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Practical Issues in Wound, Skin and Ostomy Management
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…)
Read Moreby Dr. Michael Miller
To paraphrase Carol Ann from the Movie Poltergeist…”He’s Baaaaaaaaack” ! At the end of this past May, I had a sudden and disappointing parting of the ways from my prior blog host when I discovered the newest version of the Golden Rule…those that have the gold, make the rules. Is it possible to be too opinionated? Does the textual asbestos statement at the bottom of almost every web page regarding the dissociation between the hosts and the writer’s opinions really have any meaning? I am nonetheless extremely grateful to my prior hosts for allowing me the bytes to educate, illuminate and aggravate. The silent majority, mostly practitioners and patients who appreciate the inside story versus those with the gold (who don’t mind independent thinking, as long as it comes in their flavor of Kool-Aid) have both spoken.
But as PT Barnum said “’There’s no such thing as bad publicity’ and so, recognizing that more and more people are looking for a shoulder to cry on, a voice of reason, and the company that misery loves, “Ramblings of an Itinerant Wound Care Guy” re-emerges with this blog. I want to assure you that I have always relished comments and criticism both of which are proudly posted along with the blog, as long as you agree with me.
But enough fanfare and bravado and back to the bastion of wound dabblers anonymous. My three-month involuntary hiatus did little to quench the fires of indignation regarding medicine in general and wound care in particular. I had the great honor recently of meeting one of the creators of the wound care protocols for a large wound management organization. My initial disdain at our handshake turned to admiration as he explained with great pride, how the guidelines were created for diagnosis and care at their facilities. His background in wound care was impressive and his passion for care was the purest. However, in keeping with the mantra that “No Good Deed Goes Unpunished”, he related how his master plan had become intellectual oatmeal as the docs and nurses reverted to prior, Neanderthal practices. One of the major flies in his ointment was the fact that at least one facility under management had a huge number of men over 70 in treatment including hyperbarics with 100% having the diagnosis of venous insufficiency. Not a single mention of an arterial or diabetic etiology. When he brought it to the medical directors attention, the response was simply that was what had been diagnosed. He has since gone on to what he hopes are greener pastures. As far as the pitiful remnants of the wound caregivers he left behind, we agreed that they all deserve to be patient in their own centers.
To my prior readers who once again have elected to join in on the cacophony of intolerance or a newbie who on the advice of a friend decided to see what that crazy guy is writing about this month, I offer you my thanks and a promise to ignore the golden rule whenever and wherever I can. And by the way…the opinions of the statements made in this blog do not reflect those of the web site, the publisher or the editors…Got it.
Until we ramble next time.
Click here to return to Dr. Miller’s Ramblings of an Itinerant Wound Care Guy Blog page.
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.
Read MoreBy 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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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…)
Read MoreBy 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. (more…)
Read MoreBy Yolanda G. Smith, MSN, RN, CCRN
Are you able to relax, have fun, and enjoy the simple pleasures of life? Or do you:
Be sure you’re familiar with these valuable resources for you and your patients.
Fight Colorectal Cancer has a comprehensive resource library for patients, including:
According to the National Pressure Ulcer Advisory Panel (NPUAP), incidence density is the best quality measure of pressure-ulcer prevention programs. Pressure-ulcer incidence density is calculated by dividing the number of inpatients who develop a new pressure ulcer by 1,000 patient days. Using the larger denominator of patient days allows fair comparisons between institutions of all sizes. (more…)
Read MoreBy: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS
Years ago, when I first started out in the wound care specialty, the only way to learn about new products and what was going on in the field was to “go to conference” (wound care conference). All year long, planning and excitement continued to build for our big trip. Not going wasn’t an option; our facility, patients, and administrators needed us to attend. If we didn’t, we’d be way behind our competition in regard to cutting-edge, hot-off-the-press wound care treatments and techniques.
Besides being a forum for displaying new wound care products, conference is an opportunity to network, to see what others are doing—what’s working and what isn’t— and to hear firsthand from researchers. (more…)
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By Joanne Aspiras Jovero, BSEd, BSN, RN; Hussam Al-Nusair, MSc Critical Care, ANP, RN; and Marilou Manarang, BSN, RN
A common problem in long-term care facilities, pressure ulcers are linked to prolonged hospitalization, pain, social isolation, sepsis, and death. This article explains how a Middle East rehabilitation facility battles pressure ulcers with the latest evidence-based practices, continual staff education, and policy and procedure updates. Sultan Bin Abdulaziz Humanitarian City (SBAHC) in Riyadh, Saudi Arabia, uses an interdisciplinary approach to address pressure-ulcer prevention and management. This article describes the programs, strategies, and preventive measures that have reduced pressure-ulcer incidence. (more…)
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