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Andrea Nelson
University of Leeds, Healthcare, Faculty Member
- Nurse academic with expertise in evaluating what works in woundsedit
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There is inadequate evidence to advise clinicians on the relative merits of swabbing versus tissue sampling of infected diabetic foot ulcers (DFUs). To determine (1) concordance between culture results from wound swabs and tissue samples... more
There is inadequate evidence to advise clinicians on the relative merits of swabbing versus tissue sampling of infected diabetic foot ulcers (DFUs). To determine (1) concordance between culture results from wound swabs and tissue samples from the same ulcer; (2) whether or not differences in bacterial profiles from swabs and tissue samples are clinically relevant; (3) concordance between results from conventional culture versus polymerase chain reaction (PCR); and (4) prognosis for patients with an infected DFU at 12 months' follow-up. This was a cross-sectional, multicentre study involving patients with diabetes and a foot ulcer that was deemed to be infected by their clinician. Microbiology specimens for culture were taken contemporaneously by swab and by tissue sampling from the same wound. In a substudy, specimens were also processed by PCR. A virtual 'blinded' clinical review compared the appropriateness of patients' initial antibiotic regimens based on the resu...
Research Interests: Information Systems, Wound Healing, Medicine, Library and Information Studies, Humans, and 13 moreInternal Medicine, Diabetes mellitus, Polymerase Chain Reaction, Health Technology Assessment, Diabetic Foot, Aged, Middle Aged, Concordance, Adult, Public health systems and services research, Prognosis, Cross Sectional Studies, and Diabetic Foot Ulcer
To explore pressure area related pain as a predictor of category ≥2 pressure ulcer (PU) development. Multicentre prospective cohort study. UK hospital and community settings. Consenting acutely ill patients aged ≥18 years, defined as high... more
To explore pressure area related pain as a predictor of category ≥2 pressure ulcer (PU) development. Multicentre prospective cohort study. UK hospital and community settings. Consenting acutely ill patients aged ≥18 years, defined as high risk (Braden bedfast/chairfast AND completely immobile/very limited mobility; pressure area related pain or; category 1 PU). Patients too unwell, unable to report pain, 2 or more category ≥2 PUs. Twice weekly for 30 days. Development and time to development of one or more category ≥2 PUs. Of 3819 screened, 1266 were eligible, 634 patients were recruited, 32 lost to follow-up, providing a 602 analysis population. 152 (25.2%) developed one or more category ≥2 PUs. 464 (77.1%) patients reported pressure area related pain on a healthy, altered or category 1 skin site of whom 130 (28.0%) developed a category ≥2 PU compared with 22 (15.9%) of those without pain. Full stepwise variable selection was used throughout the analyses. (1) Multivariable logistic...
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Research Interests: Nursing, Wound Healing, Medicine, Humans, Wound care, and 4 morePubmed, Pressure, Bandages, and VARICOSE ULCER
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Background Urinary incontinence (UI) is a distressing condition that limits women’s quality of life and places a heavy burden on health care services. Behavioural treatments are recommended as a first-line treatment. An evidence-based... more
Background Urinary incontinence (UI) is a distressing condition that limits women’s quality of life and places a heavy burden on health care services. Behavioural treatments are recommended as a first-line treatment. An evidence-based self-management package was developed following the Medical Research Council (MRC) framework for complex interventions. This study aimed to evaluate the feasibility and acceptability of the intervention. Methods A mixed-methods approach was undertaken, namely a randomised controlled feasibility study with nested qualitative study. Fifty women aged 55 or over living with UI, recruited from community centres were randomly assigned to either a 3-month course with the package with a support session or a control group to receive the same package only 3 months later. Principal outcome measures were: self-reported quality of life, UI severity, self-efficacy and psychological status. Analysis of covariance was undertaken to estimate within- and between- group ...
