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Practical Issues in Wound, Skin and Ostomy Management
One of many dreaded tags from a Centers for Medicare & Medicaid Survey is F-Tag 314 — Pressure ulcers.
CMS writes, “Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.” (more…)
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Wound Care Advisor attempts to select authorities who are knowledgeable in their fields. However, it does not warrant the expertise of any author, nor is it responsible for any statements made by any author. Certain statements about the uses, dosages, efficacy and characteristics of some drugs mentioned here reflect the opinions or investigational experience of the authors. Nurses should not use any procedures, medications, or other courses of diagnosis or treatment discussed or suggested by authors without evaluating the patient’s conditions and possible contraindications or dangers in use, reviewing any applicable manufacturer’s prescribing or usage information, and comparing these with recommendations of other authorities.
We encourage people with wounds and ostomy questions to contact their care provider; we are unable to provide medical advice.
Read MoreLorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Donec quam felis, ultricies nec, pellentesque eu, pretium quis, sem. Nulla consequat massa quis enim. Donec pede justo, fringilla vel, aliquet nec, vulputate eget, arcu. In enim justo, rhoncus ut, imperdiet a, venenatis vitae, justo. Nullam dictum felis eu pede mollis pretium. Integer tincidunt. Cras dapibus. Vivamus elementum semper nisi. Aenean vulputate eleifend tellus. Aenean leo ligula, porttitor eu, consequat vitae, eleifend ac, enim. Aliquam lorem ante, dapibus in, viverra quis, feugiat a, tellus. Phasellus viverra nulla ut metus varius laoreet. Quisque rutrum. Aenean imperdiet. Etiam ultricies nisi vel augue. Curabitur ullamcorper ultricies nisi. Nam eget dui. Etiam rhoncus. Maecenas tempus, tellus eget condimentum rhoncus, sem quam semper libero, sit amet adipiscing sem neque sed ipsum. Nam quam nunc, blandit vel, luctus pulvinar, hendrerit id, lorem. Maecenas nec odio et ante tincidunt tempus. Donec vitae sapien ut libero venenatis faucibus. Nullam quis ante. Etiam sit amet orci eget eros faucibus tincidunt. Duis leo. Sed fringilla mauris sit amet nibh. Donec sodales sagittis magna. Sed consequat, leo eget bibendum sodales, augue velit cursus nunc,
DISCLAIMER: All clinical recommendations are intended to assist with determining the appropriate wound therapy for the patient. Responsibility for final decisions and actions related to care of specific patients shall remain the obligation of the institution, its staff, and the patients’ attending physicians. Nothing in this information shall be deemed to constitute the providing of medical care or the diagnosis of any medical condition. Individuals should contact their healthcare providers for medical-related information.
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A new study shows a clear association between the prophylactic use of five-layer foam sacral dressings and reductions in pressure injury rates. Specifically, the study looked at the prophylactic use of Mölnlycke’s Mepilex® Border Sacrum dressing in the acute care setting over a six-year period (2010-2015). (more…)
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PolarityTE (TM) Regenerates Full-Thickness Hair-Bearing Skin in Burns and Wounds Using Their Revolutionary Platform Technology. First ever known successful regeneration of full-thickness skin and hair; Company poised to initiate human trial in the third quarter of 2017; Management to host conference call Thursday, June 8th at 4:30pm ET.
Salt Lake City, UT — (Marketwired) — 06/08/17 — PolarityTE™, Inc. (NASDAQ: COOL) today announced pre-clinical results demonstrating that the Company’s lead product, SkinTE™, regenerated full-thickness, organized skin and hair follicles in third degree burn wounds. The findings represent the first known successful regeneration of skin and hair in full-thickness swine wound models, the standard animal model for human skin. The Company expects to initiate a human clinical trial evaluating the autologous homologous SkinTE™ construct in the third quarter of 2017. (more…)
Read MoreI was thrilled to be asked to write a blog for Wound Care Advisor. They asked me to come up with a name for the blog. I thought it would be easy… NOT ! I found myself doing all this research on how to make up a good name that would be catchy and memorable. I reached out to all my wound care friends for ideas and started a long list of names. Every morning I would look at this list and add more. Then I said I had to STOP THE INSANITY! I had to refocus and asked myself… who are you writing the blog for? It’s for people like me! I am a nurse that is in love with wound care, I have been in this field for almost two decades—ouch! that just dated me. I started at bedside then moved to an educator role co-founding the Wound Care Education Institute where we have taught over 16,000 clinicians, spreading the knowledge of Wound Care so they can make a difference in their patients’ lives. I am that person that “gets the rush” every time I see a wound. (more…)
Read MoreBY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
Wound healing and nutrition go hand in hand. Without adequate fluids, calories, and protein, wound healing can be delayed.
Protein is extremely important in wound healing. Patients with wounds require almost double the protein intake (1.2 to 1.5 g/kg/day) of those without wounds. All stages of wound healing require adequate protein. The basis of the human body structure, protein is responsible for making enzymes involved in wound healing, cell multiplication, and collagen and connective-tissue building. (more…)
Read MoreBY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
Support surfaces are geared for managing our patients’ tissue load and redistributing it to prevent skin breakdown. There are three types of pressure redistribution mattresses available, classified as group 1, group 2, and group 3. Group 1 mattresses lack a power source and maintain a constant state of inflation. They include foam mattresses, gel mattresses, and air mattresses. Group 2 support surfaces, such as powered, low-air-loss, and alternating pressure mattresses use inflation and deflation to spread the tissue load over a large surface area. Group 3 mattresses include the air-fluidized mattress, a special type of powered mattress that provides the highest-pressure redistribution via a fluid-like medium created by forcing air through beads, as characterized by immersion and envelopment. (more…)
By Nancy Morgan, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
Staging pressure ulcers can get tricky, especially when we’re dealing with a suspected deep-tissue injury (SDTI). The National Pressure Ulcer Advisory Panel defines an SDTI as a “purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer, or cooler as compared to adjacent tissue… Deep tissue injury may be difficult to detect in individuals with dark skin tones. Evolution may include a thin blister over a dark wound bed. The wound may further evolve and become covered by thin eschar. Evolution may be rapid, exposing additional layers of tissue even with optimal treatment.” (more…)
BY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
We’ve talked about types of exudate (drainage). Now let’s consider the amount of exudate in wounds, which is a key part of our assessment.
No exudate present: The wound is too dry.
Scant amount of exudate present: The wound is moist, even though no measurable amount of exudate appears on the dressing.
Small or minimal amount of exudate on the dressing: Exudate covers less than 25% of the bandage. (more…)
BY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
What exactly is wound exudate? Also known as drainage, exudate is a liquid produced by the body in response to tissue damage. We want our patients’ wounds to be moist, but not overly moist. The type of drainage can tell us what’s going on in a wound.
Let’s look at the types of exudates commonly seen with wounds. (more…)
Read MoreBY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
Lower extremity ulcers are often referred as the “big three”—arterial ulcers, venous ulcers, and diabetic foot ulcers. Are you able to properly identify them based on their characteristics? Sometimes, it’s a challenge to differentiate them.
Arterial ulcers tend occur the tips of toes, over phalangeal heads, around the lateral malleolus, on the middle portion of the tibia, and on areas subject to trauma. These ulcers are deep, pale, and often necrotic, with minimal granulation tissue. Surrounding skin commonly is pale, cool, thin, and hairless; toenails tend to be thick. Arterial ulcers tend to be dry with minimal drainage, and often are associated with significant pain. The patient usually has diminished or absent pulses. (more…)
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