level C]
5. Include measures to prevent pressure ulcer development and delayed healing in patient care plan:
   1. Minimize effect of risk factors for the development of pressure ulcers and delayed healing (e.g., pressure, shear, friction, nutritional deficiencies, dehydration and dry skin conditions, skin exposure to moisture or wound contamination secondary to incontinence, perspiration or other fluids). (Lyder et al., 2002; AHCPR, 1992) [Level C]
   2. For pressure ulcers or acute wounds confirm and treat infection if needed. (Gardner et al., 2006; Franz, Steed, & Robson, 2007) [Level C]
   3. Assess and manage wound odor. (Bergstrom et al., 1994; Gardner, Frantz, & Doebbeling, 2001) [Level C]
   4. Assess and manage wound pain. (Bergstrom et al., 1994; Gardner, Frantz, & Doebbeling, 2001) [Level C]
6. Include the following as expected outcomes for acute wound or pressure ulcer patient care:
   1. Wound is not infected and is healing as evidenced by a reduction in size after 2 to 4 weeks of care (Kantor & Margolis, 1998; van Rijswijk & Polansky, 1994) [Level A]
   2. No evidence of additional skin breakdown (Gardner, Frantz, & Doebbeling, 2001; Franz, Steed, & Robson, 2007) [Level C]
7. Include the following as goals of venous ulcer patient care:
   1. Reduce risk factors for the development of venous ulcers and delayed healing, such as lower leg edema. (Cullum, Nelson, & Fletcher, 2002; Duby et al., 1993) [Level A]
   2. Prevent complications and promote healing. (Bolton et al., 2004; Bolton et al., 2006; Kerstein et al., 2001; Kobza & Scheurich, 2000; McIsaac, 2005) [Level A]
8. Include measures to prevent venous ulcer development and delayed healing in patient care plan:
   1. To reduce risk factors, order lower leg elevation (Association for the Advancement of Wound Care [AAWC], 2005) [Level C], ambulation (AAWC, 2005) [Level C] and compression (Cullum, Nelson, & Fletcher, 2002) [Level A] If patient is not ambulatory, assure frequent ankle flexes. [Level C]
   2. Review surgical and medical management options (AAWC, 2005) [Level A] and use compression bandages if appropriate (Cullum, Nelson, & Fletcher, 2002) [Level A].
   3. Provide patient and/or caregiver teaching and support. (AAWC, 2005) [Level A]
   4. Confirm and treat infection if needed (Gardner, Frantz, & Doebbeling, 2001) [Level C]
   5. Assess and manage wound pain. (Arnold et al., 1994; Charles, 2002; Charles et al., 2002; Harding et al., 2001; Polignano, Guarnera, & Bonadeo, 2004) [Level A]
   6. Assess and manage wound odor. (Cordts et al, 1992; Jorgensen et al., 2005; Ashton, 2004) [Level A]
9. Include the following as expected outcomes for venous ulcer patient care:
   1. Wound is not infected and healing as evidenced by a reduction in size after 2 to 4 weeks of care. (Kantor & Margolis; 1998; Phillips et al., 2000; van Rijswijk and the Multi-Center Leg Ulcer Study Group, 1993) [Level A]
   2. No evidence of new skin breakdown (Gardner, Frantz, & Doebbeling, 2001) [Level C]
10. Include the following as goals of patient care for mixed arterial/venous ulcers:
    1. Reduce risk factors for the development of mixed arterial/venous ulcers and delayed healing. (Kerstein, 1996) [Level C]
    2. Prevent complications and promote healing. (McIsaac, 2005) [Level C]
11. Include measures to prevent mixed arterial/venous ulcer development and delayed healing in patient care plan:
    1. Reduce risk factors (e.g., smoking, hypertension, inactivity, hyperlipidemia, hyperglycemia) (Kerstein, 1996) [Level C]
    2. Review surgical/medical management options to improve arterial circulation and compression bandages if appropriate. (Kerstein, 1996) [Level C]
    3. Provide patient and/or caregiver teaching and support (Kerstein, 1996) [Level C]
    4. Confirm and treat infection if needed. (Gardner, Frantz, & Doebbeling, 2001; Gardner et al., 2006) [Level B2]
