Guidelines for safe negative-pressure wound therapy

safe negative-pressure wound therapy

By Ron Rock MSN, RN, ACNS-BC

Since its introduction almost 20 years ago, negative-pressure wound therapy (NPWT) has become a leading technology in the care and management of acute, chronic, dehisced, traumatic wounds; pressure ulcers; diabetic ulcers; orthopedic trauma; skin flaps; and grafts. NPWT applies controlled suction to a wound using a suction pump that delivers intermittent, continuous, or variable negative pressure evenly through a wound filler (foam or gauze). Drainage tubing adheres to an occlusive transparent dressing; drainage is removed through the tubing into a collection canister. NWPT increases local vascularity and oxygenation of the wound bed and reduces edema by removing wound fluid, exudate, and bacteria. (more…)

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Author Guidelines

Wound Care Advisor, is dedicated to delivering succinct insights and information that multidisciplinary wound team members can immediately apply in their practice and use to advance their professional growth. If you’re considering writing for us, please use these guidelines to help choose an appropriate topic and learn how to prepare and submit your manuscript. Following these guidelines will increase the chance that we’ll accept your manuscript for publication

Wound Car Advisor Journal CoverAbout the journal

Wound Care Advisor serves as a practical resource for multidisciplinary skin and would care specialists. The journal provides news, clinical information, and insights from authoritative experts to enhance skin and wound care management. Wound Care Advisor is written by skin and wound care experts and presented in a reader-friendly electronic format. Clinical content is peer reviewed. It also serves as a resource for professional development and career management.

The journal is sent to Certificants of the National Alliance of Wound Care and Ostomy and other healthcare professionals, who are also dedicated to improving skin and wound care.

Editorial profile

Each issue of Wound Care Advisor offers compelling feature articles on clinical and professional topics, plus regular departments. We publish articles that present clinical tips and techniques, discuss new or innovative treatments, provide information on technology related to wound care, review medical conditions that affect wound healing such as diabetes and cardiovascular disease, address important professional and career issues, and other topics of interest to wound care specialists.

We accept submissions for these departments:

Best Practices, which includes case studies, clinical tips from wound care specialists, and other resources for clinical practice

Business Consult, which is designed to help wound care specialist manage their careers and stay current in relevant healthcare issues that affect skin and wound care.

We also welcome case studies. Please use the WCA Case Study Template as a guide

Before you submit an article…

Please send a brief email query to [email protected]. In the email, state 1) the topic of your proposed article, 2) briefly describe what the article will include, 3) provide a short summary of your background, and 4) explain why you’re qualified to write on this topic. We will respond whether or not we are interested in the article you have proposed.

Tips on writing for Wound Care Advisor

Our journal is written in simple, concise language. The tone is informal, and articles are short to medium in length (about 600 words for departments and 1200 words for feature articles). When writing the manuscript, follow these guidelines:

  • Wound Care Advisor is a clinical practice journal, so keep your information practical. Give examples that readers will relate to.
  • Although our tone is informal, the content of your article must be evidence-based, including key research findings, clinical practice guidelines and relevant standards as applicable.
  • Address readers directly, as if you’re speaking to them. Here are some examples:”As a wound care specialist, you’re probably familiar with …..””After removing the dressing, measure the wound….”
  • Use active—not passive—verbs. Active verbs engage the reader and make the writing more interesting.Sentence with a passive verb: Wound edges should be assessed for undermining.Sentence with active verb (preferred): Assess the wound edges for undermining.
  • Don’t use acronyms or abbreviations, except those you’re sure every reader is familiar with (such as “I.V.”). Instead, spell out the full term.
  • When mentioning a specific drug, give the drug’s generic name first, followed by the brand name in parentheses (if relevant).
  • Consider using boxed copy (a sidebar) for points you’d like to emphasize, clarify, or elaborate on. Also consider putting appropriate information in tables (in MS Word format). DO NOT USE MS Word’s “Insert text box” feature for sidebars. Instead, label the sidebar appropriately and put it at the end of your manuscript, after the article itself.
  • Wound Care Advisor is a digital journal, a format that encourages reader interaction. If possible, please include in your manuscript at least two links to websites, videos, or other electronic resources that would be helpful to readers.
  • Do not cite references within the text. List them in alphabetical order. References must be from professionally reliable sources and should be no more than 5 years old.

For reference style, use the American Medical Association Manual of Style: A Guide for Authors and Editors (10th ed). If you don’t have access to this book, include at least the following information for each reference you cite:

For a book: author(s), book title, edition (if appropriate), place of publication, publisher, and publication date

For a print journal article: author(s); article title; journal name; year, volume; inclusive page numbers

For online references: URL (web address) and the date you accessed the website.

