LTC Stephen Rush joined the New York Air National Guard as a pararescue flight surgeon with the 103rd Rescue Squadron in 2007. His job was to train and sustain the medical readiness of PJs assigned to the 103rd. He became the medical director for all PJs in 2012. (more…)
Read MoreSearch Results for: surgical
Necrotizing Fasciitis: Pearls & Pitfalls
A 39-year-old woman presents to the ED with leg pain and fever. She initially noted redness and pain above her knee 2 weeks ago and was evaluated at an outside hospital. She completed a 10-day course of oral antibiotics for cellulitis. Over the last two days, she has had progressive leg swelling of her entire right thigh. The pain is now so severe that she is having difficulty walking. Her past medical history is negative for diabetes mellitus, chronic liver disease, or alcohol and IV drug use.
On exam, she is febrile to 102.7 F, heart rate is 96 bpm, and blood pressure is 112/65. She has a 12 cm area of faint erythema on her right thigh and tenderness to palpation of her entire right leg with diffuse edema. There is no ecchymosis or bullae formation. (more…)
Read MoreFish Skin for Human Wounds: Iceland’s Pioneering Treatment
The FDA-approved skin substitute reduces inflammation and transforms chronic wounds into acute injuries.
Six hours north of Reykjavik, along a narrow road tracing windswept fjords, is the Icelandic town of Isafjordur, home of 3,000 people and the midnight sun. On a blustery May afternoon, snow still fills the couloirs that loom over the docks, where the Pall Palsson, a 583-ton trawler, has just returned from a three-day trip. Below the rust-spotted deck, neat boxes are packed with freshly caught fish and ice. “If you take all the skins from that trawler,” says Fertram Sigurjonsson, the chairman and chief executive officer of Kerecis Ltd., gesturing over the catch, “we would be able to treat one in five wounds in the world.” (more…)
Read MoreMorrison Community Hospital offers specialized Wound Care
Wound care is a specialized form of treatment that focuses on helping patients recover from all types of wounds, both acute and chronic (ongoing). The most common types of wounds are those that result from acute injuries, surgical procedures, diabetes, and pressure or bed sores. Wounds can also result from radiation procedures that are part of a treatment plan for cancer, and they can be a result of vascular disorders. (more…)
Read MoreRevealing Advanced Wound Care Market Growth Factors
At a time when governments are under pressure to reduce healthcare costs, the global advanced wound care market is growing, driven by an aging population and rising incidences of chronic wounds.
Advanced wound care products are typically used to manage complex wounds, including burns, chronic wounds and complex trauma and surgical wounds. Chronic and complex wounds represent one of the predominant challenges to global healthcare systems because they are hard to heal and expensive to treat. (more…)
Read MoreManaging 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…)
Read MoreBetter Skin Grafts – take only one layer
Research shows that a skin-graft harvesting system aids chronic wound recovery and reduces care costs by accelerating the healing process.
More than six million cases of chronic wounds cost $20 billion each year in the United States. Diabetic ulcers, pressure sores, surgical site wounds, and traumatic injuries to high-risk patients account for most wounds that won’t heal. (more…)
Read MoreSkin substitutes: Understanding product differences
Skin substitutes (also called tissuebased products and dermal replacements) are a boon to chronic wound management when traditional therapies have failed. When selecting skin substitutes for their formularies, wound care professionals have many product options—and many decisions to make.