    5. Assess and manage wound pain. (Daniels et al., 2002; Koksal & Bozkurt, 2003; Phillips, Stanton, Provan, & Lew, 1994; Quintanal, 1999) [Level B1]
    6. Assess and manage wound odor (Phillips, Provan, & Lew, 1994) [Level C]
12. Include the following as expected outcomes for patient care plan of mixed arterial/venous ulcers:
    1. Wound is not infected and is healing as evidenced by a reduction in size after 2 to 4 weeks of care (Kantor & Margolis; 1998; Phillips et al., 2000; van Rijswijk and the Multi-Center Leg Ulcer Study Group, 1993) [Level A]
    2. No evidence of additional skin breakdown (Gardner, Frantz, & Doebbeling, 2001) [Level C]
13. Include the following as goals of patient care for arterial ulcers:
    1. Reduce risk factors for the development of arterial ulcers and delayed healing. (Tesfaye et al,. 2005) [Level C]
    2. Prevent complications and promote healing. (Hopf et al., 2006) [Level C]
14. Include measures to prevent arterial ulcer development and delayed healing in patient care plan:
    1. Reduce risk factors (e.g., smoking, hypertension, inactivity, hyperlipidemia, hyperglycemia). (Kerstein, 1996) [Level C]
    2. Review surgical/medical management options to improve circulation. (Kerstein, 1996) [Level C]
    3. Provide patient and/or caregiver teaching and support. (Kerstein, 1996) [Level C]
    4. Confirm and treat infection if needed. (Gardner, Frantz, & Doebbeling, 2001; Gardner et al., 2006) [Level B]
    5. Assess and manage wound pain. (Daniels et al., 2002; Koksal & Bozkurt, 2003; Phillips, Stanton, Provan, & Lew, 1994; Quintanal, 1999) [Level B]
    6. Assess and manage wound odor. (Phillips, Stanton, Provan, & Lew, 1994) [Level C]
15. Include the following as expected outcomes for patient care plan of arterial ulcers:
    1. Wound is not infected and is healing as evidenced by a reduction in size after 2 to 4 weeks of care. (Kantor & Margolis; 1998; Phillips et al., 2000; van Rijswijk and the Multi-Center Leg Ulcer Study Group, 1993) [Level A]
    2. No evidence of additional skin breakdown (Gardner, Frantz, & Doebbeling, 2001) [Level C]
16. Include the following as goals of patient care for diabetic foot ulcers:
    1. Reduce risk factors for the development of diabetic foot ulcers and delayed healing. (Registered Nurses' Association of Ontario [RNAO], 2005; Frykberg et al., 2006, Brem et al, 2006) [Level C]
    2. Prevent complications and promote healing. (RNAO, 2005; Frykberg et al., 2006; Kobza & Scheurich, 2000; McIsaac, 2005) [Level C]
17. Include measures to prevent diabetic foot ulcer development and delayed healing in patient care plan:
    1. Reduce risk factors (e.g., smoking, hypertension, obesity, hyperlipidemia and high blood glucose levels). (Kerstein, 1996; Frykberg et al., 2006, Brem et al., 2006) [Level C]
    2. Review surgical/medical management options and use appropriate off‐loading techniques (Kerstein, 1996; Frykberg et al, 2006, Brem et al., 2006) [Level C]
    3. Provide patient and/or caregiver teaching and support. (Kerstein, 1996; Frykberg et al., 2006, Brem et al., 2006) [Level C]
    4. Confirm and treat infection or osteomyelitis, if needed. (Kerstein, 1996; Frykberg et al., 2006; Brem et al., 2006) [Level C]
    5. Assess and manage wound pain, if relevant. (Kerstein, 1996; Frykberg et al., 2006; Brem et al., 2006) [Level C]
    6. Assess and manage wound odor. (Kerstein, 1996; Frykberg et al., 2006; Brem et al., 2006) [Level C]
18. Include the following as expected outcomes for patient care plan of diabetic foot ulcers:
    1. Wound is not infected and is healing as evidenced by a reduction in size after 2 to 4 weeks of care (Kantor & Margolis, 1998; Phillips et al., 2000; van Rijswijk and the Multi-Center Leg Ulcer Study Group, 1993; Sheehan et.al., 2003) [Level A]
    2. No evidence of additional skin breakdown (Gardner, Frantz, & Doebbeling, 2001, Brem et al., 2006) [Level C]

