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Assessment
Wound Photography – How it Benefits Clinical Documentation
Knowing when to ask for help
Lymphedema and lipedema: What every wound care clinician should know
Understanding NPUAP’s updates to pressure ulcer terminology and staging
Balancing the wheels of life
Assessing footwear in patients with diabetes
Clinical Notes: biofilm, bariatric surgery, statins and more
Tool Kits
Clinician Resources: OSHA, Education Program, Civil Workplace
Clinical Notes: Moldable Skin Barrier, hypoglycemia, diabetic food ulcers
No more skin tears
Caution: Checklists may lead to inaccurate documentation
Clinical Notes: ostomy, pressure ulcer, burn treatment
Pros and cons of hydrocolloid dressings for diabetic foot ulcers
Case study: Peristomal pyoderma gangrenosum
Medications and wound healing
Buzz Report: Latest trends, Part 1
Time to select a support surface
Prove the Value Program
Cutaneous candidiasis
Seeing healthcare from a new perspective
Providing skin care for bariatric patients
Is your therapy department on board with your wound care team?
A collaborative approach to wound care and lymphedema therapy: Part 2
Clinician Resources: Nutrition, Treatment Algorithms, Pressure Ulcer Prevention
Immobility as the root cause of pressure ulcers
Preventing pressure ulcers in pediatric patients
Comprehensive skin assessment
Clinical Notes: Revascularization, Amputation Risk Score
Helping patients overcome ostomy challenges
Providing evidence-based care for patients with lower-extremity cellulitis
Finding common ground: Surviving wound care communication
Palliative wound care: Part 2
What exactly are “the rules”?
More from The Buzz Report: A wound care clinician’s best friend
Clinician Resources: MRSA, Dosing Calculator, CDC Resources
Linear wound measurement basics
What you need to know about transparent film dressings
You want to touch me where?
Hidden complications: A case study in peripheral arterial disease
How to assess wound exudate
Quality-improvement initiative: Classifying and documenting surgical wounds
When and how to culture a chronic wound
What’s causing your patient’s lower-extremity redness?
Skin Care & Treatment
Long-Term Outcome of Pediatric Traumatic Wound Repair: Suture Versus Tissue Adhesive
Breaking silos: Effective wound healing means treatment across the continuum
NYU docs use machine learning
One Doctor Exploring Wound Care on Earth and in Space
Management of Patients With Venous Leg Ulcers
Reduction of 50% in Diabetic Foot Ulcers With Stem Cells
Better Skin Grafts – take only one layer
Skin substitutes: Understanding product differences
Frequently asked questions about support surfaces
Herpes zoster: Understanding the disease, its treatment, and prevention
Lymphedema and lipedema: What every wound care clinician should know
Clinician Resources
Instill instead: Negative pressure wound therapy with instillation for complex wounds
Doing it cheaply vs. doing what’s best for patients
Clinical Notes: biofilm, bariatric surgery, statins and more
Wise use of antibiotics in patients with wound infections
Causes, prevention, and treatment of epibole
Clinical Notes: Moldable Skin Barrier, hypoglycemia, diabetic food ulcers
Clinician Resources: human trafficking, npuap, caregiver, ostomy, HIV
How to apply silver nitrate
No more skin tears
Clinical Notes: ostomy, pressure ulcer, burn treatment
Buzz Report: Latest trends, Part 1
Don’t go it alone
Clincal Notes: Analysis, Osteomyelitis, sickle cell, maggot
Restorative nursing programs help prevent pressure ulcers
Clinician Resources: Ulcer Prevention, CAUTI, Negative Bacteria
Clinician Resources: NPUAP, Pressure Ulcer Treatment, NIOSH
Providing evidence-based care for patients with lower-extremity cellulitis
Ankle-brachial index: A dirty word?
Palliative wound care: Part 2
Using maggots in wound care: Part 2
Using maggots in wound care: Part 1
Clinician Resources: Patient Safety, Ostomy, Wound Management
Guidelines for safe negative-pressure wound therapy
Clinician Resources: Intl Ostomy Assoc., Substance Use Disorder
“This is how we’ve always done it” isn’t good enough
When and how to culture a chronic wound
How dietary protein intake promotes wound healing
From the Editor – Wound care superhero
Understanding stoma complications
Hyperbaric oxygen therapy for treatment of diabetic foot ulcers
Lymphedema 101 – Part 2: Treatment
Ask the treatment expert: Should treatment nurses be certified?
