Benchmarking vulvar cancer wound care practice in Australia and New Zealand: A cross-sectional study

Abstract

Purpose

This study aimed to investigate current vulvar cancer wound care practices in Australia and New Zealand, identify knowledge of evidence supporting practice, explore enablers and barriers and determine areas for future improvement and research.

Methods

An online cross-sectional survey collected quantitative and qualitative data from 64 nurses and doctors between May and July 2023. Descriptive statistics and content analysis were conducted. A consumer advisory group contextualised findings within lived experiences.

Results

Common vulvar wound care practices included wound irrigation (n = 48, 83 %) and perineal drying (n = 40, 69 %), along with urinary catheters (n = 50, 86 %) and drains (n = 33, 57 %). Not using a wound dressing was common (n = 41, 71 %). Using silver (n = 25, 39 %), topical (n = 11, 17 %) or prophylactic (n = 2, 3 %) antibacterial agents were less common. Only 23 % (n = 15) of respondents reported knowledge of organisational guidance and care was commonly determined by practitioner preference, clinical assessment, and specialist wound nurse review. Reported enablers included guidance documents, clear instructions, clinician expertise, effective communication, and a well-informed patient. Reported barriers included infection, comorbidities, clinician variability, lack of evidence, systematic barriers, poor communication, and wound access challenges. The most common suggestion for improvement was the development of evidence based guidance. Four priority areas for future research were identified as; building an evidence base, evaluating the patient experience, investigating the impact of reducing risk factors and evaluating education interventions.

Conclusions

By benchmarking current wound care practices following surgery for vulvar cancer in Australia and New Zealand, priorities to direct future research and practice change efforts are supported.