![]() On review of the evidence it was noted by the working party that significant changes in theory and practice have occurred in the field of aseptic technique. The working party reviewed the search strategy to ensure it captured the intended literature. These terms were used in combination with terms associated with wound care, wound dressings, equipment storage, cleansing, and equipment recycling. Search terms and MESH headings included: asepsis, non-touch technique, aseptic technique, steriliz/sation, disinfection, microbial and bacterial contamination, hospital, healthcare and community-acquired infection. Papers related to aseptic technique in the operating room, intravenous therapy or catheterisation were excluded. All research designs, qualitative research and opinion papers were eligible for inclusion however, news items, letters and conference abstracts were excluded. All papers published in English up to October 2015 that related to topics outlined in the aims were eligible for inclusion. An initial search was conducted in MEDLINE, CINAHL, EMBASE, Current Contents and the Cochrane library. The review was undertaken using methods published by the Joanna Briggs Institute (JBI) 14,15. Specific aims were to identify evidence related to cleaning considerations when performing a wound procedure, techniques for wound cleansing, environmental considerations in performing wound management and ways in which wound dressings can be handled and stored aseptically. The objective of this review was to identify the contemporary evidence addressing topics associated with aseptic technique and infection control in wound management. ![]() To inform the development of this document, a systematic review (SR) was undertaken. Wounds Australia established a working party to develop clinical guidance on procedures associated with prevention and control of wound infection. Within Australia, the introduction of a standard on health care-associated infection 12 and publication of a national infection control policy 13 led to a demand for updated wound management procedures. Surveys indicate clinicians experience confusion about how to implement aseptic technique and other infection control principles 10,11. Historically, there have been major changes to aseptic theory in wound management 7-9. Given the impact of wound infection and significance of infection control practices in reducing its incidence, it is important that clinicians understand the implementation of infection control procedures when managing wounds. Infection control procedures are first-line strategy to prevent infection spread 6. Infection rate in lacerations is cited at 5% 5, and rate of biofilm in all acute wounds is approximately 6% 2.įacility-acquired wound infection is of particular concern given the increasing significance of antibiotic-resistant bacteria. Rates of surgical site infection vary substantially based on surgical site 3 however, recent estimates suggest 10–12% of all surgical wounds become clinically infected 4. As many as 60% of chronic wounds have infection in the form of demonstrated presence of surface bacteria or invasive biofilm 1,2. Precise incidence rates are difficult to determine due to the many types of wounds and various methods of diagnosing and tracking wound infection. Wound infection has a large impact on individuals and the health care system. ![]() ![]() Although high-level evidence on wound cleansing solutions was identified, the review concluded that there is a paucity of scientific literature on most topics related to asepsis in wound care. Findings from the 20 quantitative studies were reported in narrative summary and findings from 37 qualitative research papers were aggregated in a thematic synthesis. ![]() All levels of evidence were included in the review, including opinion papers. A systematic review using Joanna Briggs Institute methods was undertaken in order to establish the current state of the scientific literature on this topic and inform the development of recommendations for practice in this field. Wound cleansing, use of open but unused wound dressings and storage of wound management equipment are frequent issues on which clinicians request guidance. Clinicians often express confusion over the way various techniques should be applied, particularly when practising in clinical settings in which maintenance of strict asepsis is inherently difficult (for example, community-based wound management). There has been extensive ongoing debate on the application of aseptic technique in wound management over the previous decades and changes to the way in which theory is applied to clinical practice have occurred regularly. ![]()
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