Discovery Promises Unique Medicine for Treatment of Chronic and Diabetic Wounds
Ostomy
Palliative care patients
BY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
The World Health Organization defines palliative care as care that affirms life and views death and dying as part of a normal process, intends neither to speed nor delay death, provides relief from pain and other distressing symptoms, and offers support to the patient and family. (more…)
Read MoreJim Nabors Would Just Cry
by Dr. Michael Miller
For those of you not as familiar with the Hoosier State as you should be, I used to think it was essentially paradise. Jim Nabors of Gomer Pyle fame is our ubiquitous, tuneful icon with his always well-received “Back Home in Indiana” as a mantra to that source of pride. Our former Governor “My Man” Mitch Daniels was a genius who, using a combination of intelligence, common sense and the persuasive powers of a midwest Svengali, created an economic model that our neighbors can only lust after. Our medicolegal climate is among the best in the US and well it should be. However, while there are some extraordinary caregivers and facilities here, a recent US News and World Report curiously showed that almost none of our hospitals made their “Best of” lists in any category. That is not to say there is bad care but to not have a single facility in an entire state even achieve an honorable mention gives one pause to reflect. The State newspapers were notoriously quiet on this concerning fact despite their trumpeting of who does what well, when and where. (more…)
Read MoreCondemning Patients to a Leap of Faith
by Dr. Michael Miller
I have several letters after my name. The two that say “DO” indicate that I have the training of a physician and the requisite education and responsibilities that uphold those letters. They should mean to patients that my ultimate goal is to offer (and provide when the fates allow) the entire spectrum of medical care referable to what I am good at and what they came to seek solace for. Nothing less and if I keep my ego in check, certainly nothing more. Patients run the gamut of their perception of the medical field. But like the old sales nemesis called “Bait and Switch”, what is offered on the sign all too often does not truly match what is seen on the shelves. Arrogant people are that way because they are good at what they do and not afraid to tell others. As a child, we are told to let others brag about us but failing to let people know what we can and can’t do is integral to our patients’ survival and our success. The problem is that the glitz and glamour of being a healer all too often clouds our success. Some time ago, I blogged about the pseudo-utilitarianism of all those so-called “Wound Certification” Exams. At first blush, these seem to be the key to health, wealth, omniscience and outcomes equaled only by those wound care management companies. (more…)
Read MoreDon’t Kid Yourself, Amputation Is Unquestionably A Failure
by Dr. Michael Miller
I recently saw an ad for a pending lecture at a national conference that piqued my interest much like “deflate-gate”. The title of this lecture horrifically touted that Amputation need not be considered failure. As a full time wound care doc, I work to identify those conditions that place patients at risk of all consequences both limited and catastrophic. We use the catchy title of “Limb Preservation”. We start the process by engaging in the unusual behavior of making definitive diagnoses, then systematically address them in as comprehensive manner as possible. I am proud to tell you that while there are occasions in which a terminally damaged digit is lost, that we have rarely sacrificed the greater part of a foot and more, have had only 3 lower extremity amputations in the last 5 years on patients who’s care remained exclusively with us. Of course, when a patient for whom we have created and implemented a “Limb Pres” care plan is taken out of our system (usually via a hospitalization for a reason other then the lower extremity problem), the facility forces that be unfortunately but infrequently demonstrate their inadequacy and paranoia by gang-harangueing the patient and family. They are lambasted with lurid tales of the condition marching up the leg engulfing the foot, knee, torso, and brains much like a flesh-eating PacMan. The patient’s confidence now neutered has little chance against this persistent onslaught of inadequacy and so, much like the Queen song, “Another One Bites The Dust”. (more…)
Read MoreHelp Me, Help Me, Help Me…next Tuesday
by Dr. Michael Miller
Health care providers are by nature an altruistic bunch. I have the honor of interviewing potential entries to my beloved profession as part of the admissions process at the newest Osteopathic Medical School in Indiana, Marian University. The process is unique in that it does not simply ask the age old questions of “Why you want to be a physician ?”, (“Because I want to do primary care in a rural area”). No, our probing involves scenarios in which they have to look at a social situation, identify their thoughts, those of the opposing views and then cohesively demonstrate intelligence, confidence, logical thought processes and humanity…all in an 8 minute period repeated 7 times. Their responses juxtaposed against what I see in my day to day always gives me pause to think about how the practice of medicine has been so perverted by the promotion of self abdication of responsibility. The “let your government do it for you” mantras and newest politically correct definitions of disabled (encompassing everything from melancholia to dislike of red M and M’s) have resulted in a major paradigm shift in medicine. Whereas, the hospitals once touted their ability to heal all manner of maladies, they now recognize their cost ineffectiveness, more detrimental than beneficial care (just check the nutritional parameters of anyone pre and post hospitalization) and the downright danger of going to one, unless you are a burgeoning superbug. (more…)
Read MoreAlternate universes – Einstein’s insanity
I remain absolutely amazed that there are so many people doing the same thing and yet doing it so completely different. Depending on where a patient’s wound care and orders originate from, the care I try to translate from that starting point is always a combination of dressing regimens worthy of computer code in their simplicity. The only thing usually missing is the diagnosis. It’s as though they come from an identical planet in an alternate universe.
The issue is that there is the complete dissociation of what is done for a given wound care problem in one practice setting versus another. Having stayed as far away from hospital-based wound care as possible, I continue to be amazed by hospital wound teams touting their expertise while using two to three times a day dressing changes and therapies that are the antithesis of any identifiable evidence. They actually expect entities receiving their cases (including home healthcare agencies, LTAC, skilled facilities, and others) to copy the identical care scenario regardless of their widely variable situations. In fact, the only constant is the patient and his or her condition. (more…)
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Wound care treatment explained at Rotary
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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