Case study: Bariatric patient with serious wounds and multiple complications

By Hedy Badolato, RD, CSR, CNSC; Denise Dacey, RD, CDE; Kim Stevens, BSN, RN, CCRN; Jen Fox, BSN, RN, CCRN; Connie Johnson, MSN, RN, WCC, LLE, OMS, DAPWCA; Hatim Youssef, DO, FCCP; and Scott Sinner, MD, FACP

Despite the healthcare team’s best efforts, not all hospitalizations go smoothly. This article describes the case of an obese patient who underwent bariatric surgery. After a 62-day hospital stay, during which a multidisciplinary team collaborated to deliver the best care possible, he died. Although the outcome certainly wasn’t what we wanted, we’d like to share his story to raise awareness of the challenges of caring for bariatric patients. (more…)

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Burn Wounds Protected by Plastic-wrap-like nanosheets

The nanosheets act like Saran Wrap for wounds.

Like cling wrap, new biomaterial can coat tricky burn wounds and block out infection.

Wrapping wound dressings around fingers and toes can be tricky, but for burn victims, guarding them against infection is critical. Today, scientists are reporting the development of novel, ultrathin coatings called nanosheets that can cling to the body’s most difficult-to-protect contours and keep bacteria at bay.

The researchers are speaking about their materials, which they’ve tested on mice, at the 248th National Meeting & Exposition of the American Chemical Society (ACS), the world’s largest scientific society.

The meeting features nearly 12,000 presentations on a wide range of science topics and is being held here through Thursday. (more…)

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Education vital for successful wound management in the home

By Judy Bearden, MSN/ED, RN

Changes in healthcare policy and reimbursement are pushing treatment from the hospital to the community. This shift is likely to result in a higher number of complex wounds being treated in the home, which can create stress for patients and families. Education plays a key role in reducing this stress. This article focuses on education for family members or friends who are caregivers for the patient. (more…)

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Using maggots in wound care: Part 1

maggots in wound care

By: Ronald A. Sherman, MD; Sharon Mendez, RN, CWS; and Catherine McMillan, BA

Maggot therapy is the controlled, therapeutic application of maggots to a wound. Simple to use, it provides rapid, precise, safe, and powerful debridement. Many wound care professionals don’t provide maggot therapy (also called wound myiasis) because they lack training. But having maggot therapy technology available for patients adds to your capabilities as a wound care provider. (more…)

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What you need to know about transparent film dressings

transparent film dressings

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.

Transparent film dressings are thin sheets of transparent polyurethane (polymer) coated with an adhesive. These dressings are available in a variety of sizes and shapes. (more…)

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Guidelines for safe negative-pressure wound therapy

safe negative-pressure wound therapy

By Ron Rock MSN, RN, ACNS-BC

Since its introduction almost 20 years ago, negative-pressure wound therapy (NPWT) has become a leading technology in the care and management of acute, chronic, dehisced, traumatic wounds; pressure ulcers; diabetic ulcers; orthopedic trauma; skin flaps; and grafts. NPWT applies controlled suction to a wound using a suction pump that delivers intermittent, continuous, or variable negative pressure evenly through a wound filler (foam or gauze). Drainage tubing adheres to an occlusive transparent dressing; drainage is removed through the tubing into a collection canister. NWPT increases local vascularity and oxygenation of the wound bed and reduces edema by removing wound fluid, exudate, and bacteria. (more…)

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Becoming a wound care diplomat

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

The Rolling Stones may have said it best when they sang, “You can’t always get what you want,” a sentiment that also applies to wound care. A common frustration among certified wound care clinicians is working with other clinicians who have limited current wound care education and knowledge. This situation worsens when these clinicians are making treatment recommendations or writing treatment orders not based on current wound-healing principles or standards of care. (more…)

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How to assess wound exudate

how to assess wound exudate

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 plasma. Exudate can result also from conditions that cause edema, such as inflammation, immobility, limb dependence, and venous and lymphatic insufficiency.
(more…)

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It takes a village: Leading a wound team

By Jennifer Oakley, BS, RN, WCC, DWC, OMS

I used to think I could do it alone. I took the wound care certification course, passed the certification exam, and took all of my new knowledge—and my new WCC credential—back to the long-term care facility where I worked. I was ready to change the world.

It didn’t take me long to figure out that I couldn’t change the complex world of wound care alone. I needed a team of specialists who could manage my patient’s troubles with nutrition, swallowing, activities of daily living, positioning, body image issues, and many other areas that required expertise I didn’t have. (more…)

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What you need to know about hydrogel dressings

hydrogel dressings

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.

Description

Hydrated polymer (hydrogel) dressings, originally developed in the 1950s, contain 90% water in a gel base, which helps regulate fluid exchange from the wound surface. Hydrogel dressing are usually clear or translucent and vary in viscosity or thickness. They’re available in three forms: (more…)

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Clinical Notes: Debridement, Optimal Wound Healing, Diabetes, Sacral Wounds

Frequent debridement improves wound healing

A study in JAMA Dermatology reports that fre­quent debridements speed wound healing.

“The more frequent the debridement, the better the healing outcome,” concludes “Frequency of debridements and time to heal: A retrospective cohort study of 312 744 wounds.” The median number of debridements was two.

Most of the wounds in the 154,644 patients were diabetic foot ulcers, venous leg ulcers, and pressure ulcers. The study authors note that debridement is a “key process” in wound bed preparation and starting the healing process.

The findings are congruent with previous studies and are based on an analysis of the largest wound data set to date. (more…)

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How to set up an effective wound care formulary and guideline

wound care formulary and guideline

By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN

Navigating through the thousands of wound care products can be overwhelming and confusing. I suspect that if you checked your supply rooms and treatment carts today, you would find stacks of unused products. You also would probably find that many products were past their expiration dates and that you have duplicate products in the same category, but with different brand names. Many clinicians order a product by brand name, not realizing that plenty of the product is already in stock under a different brand name. (more…)

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