Wounds in a correctional facility in Malta: a point prevalence study.

Abstract

Hard-to-heal (chronic) wounds are a challenge to wound care professionals, a burden to the health service and negatively impact affected individuals' quality of life. They also consume a great deal of healthcare resources globally and are found in all settings, including prisons. Therefore, the evaluation of wound care services is essential in order to develop an awareness of where improvement can be made. The main aim of this point prevalence study was to gather data on wounds, wound aetiology and wound management in a Maltese correctional facility. A secondary aim was to compare current practice with the best evidence-based practice and clinical practice guidelines, in order to provide a set of recommendations which can be implemented to improve the service. A retrospective study was carried out, auditing the medical records of people with justice involvement. The results of the audit reported a low prevalence of wounds. While practice met existing standards, for example, no unnecessary wound swab was taken, several shortcomings in wound management were noted. To improve adherence to the clinical guidelines in conjunction with improving the quality of the current service offered in the wound clinic, a number of short- and long-term clinical recommendations were proposed including: the incorporation of pain assessment tools and C-reactive protein blood testing for identifying infection; early referral to specialised care for individuals with diabetic foot ulcers, as well as the necessity for proficient personnel specialising in wound management training.