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Managing chronic venous leg ulcers — what’s the latest evidence?

Managing chronic venous leg ulcers — what’s the latest evidence?

Chronic venous leg ulcers (CVLUs) affect nearly 2.2 million Americans annually, including an estimated 3.6% of people over the age of 65. Given that CVLU risk increases with age, the global incidence is predicted to escalate dramatically because of the growing population of older adults. Annual CVLU treatment-related costs to the U.S. healthcare system alone are upwards of $3.5 billion, which are directly related to long healing times and recurrence rates of over 50%.

CVLUs are not only challenging and costly to treat, but the associated morbidity significantly reduces quality of life. That makes it critical for clinicians to choose evidence-based treatment strategies to achieve maximum healing outcomes and minimize recurrence rates of these common debilitating conditions. These strategies, which include compression therapy, specialized dressings, topical and oral medications, and surgery, are used to reduce edema, facilitate healing, and avert recurrence. (more…)

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Wound Photography – How it Benefits Clinical Documentation

wound photography

Accurate assessment and documentation of wounds is essential for developing a comprehensive plan of care. Photography now plays a key role in wound care. The use of digital photography has enhanced the reliability and accuracy of wound documentation. Though a wound assessment in patient files includes details such as location, depth, odor, condition of surrounding tissue and other details, a visual record can be worth even more.

Digital photography is becoming a more prevalent documentation tool. According to an article published in McKnight’s, forensic nursing experts recommend using photographs to document injury. The photos show both how an injury occurred and how it is healing.

The National Pressure Ulcer Advisory Panel (NPUAP) also supports photography as a more accurate means for assessment of wound dimensions and wound base over time.

A visual confirmation to the written record, these images:

  • Facilitate better diagnosis
  • Enhance clinical documentation
  • Help to monitor the progress of wound healing
  • Help prevent litigation in wound management
  • Allow inter-disciplinary communication among the wound care team

Read more at Wound Wizard

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2016 Journal: March – April Vol. 5 No. 2

2016 Journal: March – April Vol. 5 No. 2

No more skin tears

Imagine watching your skin tear, bleed, and turn purple. Imagine, too, the pain and disfigurement you’d feel.

What if you had to live through this experience repeatedly? That’s what many elderly people go through, suffering with skin tears through no fault of their own. Some go on to develop complications.

A skin tear is a traumatic wound caused by shear, friction, or blunt-force trauma that results in a partial

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Buzz Report: Latest trends, part 2

Keeping clinicians up-to-date on clinical knowledge is one of the main goals of the Wild on Wounds (WOW) conference held each September in Las Vegas. Every year, I present the opening session, called “The Buzz Report,” which focuses on the latest-breaking wound care news—what’s new, what’s now, and what’s coming up. I discuss new products, practice guidelines, resources, and tools from the last 12 months in skin, wound, and ostomy management. In…

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Caution: Checklists may lead to inaccurate documentation

Using a checklist form to document wound care can make the task easier and faster—and help ensure that you’ve captured all pertinent data needed for assessment, reimbursement, and legal support. But the form itself may not be comprehensive; some important fields may be missing. Recently, we at Wound Care Advisor received a question from a clinician who was having trouble deciding how to code a patient’s wound in her hospital’s…

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Clinical Notes: ostomy, pressure ulcer, burn treatment

Self-management ostomy program improves HRQOL A five-session ostomy self-care program with a curriculum based on the Chronic Care Model can improve health-related quality of life (HRQOL), according to a study in Psycho-Oncology. “A chronic care ostomy self-management program for cancer survivors” describes results from a longitudinal pilot study of 38 people. Participants reported sustained improvements in patient activation, self-efficacy, total HRQOL, and physical and social well-being. Most patients had a history of…

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Clinician Resources: human trafficking, npuap, caregiver, ostomy, HIV

Check out the following resources, all designed to help you in your clinical practice. Human trafficking resources Victims of human trafficking often suffer tremendous physical and psychological damage. Clinicians play an important role in identifying potential victims so they can obtain help. Here are some resources to learn more about human trafficking. • “Addressing human trafficking in the health care setting” is an online course that includes a…

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Comprehensive turning programs can avoid a pain in the back

Turning programs are essential to prevent and promote healing of pressure ulcers and to prevent the many negative effects of immobility, ranging from constipation to respiratory infections. However, turning a patient often puts a caregiver’s body in an awkward position, which can lead to musculoskeletal damage, especially back injuries. According to the U.S. Bureau of Labor Statistics, healthcare workers suffer…

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Exercise your right to be fit!