Wound Assessment/Debridement/Treatment

1. For all acute and chronic wounds assess wound bed exudate, tissue types (granulation, epithelization, necrotic tissue or fibrin slough), wound dimensions (length, width and depth), and wound edges and surrounding skin (Bates‐Jensen, 1997; Bolton et al., 2004; Kantor & Margolis, 1998, 2000) [Level A]
2. Assess for clinical signs and symptoms of infection if the patient has an acute or chronic wound (including pressure, venous, arterial, mixed arterial/venous, or diabetic foot ulcer) and patient assessment reveals any of the following: elevated temperature, purulent exudate, foul purulent wound exudate, increasing wound pain, cellulitis, increasing wound size, undermining of the wound or peripheral wound induration. (Thomson & Smith, 1994; Dow, 2003, Brem et al., 2006; Golinko et al., 2009, Gardner, Frantz, & Doebbeling, 2001) [Level B]
3. Debride pressure ulcers with more than 25% necrotic tissue in the wound allowing professionals to select among these options: a) autolytic, b) enzymatic, c) surgical or sharp, d) other (Bergstrom et al., 1994; Burgos et al., 2000; Kerstein et al., 2001; RNAO, 2007) [Level A]
4. Alert clinicians that an assessment has not been performed in 2 weeks
   1. For pressure ulcer patient risk assessment (AHCPR, 1992; RNAO, 2005) [Level C] or
   2. For pressure ulcer wound assessment (Bergstrom et al., 1994; RNAO, 2007) [Level C]
5. Debride venous ulcers with more than 25% necrotic tissue in the wound allowing professionals to select among these options
   1. Autolytic (AAWC, 2005) [Level A]
   2. Enzymatic (AAWC, 2005) [Level B]
   3. Surgical (AAWC, 2005) [Level C]
   4. Other (Bradley, Cullum, & Sheldon, 1999) [Level C]
6. Debride mixed arterial/venous ulcers with more than 25% necrotic tissue in the wound allowing professionals to select among these options
   1. Autolytic (Mulder, 1995)
   2. Enzymatic
   3. Surgical
   4. Other (Bradley, Cullum, & Sheldon, 1999) [Level C]
7. Debride arterial ulcers with more than 25% necrotic tissue in the wound allowing professionals to select among these options once circulation is restored.
   1. Autolytic
   2. Enzymatic
   3. Surgical
   4. Other (Bradley, Cullum, & Sheldon, 1999) [Level C]
8. Debride diabetic foot ulcers with more than 25% necrotic tissue in the wound: allowing professionals to select among these options
   1. Autolytic (Mulder, 1995; Edwards, 2009) [Level A]
   2. Enzymatic (Edwards, 2009) [Level C]
   3. Surgical (Saap & Falanga, 2002; Steed et al., 1996, Brem et al., 2006) [Level B]
   4. Other (Bradley, Cullum, & Sheldon, 1999, Edwards, 2009) [Level A]
9. Debride pressure ulcers with more than 25% necrotic tissue in the wound: allowing professionals to select among these options
   1. Autolytic (Mulder, 1995, Bradley, Cullum, & Sheldon, 1999) [Level A]
   2. Enzymatic (Alvarez et al., 2002, Bradley, Cullum, & Sheldon, 1999) [Level C]
   3. Surgical (Bradley, Cullum, & Sheldon, 1999) [Level C]
   4. Other (Bradley, Cullum, & Sheldon, 1999) [Level A]
10. Debride acute wounds with more than 25% necrotic tissue in the wound: allowing professionals to select among these options
    1. Autolytic (Mulder, 1995; National Institute for Health and Clinical Excellence [NICE], 2001; Dryburgh et al., 2009)
    2. Enzymatic (Sieggreen & Maklebust, 1997)
    3. Surgical (Dryburgh et al., 2009)
    4. Other (Bradley, Cullum, & Sheldon, 1999) [Level B]
11. After debriding any chronic or acute wound, before dressing the wound, obtain hemostasis if bleeding occurs. (Sorenson, Jorgensen & Gottrup, 2004; Bergstrom et al., 1994) [Level C]
12. Describe surgical or sharp debridement of any chronic or acute wound as the removal of devitalized tissue using a scalpel, scissors, or other sharp instrument (Edwards, 2009; NICE, 2001; Bergstrom et al., 1994) [Level B]
13. Note the following with surgical or sharp debridement of any chronic or acute chronic wound:
    1. Procedure to be performed only by healthcare professionals who have demonstrated the clinical skills and who meet the relevant licensing requirements. (Bradley, Cullum, & Sheldon, 1999; Dryburgh et al., 2009) [Level B]
    2. Before dressing the wound, obtain hemostasis if bleeding occurs (Sorenson, Jergenson, & Gottrup, 2004; Bergstrom et al., 1994) [Level B]
14. Options for cleansing any chronic or acute chronic wound include:
    1. Normal saline or other non‐toxic wound cleansers such as Shur‐Clens® , Biolex™ or Irriclens® (Bergstrom et al., 1994; Rodeheaver et al., 1980; Morris, Dowlen, & Cullen, 1994) [Level B]
15. If the plan of care suggests use of a moisture retentive primary or secondary dressing, include as options: DuoDERM® CGF®, DuoDERM® CGF® Extra Thin, or Comfeel: Plus® Ulcer Dressings
    1. For any chronic wound: Chaby et al., 2007; Diabetic foot ulcers: Boulton, Meneses, & Ennis, 1999; Laing, Cogley, & Klenerman, 1992; Brem et al., 2006; Pressure ulcers: Bouza et al., 2005; de Laat, Scholte op Reimer, & van Achterberg, 2005; Jones & Fennie, 2007; Smitten & Bolton, 2005; Bradley et al., 1999; Kerstein et al., 2001; Mak et al., 2000; Petersen et al., 1991; O'Donnell & Lau, 2006) [Level A]
    2. For acute wounds: Cullum & Petherick, 2006; Goetze et al., 2006; Heffernan & Martin, 1994; Hoffman et al., 1995; Madden et al., 1989; Murharyo, 1996; Nemeth et al., 1991; Schmitt et al., 1996; Wiechula, 2003; Wyatt, McGowan, & Najarian, 1990; Wasiak, Cleland, & Campbell, 2009) [Level A]
16. If the plan of care suggests use of an absorption dressing , include as options: CombiDERM® ACD™ or other Island Dressing, AQUACEL® Hydrofiber® Dressing or Kaltostat® calcium sodium alginate dressing on:
    1. Any chronic wound: (Bergstrom et al., 1994; Armstrong & Ruckley, 1997; Harding et al., 2001; Lyon et al., 1998; Piaggesi et al., 2001; Jude et al., 2007) [Level A]
    2. Acute wounds: (Kogan, 2004; Barnea et al., 2004; Foster & Moore, 1997) [Level A]
17. If the plan of care suggests use of a hydration product on any chronic or acute wound, include as options: SAF‐Gel™, DuoDERM® Hydroactive® Gel or IntraSite® Gel, (Ohura, Sahada, & Mino, 2004; Hutchinson & Lawrence, 1991; Tan, Roberts, & Sinclair. 1993; Romanelli, 1997, Wasiak, Cleland, & Campbell, 2009). [Level A]
18. If the plan of care suggests debridement and an enzymatic debridement method, is chosen, include as options: Santyl®, Accuzyme®, or Panafil® (Burgos et al., 2000; Romanelli, 1997) [Level A]
19. Assessment of any acute or chronic wound includes the following:
    1. "None" or "No undermining," "None" or "No peripheral tissue induration," "None" or "No edema" (Bolton et al., 2004) [Level C]