Repair of skin defects has been a pressing concern for centuries. As early as the 15th century BC, Egyptian physicians chronicled procedures and herbal treatments to heal wounds, including xenografts (skin from another species). The practice of applying allografts (human cadaver skin) to wounds was first documented in 1503. In 1871, autologous skin grafting (skin harvested from the the person with the wound) was tried. Next came epithelial- cell seeding, which involves scraping off the superficial epithelium of healthy skin and transplanting the cells onto the wound. (more…)
Read More2016 Journal: Best of the Best Vol. 5 No. 5
Case study: Peristomal pyoderma gangrenosum
As a wound care specialist, you have learned about many skin conditions, some so unusual and rare that you probably thought you would never observe them. I’ve been a nurse for 38 years, with the last 10 years in wound care, and that’s certainly what I thought. But I was wrong. Let me tell you about my challenging patient with…
Causes, prevention, and treatment of epibole
As full-thickness wounds heal, they begin to fill in from the bottom upward with granulation tissue. At the same time, wound edges contract and pull together, with movement of epithelial tissue toward the center of the wound (contraction). These epithelial cells, arising from either the wound margins or residual dermal epithelial appendages within the wound bed, begin to migrate in leapfrog or train fashion across the wound bed. Horizontal movement stops when…
Clinical Notes: Healing SCI Patients, antiseptics on mahout, diabetes
Electrical stimulation and pressure ulcer healing in SCI patients A systematic review of eight clinical trials of 517 patients with spinal cord injury (SCI) and at least one pressure ulcer indicates that electrical stimulation increases the healing rate of pressure ulcers. Wounds with electrodes overlaying the wound bed seem to have faster pressureulcer healing than wounds with electrodes placed on intact skin around the ulcer.
Clinician Resources: Pressure-Injuries, Ostomy, Lymphedema, Delirium
Here is a round-up of resources that you may find helpful in your practice. New illustrations for pressure-injury staging The National Pressure Ulcer Advisory Panel (NPUAP) has released new illustrations of pressure injury stages. You can download the illustrations, which include normal Caucasian and non-Caucasian skin illustrations for reference. There is no charge for the illustrations as long as they are being used for educational purposes, but donations to…
Cutaneous candidiasis
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 cutaneous candidiasis. Cutaneous candidiasis is an infection of the skin caused by the yeast Candida albicans or other Candida species. Here’s a snapshot of this condition.
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.
How to manage peristomal skin problems
For an ostomy pouching system to adhere properly, the skin around the stoma must be dry and intact. Otherwise, peristomal skin problems and skin breakdown around the stoma may occur. In fact, these problems are the most common complications of surgical stomas. They can worsen the patient’s pain and discomfort, diminish quality of life, delay rehabilitation, increase use of ostomy supplies, and raise healthcare costs. Peristomal skin problems also perpetuate a…
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…
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-…
Our gold medal issue: Best of the Best 2016
This issue marks the fourth anniversary of the “Best of the Best” issue of Wound Care Advisor, the official journal of the National Alliance of Wound Care and Ostomy. Fittingly, it comes during an Olympics year. Since 1904, the Olympics have awarded gold medals to athletes whose performance makes them the “best of the best.” This year, we’re proud to present our own “Best…
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…
Pros and cons of hydrocolloid dressings for diabetic 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…
Clinician Resources: Pressure-Injuries, Ostomy, Lymphedema, Delirium
Here is a round-up of resources that you may find helpful in your practice.
New illustrations for pressure-injury staging
The National Pressure Ulcer Advisory Panel (NPUAP) has released new illustrations of pressure injury stages. You can download the illustrations, which include normal Caucasian and non-Caucasian skin illustrations for reference.
There is no charge for the illustrations as long as they are being used for educational purposes, but donations to support the work of NPUAP are appreciated. (more…)
Read MorePreparing the wound bed: Basic strategies, novel methods
The goal of wound-bed preparation is to create a stable, well-vascularized environment that aids healing of chronic wounds. Without proper preparation, even the most expensive wound-care products and devices are unlikely to produce positive outcomes.
To best prepare the wound bed, you need to understand wound healing physiology and wound care basics, as well as how to evaluate the patient’s overall health and manage wounds that don’t respond to treatment. (See Normal wound healing.) (more…)
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Who can perform sharp wound debridement?
Nurses and therapists often wonder if their license permits them to perform sharp wound debridement. Scope of practice varies significantly from state to state, so it’s imperative to check your state for specific guidance, but we can address some of the challenges clinicians face in deciding whether they can perform this valuable service for patients.