Nearly all clinicians know exercise is good for our physical and mental health. But incorporating it into our busy lives can be a challenge. The only types of exercise some clinicians have time for are working long shifts, juggling life’s demands, balancing the books, jumping on the bandwagon, climbing the ladder of success, and skipping meals. Clinicians are in a…

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FAQs about support surfaces

Support surfaces are consistently recommended for the prevention and treatment of pressure ulcers. So patients can derive optimal benefits from support surfaces, clinicians must understand how to use them effectively. This article answers several questions about these useful tools.

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How to apply silver nitrate

Topical application of silver nitrate is often used in wound care to help remove and debride hypergranulation tissue or calloused rolled edges in wounds or ulcerations. It’s also an effective agent to cauterize bleeding in wounds. Silver nitrate is a highly caustic material, so it must be used with caution to prevent damage to healthy tissues.

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No more skin tears

Imagine watching your skin tear, bleed, and turn purple. Imagine, too, the pain and disfigurement you’d feel. What if you had to live through this experience repeatedly? That’s what many elderly people go through, suffering with skin tears through no fault of their own. Some go on to develop complications. A skin tear is a traumatic wound caused by shear, friction, or blunt-force trauma that results in a partial-…

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Nutritional considerations in patients with pressure ulcers

Optimizing nutritional status is a key strategy both in preventing and managing pressure ulcers. In patients across all care settings, compromised nutrition— as from poor intake, undesired weight loss, and malnutrition—increases the risk of pressure ulcers. It contributes to altered immune function, impaired collagen synthesis, and decreased tensile strength. In many cases, malnutrition also contributes to wound chronicity and increases the risk for delayed and impaired wound healing. In patients with chronic…

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2016 Journal: March – April Vol. 5 No. 2

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Nutritional considerations in patients with pressure ulcers

Optimizing nutritional status is a key strategy both in preventing and managing pressure ulcers. In patients across all care settings, compromised nutrition— as from poor intake, undesired weight loss, and malnutrition—increases the risk of pressure ulcers. It contributes to altered immune function, impaired collagen synthesis, and decreased tensile strength. In many cases, malnutrition also contributes to wound chronicity and increases the risk for delayed and impaired wound healing. In patients with chronic wounds, such as pressure ulcers, a chronic inflammatory state can induce catabolic metabolism, malnutrition, and dehydration. (more…)

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Caution: Checklists may lead to inaccurate documentation

Using a checklist form to document wound care can make the task easier and faster—and help ensure that you’ve captured all pertinent data needed for assessment, reimbursement, and legal support. But the form itself may not be comprehensive; some important fields may be missing.

Recently, we at Wound Care Advisor received a question from a clinician who was having trouble deciding how to code a patient’s wound in her hospital’s electronic health record (EHR). Her patient’s specific wound and tissue types weren’t available options in the dropdown menu on the software system. Luckily, on investigating, we discovered her system provided the option to override the checklist and add comments in a notes section. (more…)

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Buzz Report: Latest trends, part 2

Keeping clinicians up-to-date on clinical knowledge is one of the main goals of the Wild on Wounds (WOW) conference held each September in Las Vegas. Every year, I present the opening session, called “The Buzz Report,” which focuses on the latest-breaking wound care news—what’s new, what’s now, and what’s coming up. I discuss new products, practice guidelines, resources, and tools from the last 12 months in skin, wound, and ostomy management.

In the January issue, I discussed some of the updates from my 2015 Buzz Report. Now I’d like to share a few more, along with some of my favorite resources. (more…)

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Pros and cons of hydrocolloid dressings for diabetic foot ulcers

Pros Cons Hydrocolloid Foot Ulcers

Diabetic foot ulcers stem from multiple factors, including peripheral neuropathy, high plantar pressures, decreased vascularity, and impaired wound healing. Contributing significantly to morbidity, they may cause limb loss and death. (See Foot ulcers and diabetes.)

