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  1. Sibbald, R. Gary MD, FRCPC
  2. Orsted, Heather L. RN, BN, ET, MSc
  3. Coutts, Patricia M. RN
  4. Keast, David H. MSc, MD, FCFP


PURPOSE: To provide the best available evidence in care of patients with chronic wounds.


TARGET AUDIENCE: This continuing education activity is intended for physicians, and nurses with an interest in wound care.


OBJECTIVES: After reading this article and taking this test, the reader should be able to:


1. Identify local factors and recommendations for preparing the wound bed, including DIME and MEASURE, and ways to promote patient adherence to the treatment plan.


2. Explain impairments and time guidelines to wound healing, problems with wound healing, and types of wound pain.



Editor's note: This "Best Practice Recommendations" article is reprinted with permission from Wound Care Canada 2006;4(1):15-29. It is 1 of 4 articles published in 2006 following the latest Nursing Best Practice Guidelines from the Registered Nurses1 Association of Ontario (RNAO), which are updated approximately every 3 years. In this article, the concept of preparing the wound bed is updated to consider the whole patient before treating the wound. The evidence presented is connected to the RNAO's recommendations from its review of the literature up to the writing of its 2006 guidelines.