Relevance of Selected Wound Assessment and Patient Care Recommendations to Evidence-based Care

1. The wound assessment and patient care recommendations support evidence based care for patients with acute and chronic wounds, including pressure ulcers, venous ulcers, mixed arterial/venous ulcers, and diabetic foot ulcers (Beitz & van Rijswijk, 1999; Bolton et al., 2004; Jones & Fennie, 2007) [Level B]

Definitions:

Evidence Criteria and Definitions for Solutions® Algorithms Recommendations Evidence Base

1. Results of two or more randomized controlled trials (RCTs) in humans or a literature review (LR) or meta‐analysis (MA) containing same provide support of efficacy. For assessment and diagnosis recommendations or risk analysis of likely outcomes: two or more prospective cohort (CO) studies
2. Results of two or more historically controlled trials (HCTs) or case controlled trials (CCTs) or a HCT or CCT provide support of efficacy plus:
   1. One RCT in humans or a LR or MA containing same
   2. For assessment and diagnosis recommendations or risk analysis of likely outcomes: two or more prospective CO studies
   3. Or when appropriate, results of two or more RCTs in an animal model validated as clinically relevant to the acute or chronic wound discussed and/or retrospective case series (RCS) provide indirect support
3. This rating requires one or more of the following:
   • C1: Results of one controlled trial (e.g., RCT, CCT or HCT) (or for assessment and diagnosis recommendations or risk prediction one prospective CO study)
   • C2: Results of at least two case series (CS) or descriptive studies or a retrospective cohort study in humans
   • C3: Expert opinion (EO)

Adapted from AHRQ (Formerly AHCPR) Pressure Ulcer (PU) Treatment Guidelines Levels of Evidence‐‐modified for generality to all chronic wounds

Eight (8) detailed clinical algorithms are provided in the original guideline document at the ConvaTec Web site for:

• Dry wound, minimal moisture: <25% necrotic tissue/fibrin slough
• Dry wound, minimal moisture: >25% necrotic tissue/fibrin slough 
• Moist-lightly exuding: <25% necrotic tissue/fibrin slough
• Moist-lightly exuding: >25% necrotic tissue/fibrin slough 
• Moist-moderately exuding: <25% necrotic tissue/fibrin slough
• Moist-moderately exuding: >25% necrotic tissue/fibrin slough 
• Wet-heavily exuding: <25% necrotic tissue/fibrin slough
• Wet-heavily exuding: >25% necrotic tissue/fibrin slough 

The type of supporting evidence is identified and graded for each recommendation (see "Major Recommendations").

