Linear wound measurement basics

November 20, 2014February 25, 2020 Wound Care Advisor

By Nancy Morgan, RN, BSN, MBA, WOC, WCC, DWC, OMS

Each issue, Apple Bites brings you a tool you can apply in your daily practice.

Measurement of wounds is an important component of wound assessment and provides baseline measurements, enables monitoring of healing rates, and helps distinguish among wounds that are static, deteriorating, or improving. All alterations in skin integrity, including those caused by ulcers, venous ulcers, arterial ulcers, neuropathic ulcers, incision lines, grafts, donor sites, abscesses, and rashes should be measured when they’re discovered and at intervals thereafter, based on institutional policy. (more…)

New Standards Tests to Prevent Pressure Injuries

June 29, 2017February 25, 2020 Wound Care Advisor

Washington, D.C. – The National Pressure Ulcer Advisory Panel (NPUAP) announced the convening of its subcommittee, the Support Surface Standards Initiative (S3I), this spring to approve new standards tests that may help prevent pressure injuries in bed-bound individuals. (more…)

Imaging technology to aid wound care

April 10, 2017February 25, 2020 Wound Care Advisor

Nash UNC Health Care is continuing its effort to bring cutting-edge technology to the hospital.

Through a recent partnership with a Maryland-based medical imaging and data analytics company called Tissue Analytics, which is dedicated to revolutionizing wound care, Nash UNC Health Care has adopted new state-of-the-art wound imaging technology to its outpatient Wound Care Center. (more…)

Measuring wounds

March 25, 2017February 25, 2020 Wound Care Advisor

BY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
An essential part of weekly wound assessment is measuring the wound. It’s vitally important to use a consistent technique every time you measure. The most common type of measurement is linear measurement, also known as the “clock” method. In this technique, you measure the longest length, greatest width, and greatest depth of the wound, using the body as the face of an imaginary clock. Document the longest length using the face of the clock over the wound bed, and then measure the greatest width. On the feet, the heels are always at 12 o’clock and the toes are always 6 o’clock. Document all measurements in centimeters, as L x W x D. Remember—sometimes length is smaller than width. (more…)

Assessing footwear in patients with diabetes

July 20, 2016February 25, 2020 Wound Care Advisor

Inappropriate footwear is the most common source of trauma in patients with diabetes. Frequent and proper assessment of appropriate footwear is essential for protecting the diabetic foot from ulceration.

Here is a step-by-step process for evaluating footwear. Be sure to evaluate footwear with the patient walking, standing, and sitting. (more…)

Clinical Notes: Moldable Skin Barrier, hypoglycemia, diabetic food ulcers

June 6, 2016February 25, 2020 Wound Care Advisor

Moldable skin barrier effective for elderly patients with ostomy

A study in Gastroenterology Nursing reports that compared to a conventional skin barrier, a moldable skin barrier significantly improves self-care satisfaction scores in elderly patients who have a stoma. The moldable skin barrier also caused less irritant dermatitis and the costs for leakage-proof cream were lower.

“The application of a moldable skin barrier in the self-care of elderly ostomy patients” included 104 patients ages 65 to 79 who had a colostomy because of colorectal cancer.

Risk factors for severe hypoglycemia in older adults with diabetes identified

(more…)

A collaborative approach to wound care and lymphedema therapy: Part 2

July 27, 2015February 25, 2020 Wound Care Advisor

By Erin Fazzari, MPT, CLT, CWS, DWC

Have you seen legs like these in your practice?

These legs show lymphedema and chronic wounds before treatment (left image) and after treatment (right image) with complex decongestive therapy (CDT)—the gold standard of lymphedema care. The patient benefited from multidisciplinary collaboration between wound care and lymphedema therapists. (more…)

Providing evidence-based care for patients with lower-extremity cellulitis

May 21, 2015February 25, 2020 Wound Care Advisor

By Darlene Hanson, PhD, RN; Diane Langemo, PhD, RN, FAAN; Patricia Thompson, MS, RN; Julie Anderson, PhD, RN; and Keith Swanson, MD

Cellulitis is an acute, painful, and potentially serious spreading bacterial skin infection that affects mainly the subcutaneous and dermal layers. Usually of an acute onset, it’s marked by redness, warmth, swelling, and tenderness. Borders of the affected skin are characteristically irregular. Although cellulitis may occur in many body areas, this article discusses the most common location—the lower limb. (more…)

Ankle-brachial index: A dirty word?

May 21, 2015February 25, 2020 Wound Care Advisor

Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS

Silence, roving eyes, fidgeting, excuses, a quick subject change—these are typical responses from healthcare clinicians when asked, “What’s the patient’s ankle-brachial index?” You’d think someone had just uttered a dirty word.

The ankle-brachial index (ABI) is a key component of the lower-extremity vascular exam, recommended and in some cases mandated by numerous clinical practice guidelines, including the most recent international guidelines on preventing and treating pressure ulcers. (more…)

Clinical Notes : Diabetes, medical honey, silver dressings, clostridium

April 6, 2015February 25, 2020 Wound Care Advisor

Guidelines for optimal off-loading to prevent diabetic foot ulcers

“The management of diabetic foot ulcers through optimal off-loading,” published in the Journal of the American Podiatric Medical Association, presents consensus guidelines and states the “evidence is clear” that off-loading increases healing of diabetic foot ulcers.

The article calls for increased use of off-loading and notes that “current evidence favors the use of nonremovable casts or fixed ankle walking braces as optimum off-loading modalities.” The authors reviewed about 90 studies. (more…)

What does it mean to participate in a wound care clinical trial?

February 9, 2015February 25, 2020 Wound Care Advisor

By Susan Beard, RN, BS, CWOCN

Suppose you’re reading an article on a new product that states the product has been through a series of clinical trials before marketing. What does this mean? Who was involved? As a clinician, could you initiate or be involved in a clinical trial of a new product? Who are clinical trial subjects, and what’s it like for them to be involved in a clinical study?

A clinical trial starts as an idea. As clinicians, we often use our critical-thinking skills to imagine a product or method of practice we think could be created or improved on to better meet our patients’ needs. The idea begins to grow and a series of events begins. (more…)

Clinician Resources: MRSA, Dosing Calculator, CDC Resources

February 9, 2015February 25, 2020 Wound Care Advisor

Special edition: Resources from the Buzz Report

This issue, we highlight some resources from “The Buzz Report,” the popular presentation given by editor-in-chief Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS, at the Wild On Wounds (WOW) conference, held each September in Las Vegas. (more…)

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