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ObjectiveTo synthesise the evidence for the multifaceted self-management interventions for older women with urinary incontinence (UI) and to understand the outcomes associated with these interventions.DesignA systematic review and... more
ObjectiveTo synthesise the evidence for the multifaceted self-management interventions for older women with urinary incontinence (UI) and to understand the outcomes associated with these interventions.DesignA systematic review and narrative synthesis to identify randomised controlled trials that investigated the effect of multifaceted self-management interventions for older women with UI.MethodsMEDLINE, PsycINFO, EMBASE, The Cochrane Library, CINAHL and Applied Social Sciences Index and s databases were searched (January 1990 to May 2019) using a systematic search strategy, complemented by manually screening the reference lists and citation indexes. Study selection, data extraction and risk of bias assessment were undertaken independently. A narrative synthesis was undertaken in which studies, interventions and outcomes were examined based on the intervention components. The effect size and 95% CI were estimated from each study.ResultsA total of 13 147 citations were identified and ...
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ABSTRACT
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The selection and application of safe and effective compression therapy requires a basic understanding of how compression achieves its clinical effects and how to identify patients who might benefit from it and those in whom it is a... more
The selection and application of safe and effective compression therapy requires a basic understanding of how compression achieves its clinical effects and how to identify patients who might benefit from it and those in whom it is a contraindication.
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Over past months the Editorial Board of the Journal of Tissue Viability have discussed the need for a section that allows the current controversial topics in wound care to be discussed. This section will pose questions that will be... more
Over past months the Editorial Board of the Journal of Tissue Viability have discussed the need for a section that allows the current controversial topics in wound care to be discussed. This section will pose questions that will be addressed by one or more experts so allowing a wide discussion of the topic. If you have a question that you think should be discussed in these pages please contact the Editor through the Tissue Viability Society Office.
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Andrea Nelson, Professor of wound healing and a member of the Cochrane Wounds Group, describes how the written word can improve wound care
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Research Interests: Nursing, Wound Healing, Medicine, Humans, Wound care, and 4 morePubmed, Pressure, Bandages, and VARICOSE ULCER
A nurse-led multicentre randomised controlled trial will compare the clinical effectiveness of weekly ultrasound combined with standard care in the treatment of... more
A nurse-led multicentre randomised controlled trial will compare the clinical effectiveness of weekly ultrasound combined with standard care in the treatment of 'hard-to-heal' venous leg ulcers. Recruitment started last autumn.
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Multi-component medical compression bandages are widely used to treat venous leg ulcers. The sub-bandage interface pressures induced by individual components of the multi-component compression bandage systems are not always simply... more
Multi-component medical compression bandages are widely used to treat venous leg ulcers. The sub-bandage interface pressures induced by individual components of the multi-component compression bandage systems are not always simply additive. Current models to explain compression bandage performance do not take account of the increase in leg circumference when each bandage is applied, and this may account for the difference between predicted and actual pressures. To calculate the interface pressure when a multi-component compression bandage system is applied to a leg. Use thick wall cylinder theory to estimate the sub-bandage pressure over the leg when a multi-component compression bandage is applied to a leg. A mathematical model was developed based on thick cylinder theory to include bandage thickness in the calculation of the interface pressure in multi-component compression systems. In multi-component compression systems, the interface pressure corresponds to the sum of the pressures applied by individual bandage layers. However, the change in the limb diameter caused by additional bandage layers should be considered in the calculation. Adding the interface pressure produced by single components without considering the bandage thickness will result in an overestimate of the overall interface pressure produced by the multi-component compression systems. At the ankle (circumference 25 cm) this error can be 19.2% or even more in the case of four components bandaging systems. Bandage thickness should be considered when calculating the pressure applied using multi-component compression systems.
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Abstract—Medical compression bandages (MCBs) are widely used to treat venous leg ulcers. Interface pressure measurement devices like PicoPress RO transducer are used occasionally to measure the pressure applied by MCBs to train nurses to... more
Abstract—Medical compression bandages (MCBs) are widely used to treat venous leg ulcers. Interface pressure measurement devices like PicoPress RO transducer are used occasionally to measure the pressure applied by MCBs to train nurses to apply MCBs with ...
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Medical compression bandages (MCBs) are widely used in the treatment of chronic venous ulcers. They should be applied with a pressure gradient reducing from the ankle to the knee. Users of current medical compression bandages are... more
Medical compression bandages (MCBs) are widely used in the treatment of chronic venous ulcers. They should be applied with a pressure gradient reducing from the ankle to the knee. Users of current medical compression bandages are dependent on their visual inspection of bandages in situ for the amount of extension and overlap in the MCBs to control the amount of