Literature Search Strategy

Joan is 45 year old lady with type 2 diabetes mellitus, her co-morbidities include the following: • Obesity • Hypertension • Hypercholesterolemia • Smoking: full pack a day Joan’s medications are all oral, a combination of antidiabetic medication, antihypertensives, and statins. She regularly sees her local general practitioner (GP) for checkups and renewals of her scripts only, despite her co-morbidities Joan mentions her HbA1c levels have remained stable and controlled over the past year. Joan works in a high paying stressful job, on her mother’s side the family has a long history of diabetes and renal disease. Joan recently presented to the local community care centre seeking treatment for a sore to her foot of over six months, stating ‘it just won’t heal’. She is unsure as to how it started but has slight insight, stating is ‘this caused by my footwear?’ Joan has been self-caring intermittently with supermarket purchased medihoney and band aids, stating she hasn’t had time to see anyone about this, seeking help now due to it becoming bigger. Wound assessment aetiology is pressure injury to the plantar aspect of her right foot related to her diabetic neuropathy and shoes. Joan has never attended a podiatry clinic for foot care, even though she has been referred by her GP, stating again she is time poor with regards to her work and family life which are her priorities. She asks the question ‘Why I was unable to heal my wound with the supermarket bought medihoney and simple dressings?’ Patient, population or problem Community based patients aged 30-55yrs with well controlled Type 2 diabetes and chronic pressure related injuries to feet Intervention, prognostic factor, or exposure Monitored wound and foot care using antimicrobial cadexomer matrix dressings with iodine, podiatric care Comparison Client self-management wound care with supermarket purchased Medihoney Outcomes Healing of wound within 3-6 months Type of Question Foreground question and possibly a combination of therapy, clinical findings and prognosis, given that the outcome is healing of a wound as opposed to chronic long term wounds. Type of Study This could be randomised control study, observational cohort studies, comparative analysis, meta analyses, systematic reviews QUESTION: ‘In community based diabetic clients aged 30-55yrs with well controlled type 2 diabetes mellitus and multiple co-morbidities who present for wound care with non-healing chronic pressure injuries to feet, will treatment with cadexomer iodine products and monitored wound care with regular podiatric care versus supermarket purchased medihoney with self-management by client, heal the wound?’