Health for all W

orld Health Day is celebrated every year on 7 April, with this year’s motto being ‘health for all’. Across Europe and the rest of the world, people’s access to healthcare varies greatly. The public health system is facing a shortage of medical personnel, which affects both the waiting times for a doctor’s examination, as well as the staff workload in providing care and treatment. The aftermath of the COVID-19 pandemic has exacerbated this situation, as many individuals’ illnesses have already reach an advanced stage when they seek medical attention. This delay in seeking treatment can significantly affect the course and outcome of a disease.

According to Eurostat data, the number of people over 65 is increasing, and life expectancy is also on the rise. As a result, we can expect a growing number of individuals with multiple illnesses, known as polymorbidity. Cardiovascular diseases, diabetes and cancer are becoming more prevalent, leading to complications such as chronic wounds and diabetic ulcers. Cancer treatment may require the creation of a stoma (colostomy, ileostomy, urostomy) and can also result in various types of malignant wounds. As the population ages, more individuals are experiencing issues with urine or fecal incontinence. These diseases and complications can significantly impact an individual’s quality of life and represent a substancial financial burden for the healthcare system.

In this context, enterostomal therapy, which involves a nurse specialist in wound, incontinence and stoma care, plays a crucial role in both preventing and treating patients with wounds, incontinence and stoma. By providing preventive measures and high-quality treatment, we can help prevent additional complications, improve patients’ quality of life and facilitate better rehabilitation, ultimately contributing to greater cost-effectiveness.

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Chronic wounds are most often the result of vascular diseases (peripheral arterial occlusive disease, venous insufficiency), diabetes, limited mobility and long-term pressure on a certain part of the body. Wound bed preparation plays a key role in providing the proper environment for tissue repair to take place. It is carried out according to the TIME concept (T-tissue management, I-infection control, M- moisture balance, E -epithelization) and provides optimal conditions for wound healing (Frykberg and Banks, 2015). The use of various types of modern wound dressings provides the conditions for wound healing according to this concept. Stoma and/or peristomal skin complications may occur in patients with a stoma. Stelton (2019) states that the incidence of stoma and peristomal skin complications varies widely, with studies reporting rates as low as 10% to as high as 82%. The majority of problems occur with the skin near the stoma as a result of urine or/and stool leakage. Therefore, a patient with a stoma must have appropriate stoma accessories that will prevent leakage and thus keep the skin around the stoma intact. In case of problems, it is important to have access to an enterostomal therapist, who will be able to give him the best advice regarding stoma care.

In European countries and around the world, access to enterostomal therapists and wound ostomy or continence specialists vary. There are differences in the number of educated professionals in a country, as well as in an area of specialisation. In some countries, the training covers all three areas: wound care, incontinence and ostomy; in others, specialists may have only have expertise in individual areas. The patient must be informed about where and when they can get help when they have problems. Such resources should be available to everyone.

Renata Batas, Consultant Editor

Frykberg RG, Banks J. Challenges in the treatment of chronic wounds. Adv Wound Care (New Rochelle). 2015;4(9):560–582. https://doi.org/10.1089/wound.2015.0635

Stelton S. CE: Stoma and peristomal skin care: a clinical review. Am J Nurs. 2019;119(6):38–45. https://doi. org/10.1097/01.NAJ.0000559781.86311.64