Initially, hydrocolloid dressings were developed to function as part of the stomal flange. Based on their success in protecting peristomal skin, they were introduced gradually into other areas of wound care. They contain wafers of gel-forming polymers, such as gelatin, pectin, and cellulose agents, within a flexible water-resistant outer layer. The wafers absorb wound exudate, forming a gel and creating a moist healing environment. (more…)

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Clinician Resources: Ulcer Prevention, CAUTI, Negative Bacteria

Start the New Year off right by checking out these resources.

Pressure ulcer prevention education

Access the following education resources from Wounds International:

The webinar “Real-world solutions for pressure ulcer prevention: Optimising the role of support surfaces” includes:

• an overview of the issue of pressure ulcers

• what to consider when choosing a support surface

• how to operationalize support surfaces in the clinical setting. (more…)

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Product Dossier

biopad-box high res imageAngelini Pharma Inc.

BIOPAD: 100% equine Type-1 collagen primary wound dressing

EXSEPT PLUS: electrolytically-produced Sodium Hypochlorite wound cleanser

SILVERSTREAM: Ionic Silver wound cleanser with menthol

ANIOSGEL 85 NPC: HYDROALCOHOLIC ANTISEPTIC GEL for skin and hands BLEACH WIPES 1: 10/1:50 : ready-to-use bleach wipes for surfaces disinfection

Angelini Pharma Inc. has one of the highest quality and most comprehensive product ranges in the chronic wound, infection control and dialysis healthcare market. Our mission is to meet our customers’ day-to-day needs with effective, reliable and high-quality products that are widely available and accessible. This goal is expressed through a clear vision: to be the physician’s first choice of product for their patients’ needs and well being. As a result of our specialists’ expertise and intensive applied research activities, efficient and closely coordinated manufacturing and distribution chain and marketing experience, Angelini Pharma Inc. has achieved excellence in our core business areas including wound care.

For more information, visit Angelini-US.com for more information.

 

hytape-picHy-Tape International

Hy-Tape International produces waterproof, zinc oxide-based adhesive tape. Patches and strips. Hy-Tape delivers its unique qualities and benefits in both critical care and everyday situations, when it counts most.

For more information, call 1.800.248.0101 or visit http://hytape.com.

 

AmerX-bothAmerx Health Care, Inc.

Amerx Health Care is proud to introduce Helix3 Bioactive Collagen Matrix (CM) and Particle (CP) dressings containing 100% Type 1 native bovine collagen for effective wound management in all wound phases.

The Amerx product line also includes top rated AmeriGel Hydrogel Wound Dressing with Oakin® for sustained moist healing of dry wounds.

For more information, visit www.amerxHC.com or call 800-448-9599.

 

CP logoColoplast

Coloplast develops products and services that make life easier for people with very personal and private medical conditions. Our business includes ostomy care, urology, continence care, and wound & skin care.

For more information, visit www.coloplast.us or call 800-788-0293

 

GlideUltra_72pxDM Systems Inc.

Combining unmatched clinical evidence with the comfort, convenience and variety that today’s healthcare marketplace demands, Heelift offloading boots prevent and treat heel pressure ulcers like no other. Joining the Heelift lineup this year is the new Heelift Glide Ultra and Heelift AFO Ultra, which have a new Ultra-Grip inner lining that provides our most comfortable boot ever while maintaining clinical superiority. Clinician Validated – Cost Performer.

Visit our Resource Center at http://www.heelift.com/heeliftresources.html for videos, sample protocols, clinical articles and more showing how Heelift Boots can lower your prevalence.

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2015 Journal: July – Aug Vol. 4 No. 4

Wound Care Advisor Journal 2015 vol4 No4

Preventing pressure ulcers in pediatric patients

As wound care clinicians, we are trained—and expected—to help heal wounds in patients of any age and to achieve positive outcomes. Basic wound-healing principles apply to all patients, whatever their age or size. The specific anatomy and physiology of vulnerable pediatric patients, however, requires detailed wound care. Unfortunately, little evidence-based research exists to support and direct the care of pediatric patients with pressure ulcers. This article describes efforts to reduce pressure ulcers in pediatric patients at Driscoll Children’s Hospital (DCH) in Corpus Christi, Texas.

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

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.

