Negative pressure wound therapy (NPWT) uses negative pressure to draw wound edges together, remove edema and infectious material, and promote perfusion and granulation tissue development. The tissue stretch and compression created by negative pressure during NPWT promotes tissue perfusion and granulation tissue development through angiogenesis, cellular proliferation, fibroblast migration, increased production of wound healing proteins, and reduction of wound area. NPWT has been used to improve healing in a variety of wounds, including traumatic injuries, surgical wounds, pressure ulcers, diabetic foot ulcers, and venous stasis ulcers. (more…)
A study in Ostomy Wound Management states the risk classification of patients using Braden Scale scores should comprise three (rather than five) levels: high risk, with a total score ≤11; moderate risk, with a total score of 12 to 16; and mild risk, with a total score ≥17.
The retrospective analysis of consecutively admitted patients at risk for pressure ulcer to an acute-care facility included 2,625 patients, with an age range from 1 month to 98 years; 3.1% developed a pressure ulcer. (more…)
Are you using the wrong kind of medical tape on your patients? Although we strive to provide the safest care possible, some nurses may not realize that medical tape used to secure tubes and dressings can cause harm. The harm may stem from using the wrong product or using a product incorrectly, which can cause adhesive failure or skin injury. (more…)
Patients in your clinical practice who develop wounds should prompt a call for “all hands on deck” to manage the situation, but some personnel may be missing the boat. Physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs) should be on board your wound care ship so patients can receive care they need. But unfortunately, sometimes they aren’t. (more…)
A declining pressure ulcer decreases the quality of life for patients and places providers at risk for regulatory citations and litigation. But it’s important for clinicians to determine whether the first appearance of skin injury is truly a stage I or II pressure ulcer or if it’s a deep tissue injury (DTI), a unique staging category for a pressure ulcer. Otherwise, a clinician might think a pressure ulcer is getting worse instead of the change being the normal progression of a pressure ulcer that is presenting as a DTI.
By: Donna Sardina, RN, MHA, WCC, CWCMS What do the Los Angeles Lakers, Green Bay Packers, Montreal Canadiens, and New York Yankees have in common? All three have “three-peated”, meaning they have won three consecutive championships. This year, we at Wound Care Advisor, the official journal of the National Alliance of Wound Care and Ostomy (NAWCO), mark our own three-peat—our…
Mild compression diabetic socks safe and effective for lower extremity edema Diabetic socks with mild compression can reduce lower extremity edema in patients with diabetes without adversely affecting arterial circulation, according to a randomized control trial presented at the American Diabetes Association 75th Scientific Sessions Conference.
The resources below will help you address issues in your practice. NPUAP position statement on hand check for bottoming out Use of the hand check to determine “bottoming out” of support systems should be limited to static air overlay mattresses, according to a position statement from the National Pressure Ulcer Advisory Panel (NPUAP).
By Jennifer Oakley, BS, RN, WCC, DWC, OMS It’s time again for annual staff education, and you, the certified wound clinician, need to teach the staff at your organization. You dream of staff entering a state-of-the-art classroom with computers at each station, mannequins, wound anatomy models, and enough products for each student to do hands-on demonstrations. But when you open…
By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN A declining pressure ulcer decreases the quality of life for patients and places providers at risk for regulatory citations and litigation. But it’s important for clinicians to determine whether the first appearance of skin injury is truly a stage I or II pressure ulcer or if it’s a deep tissue injury (DTI),…
By Cindy Barefield, BSN, RN-BC, CWOCN Like many hospitals, Houston Methodist San Jacinto Hospital uses national benchmarks such as the National Database of Nursing Quality Indicators (NDNQI®) to measure quality outcomes. Based on benchmark reports that showed an increased trend of pressure ulcers in critically ill patients in our hospital, the clinical nurses in our Critical Care Shared Governance Unit-Based…
By Beth Hoffmire Heideman, MSN, RN No one wants an ostomy, but sometimes it’s required to save a patient’s life. As ostomy specialists, our role is to assess and intervene for patients with a stoma or an ostomy to enhance their quality of life. We play an active role in helping patients perform self-care for their ostomy and adjust to…
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. Exudate (drainage), a liquid produced by the body in response to tissue damage, is present in wounds as they heal. It consists of fluid that has leaked out of blood vessels and closely resembles blood…
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. Medical gauze, a bleached white cloth or fabric used in bandages, dressings, and surgical sponges, is the most widely used wound care dressing. Commonly known as “4×4s,” gauze is made from fibers of cotton, rayon,…
By Gail Rogers Hebert, MS, RN, CWCN, WCC, DWC, OMS, LNHA The World Health Organization defines palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other…
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…
Mild compression diabetic socks safe and effective for lower extremity edema
Diabetic socks with mild compression can reduce lower extremity edema in patients with diabetes without adversely affecting arterial circulation, according to a randomized control trial presented at the American Diabetes Association 75th Scientific Sessions Conference. (more…)
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…)
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 at and touching the skin from head to toe, with a particular emphasis on bony prominences and skin folds. Comprehensive skin assessment is repeated on a regular basis to determine whether changes in the skin’s condition have occurred. The goal of a skin assessment is to identify problem areas promptly for treatment and prevention. (more…)
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.
Here’s an example of how I worked with our team to help one of these challenging patients. (more…)
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…)
Research has shown that exercise can help ease symptoms in patients with arterial insufficiency, venous insufficiency, neuropathic disease, or a combination of these conditions. Here’s what you need to know to ensure your patients reap the most benefits from exercise. (more…)
Have you seen legs like those shown in the images below in your practice? These images show lymphedema and venous stasis ulcers, illustrating the importance of collaboration between clinicians in two disciplines: lymphedema and wound care. (more…)
