Antibiotic resistance is a pressing public health threat not only in the United States, but worldwide. According to the World Health Organization (WHO), it is one of the major threats to human health.
Despite these concerns, antibiotics continue to be widely used—and overused. In long-term care, for instance, antibiotics are the most frequently prescribed medications, with as many as 70% of residents receiving one or more courses per year. And antibiotics are consistently ordered for suspected pressure ulcer infections.
Here is what clinicians who care for patients with wounds can do to help reduce antibiotic resistance. (more…)
Using maggots to treat wounds dates back to 1931 in this country. Until the advent of antibiotics in the 1940s, maggots were used routinely. In the 1980s, interest in them revived due to the increasing emergence of antibiotic-resistant bacteria.
At Select Specialty Hospital Houston in Texas, we recently decided to try maggot therapy for a patient with a particularly difficult wound. In this case study, we share our experience. (more…)
Which statement about hyperglycemia and mortality in patients receiving nutritional support is correct?
a. Compared to parenteral nutrition (PN), general nutrition (EN) increases hyperglycemia risk nearly twofold.
b. Compared to EN, PN increases hyperglycemia risk nearly twofold.
c. Patients whose blood glucose (BG) level stays above 220 mg/dL during PN therapy have an increased risk of death.
d. Patients whose blood glucose (BG) level stays above 220 mg/dL during PN therapy have a decreased risk of death.
Correct answer: b. Experts estimate that up to 30% of patients receiving EN and more than 50% of those receiving PN develop hyperglycemia, defined as a BG level above 200 mg/ dL. Compared to EN, PN increases hyperglycemia risk nearly twofold, even when caloric intake is similar. One study found inadequate glucose control both before and during nutrition therapy predicted a higher mortality risk.
Assessment and care planning for wound healing should include a thorough review of the individual’s current medications to identify those that may affect healing outcomes. Clinicians must then weigh the risks and benefits of continuing or discontinuing the medications. In some cases, the risk of discontinuing the medication outweighs the importance of wound healing, so the goal of the care plan should be adjusted to “maintain a wound” instead of “healing.” (more…)
A fundamental rule of wound care is to treat the “whole” patient, not just the “hole” in the patient. To do this, we need to focus on a holistic
approach to healing, which means evaluating everything that’s going on with the patient—from nutrition, underlying diseases, and medications to activity level, social interactions, and even sleep patterns.
We know that as specialists, we’re expected to do all of these things. But in the real world, we can’t be specialists in all areas. That’s where the team concept comes in. In fact, the team approach is imperative for helping us heal our patients’ wounds and achieve our overall goal of improving patient outcomes. (more…)
The authors of the article explain evidence-based practice and provide useful definitions for key terms. They then provide a list of eight questions to use when evaluating SRs and practical tips such as how to search for SR and MA studies. The article finishes with a list of eight interventions supported by the most evidence: hydrocolloidal dressings, honey, biosynthetic dressings, iodine complexes, silver compounds, hydrogels, foam dressings, and negative pressure wound therapy. (more…)
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. (more…)
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…)
Abstract: Background. The evaluation and treatment of heel pressure injuries are a significant and expensive sequela of the aging population. Although the workup of patients with lower extremity tissue loss usually involves an assessment of the arter…
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.…
BY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
What exactly is wound exudate? Also known as drainage, exudate is a liquid produced by the body in response to tissue damage. We want our patients’ wounds to be moist, but not overly moist. The t…
Summary
This project is an observational trial investigating wound cosmetic appearance after repair of traumatic skin lacerations in the head area of pediatric patients with two different approaches to skin closure: sutures versus tissue adhesive. P…
Safety and Efficacy Study of VM202 in the Treatment of Chronic Non-Healing Foot Ulcers. This study will assess the safety and efficacy of using gene therapy via intramuscular injections of the calf for patients with chronic non-healing foot ulcers.
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Carol Emanuele beat cancer. But for the last two years, the Philadelphia woman has been fighting her toughest battle yet. She has an open wound on the bottom of her foot that leaves her unable to walk and prone to deadly infection.
In an effort to…
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 specia…
As a wound care expert, you’re probably consulted for every eruption, scrape, and opening in a patient’s skin. Occasionally during a patient assessment, you may scratch your head and ask yourself, “What is this? I’ve never seen anything like it.”
