Tissue Viability Service

• The Tissue Viability service aims to provide specialist pressure ulcer prevention and management strategies, wound care advice for the assessment and management of patients with wound healing challenges. NHS Tayside’s Tissue Viability service is an integrated specialist nurse led service covering acute services, Health and Social Care Partnership in all localities and Care Homes across the whole of Tayside.

The Tissue Viability service will:

• Provide expert advice and support in all aspects of Tissue Viability
• Provide an online/electronic referral service in line with criteria listed below
• Sign post appropriate referrals to other specialties where relevant
• Provide expertise in relation to specialist pressure relieving and reducing equipment.

The Tissue Viability Service works in partnership with colleagues, please note that when referring to the service, the patient remains on your caseload with the referrer maintaining primary responsibility for the patient.
 

• Multiple Grade 3 pressure ulcers.
• Patients with Grade 4 and/or ungradable pressure ulcers.
• Rapidly deteriorating wounds.
• Non healing complex wounds.
• Malignant/fungating wounds.
• Lower limb cellulitis with extensive blistering or devitalised tissue for debridement.
• Moisture associated skin damage (excoriation) that is moderate or severe.
   

Please see Criteria for Referral and Initial Response Times for details.
Please ensure that all referrals for complex pressure ulcers are sent to Tissue viability initially. We will coordinate with the Plastics team as needed and provide further guidance.

 

Please do not refer a patient to Tissue Viability if they are already under a specialist team for the wound you wish to refer or require a first referral for a specific reason as per list below

• Lower limb/leg ulcers: refer to Dermatology
• Arterial lower limb ulceration: refer to Vascular
• Foot wounds: refer to Podiatry Service (check referral guidance)
• Lymphoedema without wounds, refer to Lymphoedema service
• Burns: refer to Plastic Surgery
• Post-op Plastic Surgery wounds, follow Plastic Surgery advice
• Haematoma’s & extensive skin tears requiring surgical debridement or review: refer to Plastic Surgery; otherwise manage at ward/clinic level.
   
• Acute extravasations prior to skin breakdown: use existing guidelines
• There are pathways in the Wound Formulary explaining referral routes for all wound care specialist teams, please refer to them for further guidance.
• For all pressure ulcers that occur on the foot, refer to Podiatry pathway for guidance on referral processes.
  
  
   

Referral to the Tissue Viability service is not available via Trakcare or SCI Gateway. Clinical images are required to fully assess wound.
Referral is through the processes outlined below;

• Please complete the " Chronic wound pre-referral check list" and address any factors inhibiting wound healing .
• Please fully complete referral form provided below.
• Referrals must be emailed to this address tay.tvnservice@nhs.scot
• ALL referrals must be accompanied by up-to-date clinical images.

Referrals will be triaged, and contact made with the referring professional within our specified response times (please refer to Tissue Viability Service Specification below).

Once we have received a referral, the initial assessment will be conducted through our electronic clinic (e-clinic), where referrals will be triaged. Based on this assessment, either specialist advice will be emailed back to you, or arrangements will be made for a Near-Me or in-person appointment. Please note that in-person reviews are reserved for specific circumstances, such as the management of more complicated wounds or situations where specialised skills are necessary, including sharp debridement of devitalised tissue.

Type of Review:
• Following receipt of a referral with clinical images, a TVN will allocate an Electronic-Clinic appointment. The patient and/or care giver or HCP does not need to be present at this appointment.
• Near me appointment: The patient and HCP must be present with the TVN for this appointment to go ahead. Instructions will be sent out in the post on how to access the Near Me Clinic appointment.
• In person review: A TVN will attend in person to review the patient.

• Service specification
• Referral Form

For general advice, refer to resources available on the webpage or contact the clinical mailbox.