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Cross-sectional study
Wound prevalence in community care settings in Ireland ranges from 2.7% in prisons to 33.5% in intellectual disability services, with pressure ulcers, leg ulcers, self-inflicted abrasions and surgical wounds the most common
  1. Michael Clark
  1. Correspondence to Michael Clark
    Welsh Wound Network, 210 Capella House, Cardiff CF10 4RE, UK; michael.clark21{at}btopenworld.com

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McDermott-Scales and colleagues report a communitybased point prevalence survey of chronic and acute wounds conducted in 2007 within an unspecified geographical area in Ireland. This is one of a growing number of population-based wound prevalence surveys,1 2 although it may be unique in that it includes only community care locations rather than a mix of acute and community services. The study provides data obtained within addiction and prison services previously unreported in other surveys.

The survey was based on reporting of wounds by 148 nurses invited to participate (responses from 144, 97.2% response). Although the survey questionnaire was said to be based on a validated tool, it had been modified. No information was provided on the reliability of the survey tool, with the reliability of responses being predicated on intensive educational sessions provided to the participating nurses. The survey identified 290 people with wounds among a population of 1854 receiving care from the participating nurses (prevalence 15.6%). Of the people with wounds, 76 had pressure ulcers, 55 had leg ulcers, 41 had self-inflicted superficial abrasions (stated to occur mainly in services for the intellectually disabled), and 32 people had surgical wounds. The 290 people with wounds had a total of 557 wounds, with almost 8% having five or more wounds. The people with wounds ranged in age from 6 weeks to 101 years (mean 64.4, SD 22.7 years), with 56.2% (163/290) being female. Antibiotic consumption relating to wound infection was reported to be relatively common, with 13.1% (38/290) prescribed antibiotics at the time of the survey. People with wounds were reported in the addiction (7/31) and prison (7/262) services. In prison the most commonly encountered wounds were lacerations (3/7); in the addiction services it was noted in the discussion that leg ulcers and abscesses were the most common wounds, although the data were not reported.

This study did not report the accuracy with which the community nurses reported wounds. This gap is also noticeable in previous population-based surveys, such as that by Vowden and Vowden.2 The uncertainty around the accuracy of wound reporting is the major weakness in this audit, and steps should be taken to formally ascertain inter-rater reliability in future wound audits. Identification of wounds may also have posed challenges for the present study: the participating nurses were provided with visual guides to the different presentations of pressure ulcers but text-based definitions of other wound types.

This audit helps to establish that wounds are commonly encountered across a wide range of community services and provides support for the establishment and retention of community-based wound services. However, it would be challenging to generalise the number and pattern of wounds encountered in the study to other community-based services without greater knowledge of the population served by the surveyed care providers.

The overall prevalence of 2.17 per 1000 population in this survey is lower than that reported by Srinivasaiah and colleagues1 and by Vowden and Vowden,2 who found that 3.55 people per 1000 population had wounds. The difference is probably due to the exclusion of acute services from this survey; for example, 32% of the people with wounds reported by Vowden and Vowden2 were in acute services.

Knowledge of the number, type and location of wounds within acute and community services will depend on the accurate reporting of data, and steps should be taken to develop a survey methodology that provides robust, comparable data across geographical areas. This will require attention to the reporting of the attributes of the population served by the services audited.

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  • Competing interests None.

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