Mo…
It’s been a stressful day at work—nothing new. One confused patient pulled off her ostomy bag, you’re having difficulties applying negative-pressure wound therapy on another, and a third patient’s family is
angry with you. We all experience stressfu…
On April 13, 2016, the National Pressure Ulcer Advisory Panel (NPUAP) announced changes in pressure ulcer terminology and staging definitions. Providers can adapt NPUAP’s changes for their clinical practice and documentation, but it’s important to no…
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, polyester, or a combination of these fibers. Surgical gauze must meet standards of purity, thread count, construction, and sterility according to the United States Pharmacopeia. (more…)
According to a study published in Diabetes Care, the economic burden associated with diagnosed diabetes (all ages) and undiagnosed diabetes, gestational diabetes, and prediabetes (adults) exceeded $322 billion in 2012, amounting to an economic burden exceeding $1,000 for each American. (more…)
As I write this, I am still feeling the energy from the 11th annual Wild on Wounds Conference. What a great group of wound care clinicians. With close to 1,000 attendees, the conference was fun, friendly, and jam-packed with sessions for all levels of clinicians, from beginners to advanced. Many of the attendees shared their frustrations in choosing one session over another with comments such as, “It was so difficult because of all of the great educational offerings.”
Once again, the National Alliance of Wound Care and Ostomy (NAWCO) had an answer table set up in the registration area. We enjoyed the many inquiries we received, and it was nice to put faces with names.
Each year, NAWCO gives four awards to deserving clinicians who put their hearts and souls into their work. We have so many talented and committed certified wound care clinicians that it seemed only fitting to recognize these talented people and give them the opportunity to shine. These individuals are nominated by their colleagues, coworkers, peers, and subordinates, and we had an abundance of nominations. While we would have loved to recognize all of the nominees, the committee could choose only four.
During the closing session, appropriately titled “Pay it Forward,” NAWCO recognized these four exceptionally talented, committed, hard-working clinicians for their achievements in their work with wound care patients. I wanted to share some of the impressive comments made about the award winners.
Outstanding Work in Diabetic Wounds:
Anna Ruelle, DPM, WCC
• “Voted ‘top doctor’ 11+ years in a row by peers”
• “Greatly reduced the incidence of below-the-knee amputations and loss of limb”
• “Never lets the sun set on a diabetic ulcer or wound when a patient calls.”
Outstanding Research in Wound Care:
Michael Katzman, RN, BSN, ONC, WCC
• “Known for his expertise in wound care and for being very approachable, professional, and a mentor to others”
• “Works collaboratively with other hospital skin champions to develop a protocol to prevent and treat skin tears through evidence-based research”
• “Offers regular in-services while collaborating with others to continuously improve outcomes.”
Outstanding WCC of the Year:
Chelsey Hawthorne, RN-BC, BSN, WCC
• “Serves as one of the certified nurses in a long-term care facility, and is a resource for the medical-surgical and other skilled units”
• “Works with the Magnet® Program supervisor to assist in getting more nurses certified through NAWCO”
• “Collaborates with the health system’s wound care clinic to ensure proper delivery of care to the residents.”
2014 Scholarship sponsored by Joerns® RecoverCare:
Craig Johnson, RN, BSN
• “Serves as staff nurse at a busy skilled nursing facility with a diverse and complex veteran population”
• “Demonstrates an overwhelming and sincere interest in wound care”
• “Designed and developed a mobile Wound Cart, which is used as a tool in the unit’s Wound Rounds Process.”
NAWCO is proud and honored to recognize the achievements of such a dedicated group of wound care clinicians. All of us at NAWCO congratulate the 2014 award winners.
Disclaimer: The views expressed in this article are those of the author and do not necessarily represent the views of, and should not be attributed to, Wound Care Advisor. All clinical recommendations are intended to assist with determining the appropriate wound therapy for the patient. Responsibility for final decisions and actions related to care of specific patients shall remain the obligation of the institution, its staff, and the patients’ attending physicians. Nothing in this information shall be deemed to constitute the providing of medical care or the diagnosis of any medical condition. Individuals should contact their healthcare providers for medical-related information.
