[Sue Greig]

Hi Fiona,
The ‘wound field concept’ was being taught in some tertiary centres and several years ago was criticised as not being compliant with the need for ANTT especially in acute care, with acute wounds or devise management. I was advised at the time that it’s premise is that the dressing field and the ‘wound’ field are the same and neither are sterile and all items can move between each freely.

Several of us lobbied strongly that this not be taught for acute care and if it had any place in health care it would only be in the community or home care situation when dealing with chronic wounds but the principles confused practice and allowed for poor practice that put patients at risk in the acute care setting.

Regards,
Sue

Sue Greig
Infection Prevention and Control Clinical Nurse Consultant
Sydney Hospital and Sydney Eye Hospital

(02) 9382 7199 (direct)

Senior Project Officer
National HAI Prevention Program
Australian Commission on Safety and Quality in Health Care
Email sue.greig@safetyandquality.gov.au

Hi All,

I was recently introduced to the wound field concept by a new graduate nurse who had failed her aseptic non touch technique competency as she was using the wound field concept that she was taught at her university.

Although I can find theoretical information on this concept I have not found any research to show that this is a clinically better practice than using an ANTT. It does not appear to be included in the latest Australian Infection Control Guidelines or the new national standards either.

Does anyone have any references to support the wound field concept especially in relation to reduction in HAI rates?
Does anyone use this concept in their facility?

Kind Regards,

Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
Fiona.Desousa@sah.org.au
185 Fox Valley Road, Wahroonga, NSW, 2076

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[Sue Greig]

Hi Saffron,
We have a hand unit here at Sydney Hospital and we don’t use paraffin wax baths due to the infection and safety risks but I do know it is extensively used in the beauty industry for manicures and I think they put the warmed paraffin into a glove and then insert the clients hand into the glove. However, I am sure there is varied practices. The Skin Penetration Guidelines from some of the States cover the use of wax but this is usually for hair removal, but the same principles apply in relation to bacteria/viruses and fungi. It is difficult to sterilise or disinfect wax, and significant safety issues with attempting to undertake this with large quantities of wax and therefore it should be single use unless you have process in place for thermal disinfection – e.g. code of practice for skin penetration procedures (WA).

Regards,
Sue

Sue Greig
Monday and Tuesday only
Infection Prevention and Control
Clinical Nurse Consultant
Sydney Hospital and Sydney Eye Hospital

Wednesday to Friday this position is covered by
Yao Yu (George) and he can be contacted on the same contact details

(02) 9382 7199 (direct)
yao.yu@sesiahs.health.nsw.gov.au
P Please consider the environment before printing this e-mail

Hi all

I am looking for some guidelines around the use of “wax baths” used in community health centres.
These baths are large basins with paraffin wax which is heated up and patients place their hands in it for 15 minutes as part of rehab for arthritis, scar tissue etc
If anybody can direct me to or share with me some written guidelines it would be much appreciated.
Regards
Saffron

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Saffron Brown

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Tasmanian Infection Prevention & Control Unit (TIPCU)

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[Sue Greig]

Hi Matt and Michael,
We have done suture removal with nurses and hand therapists using pigs trotters in the past and whilst it is realistic it has several infection implications that need to be considered apart from occupational exposures. These include:
Biological spills – ensure where the activity is going to occur can be cleaned effectively – no carpet. We used a wet lab.
Supply of appropriate PPE for training session, waste disposal.
Ensuring HH resources are available.
Handling of any instrumentation that is reusable and then reprocessing it – strongly suggest you use disposable.
Disposal of used tissue – pigs trotters – great for dog bones
Managment of occupational expsoures – as per HCWs re Hep B and other BBV and for the additional diseases Matt has identified – several are not in Australia but pigs are a natural home for may infectious agents that do cause disease in humans and Standard Precautions and use of PPE needs to be considered for the training session. Hopefully you are getting pigs trotters that have been prepared for human consumption and therefore they will be clean and meet the relevent food standards in your state/territory. At this time we have not had an occupational exposure associated with the training sessions but would undertake a management plan based on risk assessment if it did occur.

In addition to this we have now changed to using compressed foam for these sessions and they work well for training suture removal and don’t create risks that need to be managed that I have already identified. Also much less tedious and much safer to complete the suturing. The last time we used pigs trotters we did over 8 hrs suturing preparing the pigs trotters for the sessions.

Regards,
Sue

________________________________

Hi Michael,
I did a quick google search and came up with this list of zoonoses from pigs. There doesn’t appear to be much out there! Someone who does xenotransplants might know more (Prince of Wales in Sydney comes to mind).
Cheers Matt

* Anthrax
* Ascaris suum
* Botulism
* Brucellosis
* Cryptosporidium
* Entamoeba polecki
* Erysipelothrix rhusiopathiae
* Flavobacterium Group IIb-like organism
* Foot and Mouth Disease virus
* Influenza
* Leptospirosis
* Pasteurella aerogenes and multocida
* Pigbel
* Psittacosis
* Rabies
* Salmonellosis (S.cholerae-suis)
* Sarcosporidiosis
* Scabies
* Sparganosis (Wild pigs)
* Streptococcus dysgalactiae (Group L Beta-haemolytic)
* Streptococcus milleri
* Streptococcus suis type 2 (group R)
* Swine Vesicular Disease virus
* Swine influenza virus
* Taenia solium
* Trichinella spiralis
* Tularaemia
* Yersiniosis (Plague)

On 15/07/2010 8:28 AM, Wishart, Michael wrote:

We are starting to teach suturing using ‘pig trotters’. I have been
asked what process we should follow if any of the students suffer a
needlestick on a suture needle used for this. I have no idea!

Does anyone have any sage advice? What if anything should we do as
follow-up of a student exposed to pig tissue??

Thanks
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
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