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quickest method is surgical debridement which must be done by a skilled surgeon because of the distorted anatomy and the risk of capillary bleeding Surgical debridement is not a suitable option for patients with a history of capillary bleeding into the wound A variety of wound management products can be used, depending on the amount of exudate Alginates can be used on heavily exuding wounds When there is moderate to low exudate, an amorphous hydrogel and occasionally hydrocolloids can be used The position, size and spread of the lesion can affect dressing choice Capillary bleeding can be frightening for both the patient and the nurse When there is a history of capillary bleeding, great care should be taken when removing the old dressing If the dressing is adherent, it should be soaked with saline before removal is attempted It may also be necessary to remove the dressing slowly in stages.

Many kinds of sauces and accompaniments are appropriate for grilled meats,including compound butters, butter sauces such as b arnaise; brown sauce variations such as Bercy, mushroom, and bordelaise; tomato sauce variations; and salsas and relishes. For other examples, see the recipes in this section. Note that, unlike pan sauces made by deglazing saut pans (see p. 313), all these sauces are prepared in advance because broiling or grilling does not give you the opportunity to deglaze a pan. Part of the appeal of broiled and grilled meats is their brown,crisp surface.For this reason, it is best not to cover the item with the sauce. Also, less sauce is usually served with grilled items than with saut ed items. Serve the sauce on the side or around the meat or, at most, in a thin ribbon across only part of the meat. Similarly, vegetables and accompaniments for broiled and grilled meats should, in most cases, not be heavily sauced. Grilled vegetables are often good choices as accompaniments.

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locked away in little cubicles working on less than enterprise-scale problems. Analysts and analytics can do so much more. The analytic tool box (statistics, forecasting, operations research, data mining, etc.) can create great value for the enterprise. In the research for his book Competing on Analytics, Tom Davenport discovered that at Quaker Chemical, each business unit has a business adviser an analytical specialist reporting to the head of the business unit. 18 The role acts as an intermediary between the suppliers (normally the IT organization) and users (executives) of data and analyses. The advisors not only stimulate demand by showing the business unit how analysis can be useful but, as intermediaries, explain business needs to the suppliers and ensure that business-relevant data and analysis will be provided. Wachovia has a similar arrangement in its Customer Analytics group, in which analytical teams are tied to particular business units and act as partners in creating and ful lling analytical demand. Managers of these groups commented frequently that a relationship of trust between the analyst and the executive decision maker is critical to the success of an analytical strategy.

Table 22-2 (continued)

It is better to take a long time to remove a dressing than to start bleeding which is dif cult to control Adrenaline can be applied directly to the wound to control profuse bleeding However, it should be used with caution, under medical supervision Alginate dressings are useful when there is oozing and can be removed easily by washing away with saline If there is persistent bleeding, the haemoglobin should be checked regularly Blood transfusions may be necessary to treat anaemia If the lesion is being treated with radiotherapy, attention must be given to dressing selection A variety of dressings have been found to be suitable: charcoal dressings, alginates and an amorphous hydrogel Dressing retention may be a problem Ideally, the dressing should not be too bulky because it makes the wearing of clothes dif cult and the patient becomes very self-conscious.

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