When should we take “No” for an answer?

By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS

Have you ever had a patient yell “Get out of my room!” or “Don’t touch me! I don’t want to be turned”? How about “No! Don’t put those compression stockings on my legs!” or “No, I’m not going to wear those ugly orthopedic shoes!” or “No way. I can’t stay in bed. I have to go to Bingo!”?

As clinicians, our first instinct usually is paternalistic, as if we’re the patient’s parent who knows what’s best for our child. We think, “Sorry, but you have to do this. It’s for your own good.” And we convey that idea to the patient. (more…)

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Using maggots in wound care: Part 2

Maggots Wound Care

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

Note From the Editor: This is the second of two articles on maggot therapy. The first article appeared in our July/August 2014 issue, Read part 1 here.

Whether your practice is an acute-care setting, a clinic, home care, or elsewhere, maggot debridement therapy (MDT) can prove to be a useful tool in wound care. But setting up any new program can meet resistance—and if you seek to establish a maggot therapy program, expect to meet significant resistance. By arming yourself in advance, you can achieve your goal more easily. This article covers all the bases to help you get your maggot therapy program off the ground. (more…)

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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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Best of the best, the sequel

By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS

Welcome to our second annual “Best of the Best” issue of Wound Care Advisor, the official journal of the National Alliance of Wound Care and Ostomy (NAWCO). This may be the first time you have held Wound Care Advisor in your hands because normally we come to you via the Internet. Using a digital format for this peer-reviewed journal allows us to bring you practical information that you can access anytime, anywhere and gives you the ability to access videos and other links to valuable resources for you and your 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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Device–related pressure ulcers: Avoidable or not?

device related pressure ulcer

By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS

A medical device–related pressure ulcer (MDRPU) is defined as a localized injury to the skin or underlying tissue resulting from sustained pressure caused by a medical device, such as a brace; splint; cast; respiratory mask or tubing; tracheostomy tube, collar, or strap; feeding tube; or a negative-pressure wound therapy device. The golden rule of pressure ulcer treatment is to identify the cause of pressure and remove it. Unfortunately, many of the medical devices are needed to sustain the patient’s life, so they can’t be removed. (more…)

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Clinical Notes: Aspirin, Skin Infections, NPWT surgical incisions

Aspirin inhibits wound healing

A study in the Journal of Experimental Medicine describes how aspirin inhibits wound healing and paves the way for the development of new drugs to promote healing.

The authors of “12-hydroxyheptadecatrienoic (12-HHT) acid promotes epidermal wound healing by accelerating keratinocyte migration via the BLT2 receptor” report that aspirin reduced 12-HHT production, which resulted in delayed wound closure in mice. However, a synthetic leukotriene B4 receptor 2 (BLT2) agonist increased the speed of wound closure in cultured cells and in diabetic mice. (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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Confronting conflict with higher-ups

By Pam Bowers, RN, and Liz Ferron, MSW, LICSW

Conflict in the workplace is a fact of life, and dealing with it is never easy. Sometimes it seems easier to ignore it and hope it will take care of itself. But in healthcare organizations, that’s not a good strategy. Unresolved conflict almost always leads to poor communications, avoidance behavior, and poor working relationships—which can easily affect patient safety and quality of care. (more…)

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You want to touch me where?

By Debra Clair, PhD, APRN, WOCN, WCC, DWC

Providing wound care requires a great deal of knowledge and skill. To become a wound care nurse entails taking classes, gaining and maintaining certifications, and acquiring on-the-job experience. But despite your education, knowledge, skills, and certifications, you may encounter problems when wound care requires you to touch the patient in a sensitive or embarrassing area. Touching the patient in these areas is called intimate touch. (more…)

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2014 Journal: July August Vol. 3 No. 4

Wound Care Advisor Journal 2014 vol3 no4

Using maggots in wound care: Part 1

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.

Knowledge of maggot biology and life history helps wound care practitioners optimize therapy and anticipate or prevent problems. Educating patients and colleagues about maggot therapy can reduce stress and simplify your life as a wound care professional, whether you’re a novice or an experienced maggot therapist.

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Clinical Notes: Aspirin, Skin Infections, NPWT surgical incisions

Aspirin inhibits wound healing A study in the Journal of Experimental Medicine describes how aspirin inhibits wound healing and paves the way for the development of new drugs to promote healing. The authors of “12-hydroxyheptadecatrienoic (12-HHT) acid promotes epidermal wound healing by accelerating keratinocyte migration via the BLT2 receptor” report that aspirin reduced 12-HHT production, which resulted in delayed wound…

Clinician Resources: Colorectal, ADA, Carbapenem-resistant

Be sure you’re familiar with these valuable resources for you and your patients. Colorectal cancer resources Fight Colorectal Cancer has a comprehensive resource library for patients, including: a link to “My Colon Cancer Coach,” which provides a personalized report to help guide patients in making treatment decisions archives of webinars (past topics include healthy changes that may reduce recurrence, highlights…

Confronting conflict with higher-ups

By Pam Bowers, RN, and Liz Ferron, MSW, LICSW Conflict in the workplace is a fact of life, and dealing with it is never easy. Sometimes it seems easier to ignore it and hope it will take care of itself. But in healthcare organizations, that’s not a good strategy. Unresolved conflict almost always leads to poor communications, avoidance behavior, and…

Creating an effective care plan

By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN The development of a care plan related to skin integrity can be challenging for any clinician. It takes a strong understanding of skin integrity risk factors and knowledge of how to modify, stabilize, and eliminate those risk factors. This article provides tips for the care-planning process.

Creating effective education programs on a shoestring budget

By Jennifer Oakley, BS, RN, WCC, DWC, OMS It’s time again for annual staff education, and you, the certified wound clinician, need to teach the staff at your organization. You dream of staff entering a state-of-the-art classroom with computers at each station, mannequins, wound anatomy models, and enough products for each student to do hands-on demonstrations. But when you open…

device related pressure ulcer

Device–related pressure ulcers: Avoidable or not?

By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS A medical device–related pressure ulcer (MDRPU) is defined as a localized injury to the skin or underlying tissue resulting from sustained pressure caused by a medical device, such as a brace; splint; cast; respiratory mask or tubing; tracheostomy tube, collar, or strap; feeding tube; or a negative-pressure wound therapy device. The golden rule…

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…

How to love and care for yourself unconditionally

By Yolanda G. Smith, MSN, RN, CCRN Are you able to relax, have fun, and enjoy the simple pleasures of life? Or do you: have trouble falling or staying asleep? smoke, drink, or eat to reduce tension? have headaches, back pain, or stomach problems? get irritated or upset over insignificant things? have too much to do and too little time…

maggots in wound care

Using maggots in wound care: Part 1

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…

transparent film dressings

What you need to know about 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.

You want to touch me where?

By Debra Clair, PhD, APRN, WOCN, WCC, DWC Providing wound care requires a great deal of knowledge and skill. To become a wound care nurse entails taking classes, gaining and maintaining certifications, and acquiring on-the-job experience. But despite your education, knowledge, skills, and certifications, you may encounter problems when wound care requires you to touch the patient in a sensitive or…

2014 Journal: July August Vol. 3 No. 4

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