Quizzes

Wound InfectionsHyperbaric Oxygen TherapyAssess Diabetic FootRam's Horn
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Think a Patient Has Rights? They Left.

Patient Rights

by Dr. Michael Miller

There are few absolutes in my universe. I know that my youngest daughter will gleefully and with full malice (but humorously presented) find something to torment me about every time I see her; referrals from family practice docs arrive well marinated in multiple antibiotics with nary a diagnosis in sight (save for the ubiquitous “infection”); and that regardless of what I recommend, offer, beg, plead, or cajole, that the patient has the complete and total power to make their decisions regarding their care and who provides it. Unless they are deemed by multiple authorities to be incapable of making a decision, until the appropriate paperwork or an emergency situation exists mandating immediate lifesaving action, the ball bounces squarely in their court…or so I thought. (more…)

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If All You Have is a Hammer, What Happens When You Run Out of Nails?

hammer

by Dr. Michael Miller

Over the years of making house calls for wound care, I found that there was a real need for home based mental health and behavioral care, palliative care, podiatry and lots of other things. We cater to those who are home bound based on the classic definition involving the word “Taxing”. One of the more prevalent problems affecting all patients involves the nebulous but ubiquitous, nerve jangling, aptly named, “5th Vital Sign”, namely pain. As a part of my medical group, we have created a program that provides pain management not just to the home bound but all those whose lives and lifestyles are affected adversely by it. The program is a monument to government bureaucracy involving multiple layers of paperwork, mental health evaluations, testing of bodily fluids for both illegal and legal substances and then, the actual evaluation of the patient commences. After all hurdles are vetted and then jumped, then and only then does a prescription for the appropriate nostrum leave the pad. In wound care, we treat based on the etiology, the location, the related factors, the amounts of drainage, the surrounding tissues and so on, ad nauseum. Not surprisingly, in pain management, the scenario is much different. In wound care the mantra of the dabbler is see the hole, fill the hole. In pain management, the goal is to minimize pain to maximize functionality but the overriding questions are how this is accomplished. (more…)

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eBooks

Creating an Ideal Microenvironment for Wound Cleansing

[Sponsored by Angelini Pharma, Inc.]

With so much focus on dressing choices, it’s easy to forget the importance of wound cleansing. Wound cleansing can help achieve the goals of wound bed preparation by removing microorganisms, biological and environmental debris to create an environment beneficial to healing as well as facilitating wound assessment by allowing clear visualization of the wound.

Preventing Infections in Patients with Wounds eBook

[Sponsored by Angelini Pharma, Inc.]

Proper wound care is essential to preventing infections for patients in all practice settings, and healthcare providers should stay informed about the most current and effective treatments out there.

Recognizing factors that increase patients’ susceptibility to infection allows providers to identify risks and take measures to prevent infection from occurring or worsening.

eBook: Treatment of Hard-to-Heal Wounds with Collagen-Based Dressings

[Sponsored by Angelini Pharma, Inc.]

Receive a free BioPad Sample and a free eBook with more details.

BioPad Wound Dressing with Collagen: BioPad, is a 100% equine Type-1 collagen primary wound dressing used to treat hard to heal wounds.

The BioPad collagen dressing has the highest collagen content on the market up to 5 times the amount of collagen. 

BioPad™ is the perfect dressing for wounds.

eBook: Caring for Wounds eBook Series: Pressure Injuries

[Sponsored by Angelini Pharma, Inc.]

Learn how your healthcare team can provide better patient care.

Patient care teams rely on the wound care nurse alone to implement a pressure ulcer prevention program; however, a successful program requires involvement from the entire care team and is a 24/7 endeavor.

eBook: Skin Damage Associated with Moisture and Pressure

[Sponsored by Convatec]

Tips on how to differentiate and goals for protection and management.

* Identify how wounds are classified according to wound depth and etiology.
* Describe the etiology of a pressure injury (PI) and incontinence-associated skin damage (IAD).
* Discuss evidence-based protocols of care of prevention and management if IAD and PIs.
* Describe the NPUAP-EPUAP Pressure Injury Classification System.
* Identify appropriate products that can be used for preventioin and treatment of IAD and PIs.

eBook: Needlestick Risks: Defense and Rescue Strategies for Nurses

[This e-book has been developed through an educational grant from CM&F Group]

Learn more about: 
A Continuing Risk for Healthcare Workers, Sharps Injuries: Facts and Figures, Proactive Steps for Yourself and Your Colleagues, A Preventable Injury, A Downloadable Workbook from the CDC, The Case for Coverage, If You are Exposed.

Needlesticks and other sharps-related exposures to bloodborne pathogens (including HIV, hepatitis B virus, and hepatitis C virus) continue to pose a significant occupational risk for healthcare workers

 

Safe Biopsies eBook: Protect yourself and your patients.