Not stated

An implementation strategy initiated by ConvaTec in the form of Solutions® Algorithms for Skin and Wound Care: Customer Implementation Guide. This document provides an outline of identified best practices for implementation and encourages the establishment of key milestones and completion dates. In addition, there are Solutions® Programs for Acute, Long Term Care and Home Health venues. These programs provide standardized training programs and tools (see the "Availability of Companion Documents" field) for facilities engaged in wound care. Qualified trainers teach health care professional within requesting facilities how to link strategies for prevention and management of chronic and acute wounds to improve clinical and economic wound outcomes.

Not applicable: The guideline was not adapted from another source.

Funding for development of this guideline was provided through educational grants from ConvaTec, a Bristol-Myers Squibb Company and through National Institutes of Health (NIH) funding (NIH Grants 1R43NR003474-01 and 1R43NR007717-01).

Not stated

Lia van Rijswijk, MSN, CWCN, Adjunct Associate Professor of Nursing; Janice Beitz, PhD, RN, CS, CNOR, CWOCN, Associate Professor of Nursing; Laura Bolton, PhD, Adjunct Assoc Professor, Surgery; Patrick McNees, PhD, Professor; Barbara Bates-Jensen, PhD, Professor; Barbara Braden, PhD, Professor and Dean

All members of the group that authored the guideline have consulted for and/or performed educational activities for various wound and health care companies, including ConvaTec. None are major stakeholders or officers at ConvaTec or any company with a prior or current major interest in the Solutions® guideline.

This is the current release of the guideline.

This guideline updates a previous version: ConvaTec. SOLUTIONS wound care algorithm. Princeton (NJ): ConvaTec; 2005. 8 p.

Electronic copies: Not available at this time.

Print copies: Available from the ConvaTec Information Center: 1-800-422-8811.

The following are available:

• Beitz JM, van Rijswijk L. Using wound care algorithms: a content validation study. J Wound Ostomy Continence Nurs. 1999 Sep;26(5):238-9, 241-9. (Literature ID: #US-06-1300)
• Beitz JM, van Rijswijk L. A cross-sectional study to validate wound care algorithms for use by registered nurses. Ostomy Wound Management 2010;56(4):46-59.
• Bolton L, McNees P, van Rijswijk L, de Leon J, Lyder C, Kobza L, Edman K, Scheurich A, Shannon R, Toth M; Wound Outcomes Study Group. Wound-healing outcomes using standardized assessment and care in clinical practice. J Wound Ostomy Continence Nurs. 2004 Mar-Apr;31(2):65-71. (Literature ID: #US-07-1013)
• Evidence base for content-validated recommendations underlying Solutions® algorithm. Princeton (NJ): ConvaTec; 2009. 15 p.
• Solutions® algorithms for skin and wound care. Comprehensive wound prevention and management guide. Princeton (NJ): ConvaTec; 2008 Nov. 180 p. (Literature ID: #US-07-71)
• Solutions® algorithms for skin and wound care. Expert guide. Princeton (NJ): ConvaTec; 2008 Nov. 48 p. (Literature ID: #AP-004059-US)
• Solutions® algorithms for skin and wound care: customer implementation guide. Princeton (NJ): ConvaTec; 2007 Dec. 4 p. (Literature ID: #US-07-2119)
• Solutions® programs for long-term care. Princeton (NJ): ConvaTec; 2008 Mar. 12 p. (Literature ID: #US-08-656)
• Solutions® programs for acute care. Princeton (NJ): ConvaTec; 2008 Mar. 10 p. (Literature ID: #US-08-630)
• Solutions® programs for home health. Princeton (NJ): ConvaTec; 2008 Mar. 8 p. (Literature ID: #US-08-657)

Print copies: Available from the ConvaTec Information Center: 1-800-422-8811.

None available

This NGC summary was completed by ECRI on July 27, 2006. The information was verified by the guideline developer on August 24, 2006. This NGC summary was updated by ECRI Institute on August 7, 2009. The updated information was verified by the guideline developer on August 26, 2009.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.