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deep tissue injury

Case study: Early detection and treatment resolves a deep tissue injury

By Todd Zortman, RN, WCC, and James Malec, PhD Pressure ulcers are a chronic healthcare burden for both patients and pro­viders. Over 2.5 million patients in the United States are affected annually by pressure ulcers, with nearly 60,000 of those cases directly resulting in death. From a provider’s perspective, the cost of individual care ranges anywhere from $500 to $70,000…

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short stay facility

Case study: Working under a time crunch in a short-stay facility

By Janet Wolfson, PT, CWS, CLT-LANA After landing my dream job as the wound care coordinator at an inpatient rehabilitation facility (IRF), I found myself trying to determine how much healing could be achieved for our more challenging patients, given the constraints of reimbursement and what can be done in the typical 10 to 14 days of a patient stay.…

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Amputation Risk Score

Clinical Notes: Revascularization, Amputation Risk Score

Leg revascularization fails to improve outcomes in nursing home patients Lower-extremity revascularization often fails to improve outcomes in nursing home patients, according to an article in JAMA Internal Medicine. “Functional outcomes after lower extremity revascularization in nursing home residents: A national cohort study” found that few patients are alive and ambulatory a year after surgery, and those who are alive…

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Clinician Resources: Nutrition, Treatment Algorithms, Pressure Ulcer Prevention

Check out these resources for your practice. Be a nutrition champion One in three patients enters a hospital malnourished. Fight malnutrition by viewing six short videos from the Alliance to Advance Patient Nutrition, including “Rapidly Implement Nutrition Interventions” and “Recognize and Diagnose All Patients at Risk of Malnutrition.” The videos show how to collaborate with the care team to become…

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Comprehensive skin assessment

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. Here’s an overview of performing a comprehensive skin assessment. In the healthcare setting, a comprehensive skin assessment is a process in which the entire skin of a patient is examined for abnormalities. It requires looking…

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From the Editor: Tips on staging pressure ulcers

By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Pressure ulcers have been a health concern for a long time—since at least 5,000 years ago, when evidence of a pressure ulcer was found on an ancient Egyptian mummy. But not until 1975 did the staging classification system we’re familiar with begin. This system was designed to make things easier by…

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Immobility as the root cause of pressure ulcers

By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN Many factors can contribute to the formation of a pressure ulcer, but it’s rare that one develops in an active, mobile patient. As the National Pressure Ulcer Advisory Panel 2014 guidelines state, “Pressure ulcers cannot form without loading, or pressure on the tissue. Extended periods of lying or sitting on a particular…

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Motivational interviewing: A collaborative path to change

By Sharon Morrison, MAT, RN Michael had diabetes and a history of elevated blood glucose levels. A long-time drinker, he seemed to have no interest in giving up the habit. I met him while working as a diabetes nurse educator for the Boston Health Care for the Homeless Program, traveling from shelter to shelter to help persons with diabetes set…

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Preventing pressure ulcers in pediatric patients

By Roxana Reyna, BSN, RNC-NIC, WCC, CWOCN As wound care clinicians, we are trained—and expected—to help heal wounds in patients of any age and to achieve positive outcomes. Basic wound-healing principles apply to all patients, whatever their age or size. The specific anatomy and physiology of vulnerable pediatric patients, however, requires detailed wound care. Unfortunately, little evidence-based research exists to…

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2015 Journal: July – Aug Vol. 4 No. 4

Click here to access the digital edition

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Role of rehab in wound care

 By Bill Richlen, PT, WCC, DWC, and Denise Richlen, PT, WCC, DCCT

How many times have you heard someone say, “I didn’t know PTs did wound care”? Statements like this aren’t uncommon. The role of physical therapists (PTs), occupational therapists, and speech therapists in wound care is commonly misunderstood by and even a mystery to many clinicians. Sometimes the therapists themselves are confused about reimbursement or what their role on the wound care team can be. (more…)

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What exactly are “the rules”?

By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Editor-in-Chief

During a recent wound care presentation, an audience member jumped up to contradict the speaker. “That is incorrect,” she asserted. “The rules state….” When someone asked her what rules she was referring to, she replied, “The government’s rules.”

On the surface, that might seem like a straightforward answer. But when you stop to think about it, what government did she mean? Federal? State? Local? (more…)

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