[This e-book is brought to you by BiopSafe]

Safe biopsy handling
One of the most common problems in connection with biopsy handling is the risk of being exposed to formalin either through touch or inhalation. A risk that doctors, veterinarians, laboratory technicians and nurses are exposed to every day.

With BiopSafe the problem is finally solved.

receive a free BiopSafe Sample and a free eBook PDF with more information and details.

 
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Wound care treatment explained at Rotary

Wound Care Solutions at Community Hospitals and Wellness Centers-Bryan

When treating people for wounds, the care team preforms both a comprehensive diagnosis and comprehensive treatment, Kathy Khandaker, director of wound care at Community Hospitals and Wellness Centers-Bryan, told the Bryan Rotary Club at its Friday meeting.

The wound care clinic opened at CHWC in 2006, added ostomy care in 2007, continence care in 2010 and added a full-time physician in 2015. The care team includes a wound care nurse, a hyperbaric oxygen therapy technician and a receptionist in addition to the physician. (more…)

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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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Stem Cell Dynamic Therapy Could Heal Wounds

It’s necessary for the skin to heal the wounds after getting injured. For the first time, scientists discovered that the changing stem cell dynamics contribute to wound healing. The main purpose of these studies was to understand how stem cells differentiate, migrate, and proliferate to repair the tissue damage after trauma.

A team from Université libre de Bruxelles (ULB) started their research on stem cells. Professor of ULB, Dr. Cédric Blanpain MD/Ph.D, WELBIO investigator and the lead researcher of this study, defined the cellular and molecular mechanisms that play active roles in wound healing. The research report was first published in the Journal of Nature Communications.

The skin of a creature is just like an outer shield which protects the inner tissues and other organs from outer injuries. If somehow the outer shield gets disrupted then body activates a cascade of cellular and molecular event to repair the damage and restore skin integrity. ScienceDaily reported that minor defects in these events lead to improper repair causing acute and chronic wound disorders.

In the new study, scientists revealed that distinct stem cells populations contribute in healing the wound. Although it is not cleared yet how proliferation, differentiation, and migration get balanced by stem cell populations during the healing process. Co-author of this study Dr.Sophie Dekoninck said in a statement,“The molecular characterization of the migrating leading edge suggests that these cells are protecting the stem cells from the infection and mechanical stress allowing a harmonious healing process”.

Read more at The Science Times

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One Doctor Exploring Wound Care on Earth and in Space

In laboratories all across the globe, scientists are uncovering new and exciting breakthroughs in the realm of wound healing.

For instance, a team out of Texas is blinding bacteria to prevent their spread. Meanwhile, a collective of doctors from the U.K. recently developed some intriguing new vacuum tech to treat chronic ulcers. There’s even been research into drug treatments, like how opioids may actually prevent proper wound care.

Each team has taken a different approach or tackled a unique situation or medical ailment, and that ensures a more well-rounded coverage that helps a larger pool of patients. However, few scientists have a more grand scope than Ronke Olabisi, a professor of biomedical engineering at Rutgers University.

Reaching for the stars

As the university explained in a recent press release, Olabisi is hard at work on several projects aimed at improving wound healing both on earth and during manned space missions. During space travel, especially as astronauts spend months at a time in stations, the lack of gravity has a huge impact on the human body. Muscle and bones will actually start to deteriorate, and tissues will lose much of their elasticity. Olabisi’s main goal is to study in-depth why this occurs and how to fix, and she believes she can apply much of the same knowledge to wound care on Earth.

Read more at Advanced Tissue

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Skin 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…)

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Frequently asked questions about support surfaces

The National Pressure Ulcer Advisory Panel (NPUAP) describes support surfaces as “specialized devices for pressure redistribution designed for management of tissue loads, microclimate, and/or other therapeutic functions.” These devices include specialized mattresses, mattress overlays, chair cushions, and pads used on transport stretchers, operating room (OR) tables, examination or procedure tables, and gurneys. Some support surfaces are part of an integrated bed system, which combines the bed frame and support surface into a single unit. (more…)

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Herpes zoster: Understanding the disease, its treatment, and prevention

Herpes zoster: Understanding the disease, its treatment, and prevention

Herpes zoster (HZ, also called shingles) is a painful condition that produces a maculopapular and vesicular rash. Usually, the rash appears along a single dermatome (band) around one side of the body or face.

In most cases, pain, tingling, burning, or itching occurs a few days before the rash. Next, blisters form, scabbing over in 7 to 10 days. In rare cases, the rash is widespread, resembling varicella zoster (VZ, or chickenpox) rash. Pain can range from mild to severe and may be dull, burning, or gnawing. It may last weeks, months, or even years after the blisters heal. Shingles on the face may impair vision or hearing. (more…)

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