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Practical Issues in Wound, Skin and Ostomy Management
Topical application of silver nitrate is often used in wound care to help remove and debride hypergranulation tissue or calloused rolled edges in wounds or ulcerations. It’s also an effective agent to cauterize bleeding in wounds. Silver nitrate is a highly caustic material, so it must be used with caution to prevent damage to healthy tissues. (more…)
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Imagine watching your skin tear, bleed, and turn purple. Imagine, too, the pain and disfigurement you’d feel.
What if you had to live through this experience repeatedly? That’s what many elderly people go through, suffering with skin tears through no fault of their own. Some go on to develop complications.
A skin tear is a traumatic wound caused by shear, friction, or blunt-force trauma that results in a partial- or full-thickness injury. Skin tears are painful because the precipitating injury commonly involves the dermis, which is rich with nerve endings. (more…)
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As a wound care specialist, you have learned about many skin conditions, some so unusual and rare that you probably thought you would never observe them. I’ve been a nurse for 38 years, with the last 10 years in wound care, and that’s certainly what I thought. But I was wrong. Let me tell you about my challenging patient with an unusual skin condition.
A perplexing patient (more…)
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Being positive in a negative situation is not naïve. It’s leadership.
— Ralph S. Marston, Jr., author and
publisher of The Daily Motivator website
Clinicians may encounter many challenges and stressors in the workplace—long hours, rotating shifts, inadequate staffing, poor teamwork, and pressure to achieve higher performance levels in an emotionally and physically demanding field.
But hope exists. Positive psychology uses scientific understanding and interventions to help people achieve a more satisfactory life. Positive psychologists have shown that building positive emotions can change the way we approach and view our environment, helping us become healthier, happier, and more resilient and helping employees and teams become more productive and engaged. (more…)
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We all lead busy lives, with demanding work schedules and home responsibilities that can thwart our best intentions. Although we know it’s our responsibility to stay abreast of changes in our field, we may feel overwhelmed when we try to make that happen.
Keeping clinicians up-to-date on clinical knowledge is one of the main goals of the Wild On Wounds (WOW) conference, held each September in Las Vegas. Each year, I present the opening session of this conference, called “The Buzz Report,” which focuses on the latest-breaking wound care news—what’s new, what’s now, what’s coming up. I discuss innovative new products, practice guidelines, resources, and tools from the last 12 months in skin, wound, and ostomy management. This article highlights the hottest topics from my 2015 Buzz Report. (more…)
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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…)
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Value of systematic reviews and meta-analyses in wound care
“Systematic reviews and meta-analyses—literature-based recommendations for evaluating strengths, weaknesses, and clinical value,” in Ostomy Wound Management, discusses evidence-based practice and how systematic reviews (SRs) and meta-analyses (MAs) can help improve management of wound care patients.
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…)
Read MoreBy Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS
Having the proper support surface for beds and wheelchairs is imperative in preventing pressure ulcers. “Pressure” ulcers are named that for a reason—pressure is the primary cause of interruption of blood flow to the tissue. Unfortunately, guidelines for support surface selection tend to make recommendations for the type of surface to use after a pressure ulcer has developed. Another factor that complicates matters is the development of deep-tissue injuries. These injuries start at the bone level, which means that often, tissue damage is extensive before we see visible signs and realize that the support surface we chose might not have been effective enough. (more…)
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By Gail R. Hebert, MS, RN CWCN, DWC, WCC, OMS
How would you react if you heard a 600-lb patient was being admitted to your unit? Some healthcare professionals would feel anxious—perhaps because they’ve heard bariatric patients are challenging to care for, or they feel unprepared to provide their care. (more…)
Read MoreBy Leanne Richbourg, MSN, RN, APRN-BC, CWON-AP, CCCN, GCNS-BC
Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is the gold standard for surgical treatment of ulcerative colitis (UC) or familial adenomatous polyposis (FAP). It’s also done to treat colon and rectal cancers, such as those caused by Lynch syndrome (LS). IPAA allows the patient to maintain fecal continence and evacuate stool from the anus after colon and rectum removal. A temporary ileostomy may be part of the overall process, but there’s no need for a permanent stoma. (See Understanding ulcerative colitis, FAP, and Lynch syndrome.) (more…)
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By Cheryl Robillard, PT, WCC, CLT, DWC
Patients in your clinical practice who develop wounds should prompt a call for “all hands on deck” to manage the situation, but some personnel may be missing the boat. Physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs) should be on board your wound care ship so patients can receive care they need. But unfortunately, sometimes they aren’t. (more…)
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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…)
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