About tables, photos, and illustrations

We encourage you to submit tables, photographs, and illustrations for your article (although we can’t guarantee we’ll publish them).

  • Submit them in a separate electronic file. Identify the source of each table, photo, or illustration and include a brief caption or label (e.g., “Illustration #1: Preventing complications from diabetes. From American Diabetic Association, 2006″). In the body of your article, indicate where the photo or illustration should be placed (e.g., “Insert Illustration #1 here.”) If you believe specific items in the photo or illustration should be identified, tell us this in a note. (Be aware that any person whose image is shown in a photograph must sign a consent form that gives us permission to publish it.)
  • Do not embed tables, figures, or images in the same file as the body of your article. Also, do not submit any text in a box or otherwise put rules around it, above, or below it. Instead, label this copy as a sidebar and submit it in a separate word file or at the end of the main article.
  • Authors are responsible for obtaining permission for material with a copyright. That includes figures, tables, and illustrations from other journals. It’s best to obtain permission before you submit the article and include documentation that you’ve received permission and any specific credit line that must be printed with the image. However, in cases where you must pay to use an image, note in the submission that you will obtain permission if the article is accepted for publication.

Important cautions

The article must be your own original work. Do not submit material taken verbatim from a published source.

How to submit your article

Submit your manuscript electronically as an MS Word file. Follow these guidelines:

  • At the top of the first page of the document, place the article title, your initials (not yourname), and the date.
  • DO NOT include extra hard returns between lines or paragraphs, extra spaces between words, or any special coding.
  • Send a separate cover letter that includes your name; credentials; position; address; home, cell, and work telephone numbers; email address; and your employer’s name, city, and state.
  • Email the article and any other attachments to [email protected] and [email protected].

What happens to your manuscript after submittal?

  • You will receive an email confirming receipt.
  • If your manuscript contains clinical information and we believe it has publication potential, we will send it out for blind peer review (neither you nor the reviewers will know who wrote the article). All manuscripts also receive an internal editorial review. After the review, we’ll let you know whether the manuscript has been accepted, accepted pending revisions, or declined.
  • If we accept your manuscript for publication, we’ll ask you to sign an agreement that gives HealthCom Media (publisher of Wound Care Advisor) the rights to your article so that it can be published. Each author must sign a separate agreement.
  • Your article will go through our in-house editorial process, where professional editors ensure consistency with our editorial style. You will have a chance to review the edited version before it’s published.
  • We will email you if we decide not to publish your manuscript.

Thank you for considering publishing in Wound Care Advisor, the official journal of the National Alliance of Wound Care and Ostomy, the official. If you have any questions, please email: Cynthia Saver, RN, MS, at [email protected] or [email protected].

Copyright © 2017, HealthCom Media. All rights reserved.

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Leprosy cases are rising in the US – what is the ancient disease and why is it spreading now?

leprosy

By Robert A. Schwartz, Rutgers University

The word “leprosy” conjures images of biblical plagues, but the disease is still with us today. Caused by infectious bacteria, some 200,000 new cases are reported each year, according to the World Health Organization. In the United States, leprosy has been entrenched for more than a century in parts of the South where people came into contact with armadillos, the principle proven linkage from animal to humans. However, the more recent outbreaks in the Southeast, especially Florida, have not been associated with animal exposure.

The Conversation talked with Robert A. Schwartz, professor and head of dermatology at Rutgers New Jersey Medical School, to explain what researchers know about the disease.

What is leprosy and why is it resurfacing in the US?

Leprosy is caused by two different but similar bacteria — Mycobacterium leprae and Mycobacterium lepromatosis — the latter having just been identified in 2008. Leprosy, also known as Hansen’s disease, is avoidable. Transmission among the most vulnerable in society, including migrant and impoverished populations, remains a pressing issue.

This age-old neglected tropical disease, which is still present in more than 120 countries, is now a growing challenge in parts of North America.

Leprosy is beginning to occur regularly within parts of the southeastern United States. Most recently, Florida has seen a heightened incidence of leprosy, accounting for many of the newly diagnosed cases in the U.S.

The surge in new cases in central Florida highlights the urgent need for health care providers to report them immediately. Contact tracing is critical to identifying sources and reducing transmission.

Traditional risk factors include zoonotic exposure and having recently lived in leprosy-endemic countries. Brazil, India and Indonesia have each noted more than 10,000 new cases since 2019, according to the World Health Organization data, and more than a dozen countries have reported between 1,000 to 10,000 new cases over the same time period.

Why was leprosy stigmatized in biblical times?

Evidence suggests that leprosy has plagued civilization since at least the second millennium B.C.

