Relevance to nursing practice and case study

Critical appraisal
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Introduction
The models of critiquing should focus on various aspects of nursing practice but more applicable for a specific case like wound care (Pearson et al., 2005). In order to improve wound healing it is necessary to improve the wound environment, as bacteria delay healing by competing with host cells (Fong & Wood, 2006). According to the ISI Journal Citation reports ranking in 2012, the Wound Repair and Regeneration Journal was ranked11/59 in dermatology, 28/199 (surgery,) 109/185, (cell biology) and 50/ 121 (Medicine Research & Experimental) (Hebda, 2014)
Miler et al (2010) focus on the differences between cadexomer iodine and nanocrystalline silver on the healing of leg ulcers. Leg ulcers have a more devastating impact than most wounds, with bacterial colonization likely to lead to infection. The authors are based in Australia including , Royal Melbourne Hospital, Melbourne, Australia, School of Public Health, La Trobe University, Melbourne, Vic., Australia, School of Nursing, University of Melbourne, Melbourne, Vic., Australia, Royal District Nursing Service Helen Macpherson Smith Institute of Community Health, St. Kilda, Vic., Australia and Silver Chain Nursing Association.
Background/ aims
Similar to wounds, leg ulcers are treated using moist wound dressings and multilayer compression therapy. However, there is a risk that bacteria colonization will affect the ulcers as bacterial burden needs to be well managed to deal with delayed healing. The typical nursing practice is to use primary dressings with antimicrobial properties when wounds and leg ulcers have been identified as colonized (Miler, 2010). Nonetheless, there is still no consensus on the best way through which antimicrobial preparations can be used to reduce wound infection. Evidence-based medicine can allow health care practitioners to use limited resources efficiently while also improving wound care (Al-Benna, 2010). Hence, there is a need to highlight on the performance of various dressing techniques and impact on overall healing rate.
Both silver and cadexomer iodine primary dressings have anti microbial properties typically used in treatment of critically colonized legs. Nanocrystalline silver dressings have the potential to act as barriers to bacteria like the methicillin-resistant Staphylococcus aureus (MRSA) (Strohal et al., 2005) Even though, the two techniques have been accepted for there effectiveness, few studies focus on comparing the results of the two techniques. Hence, the article delves into evidence comparing results between the two as well as giving a summary on the techniques. The authors highlight that there are few systematic reviews on effectiveness of silver dressings in leg ulcer management. Thus, there is a need to focus on the randomized clinical trial that touches on the effect of silver on wounds.
Methods
The research relied on a RCT design c...