From that time until the mid-20th century, limited treatments were available, so the bacteria could infiltrate the body and cause prominent physical deformities such as disfigured hands and feet. Advanced cases of leprosy cause facial features resembling that of a lion in humans.

Many mutilating and distressing skin disorders such as skin cancers and deep fungal infections were also confused with leprosy by the general public.

Fear of contagion has led to tremendous stigmatization and social exclusion. It was such a serious concern that the Kingdom of Jerusalem had a specialized hospital to care for those suffering from leprosy.

How infectious is leprosy?

Research shows that prolonged in-person contact via respiratory droplets is the primary mode of transmission, rather than through normal, everyday contact such as embracing, shaking hands or sitting near a person with leprosy. People with leprosy generally do not transmit the disease once they begin treatment.

Armadillos represent the only known zoonotic reservoir of leprosy-causing bacteria that threaten humans. These small mammals are common in Central and South America and in parts of Texas, Louisiana, Missouri and other states, where they are sometimes kept as pets or farmed as meat. Eating armadillo meat is not a clear cause of leprosy, but capturing and raising armadillos, along with preparing its meat, are risk factors.

The transmission mechanism between zoonotic reservoirs and susceptible individuals is unknown, but it is strongly suspected that direct contact with an infected armadillo poses a significant risk of developing leprosy. However, many cases reported in the U.S. have demonstrated an absence of either zoonotic exposure or person-to-person transmission outside of North America, suggesting that transmission may be happening where the infected person lives. But in many cases, the source remains an enigma.

Some people’s genetics might make them more susceptible to leprosy infections, or their immune systems are less capable of resisting the disease.

Stigma and discrimination have prevented people from seeking treatment, and as a result, “concealed” cases contribute to transmission.

How do you recognize it?

Leprosy primarily affects the skin and peripheral nervous system, causing physical deformity and desensitizing one’s ability to feel pain on affected skin.

It may begin with loss of sensation on whitish patches of skin or reddened skin. As the bacteria spread in the skin, they can cause the skin to thicken with or without nodules. If this occurs on a person’s face, it may rarely produce a smooth, attractive-appearing facial contour known as lepra bonita, or “pretty leprosy.” The disease can progress to causing eyebrow loss, enlarged nerves in the neck, nasal deformities and nerve damage.

The onset of symptoms can sometimes take as long as 20 years because the infectious bacteria have a lengthy incubation period and proliferate slowly in the human body. So presumably many people are infected long before they know that they are.

Fortunately, worldwide efforts to screen for leprosy are being enhanced thanks to organizations like the Order of Saint Lazarus, which was originally founded in the 11th century to combat leprosy, and the Armauer Hansen Research Institute, which conducts immunologic, epidemiological and translational research in Ethiopia. The nongovernmental organization Bombay Leprosy Project in India does the same.

How treatable is it?

Leprosy is not only preventable but treatable. Defying stigma and advancing early diagnosis via proactive measures are critical to the mission of controlling and eradicating it worldwide.

Notably, the World Health Organization and other agencies provide multi-drug therapy at no cost to patients.

In addition, vaccine technology to combat leprosy is in the clinical trials stage and could become available in coming years. In studies involving nine-banded armadillos, this protein-based vaccine delayed or diminished leprous nerve damage and kept bacteria at bay. Researchers believe that the vaccine can be produced in a low-cost, highly efficient manner, with the long-term prospect of eradicating leprosy.

If health care professionals, biomedical researchers and lawmakers do not markedly enhance their efforts to eliminate leprosy worldwide, the disease will continue to spread and could become a far more serious problem in areas that have been largely free of leprosy for decades.

The World Health Organization launched a plan in 2021 for achieving zero leprosy.The Conversation

Robert A. Schwartz, Professor and Head of Dermatology, Rutgers New Jersey Medical School, Rutgers University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Flesh-eating bacteria infections are on the rise in the US

Vibrio vulnificus

By Bill Sullivan, Indiana University

Flesh-eating bacteria sounds like the premise of a bad horror movie, but it’s a growing – and potentially fatal – threat to people.

In September 2023, the Centers for Disease Control and Prevention issued a health advisory alerting doctors and public health officials of an increase in flesh-eating bacteria cases that can cause serious wound infections.

I’m a professor at the Indiana University School of Medicine, where my laboratory studies microbiology and infectious disease. Here’s why the CDC is so concerned about this deadly infection – and ways to avoid contracting it.

What does ‘flesh-eating’ mean?

There are several types of bacteria that can infect open wounds and cause a rare condition called necrotizing fasciitis. These bacteria do not merely damage the surface of the skin – they release toxins that destroy the underlying tissue, including muscles, nerves and blood vessels. Once the bacteria reach the bloodstream, they gain ready access to additional tissues and organ systems. If left untreated, necrotizing fasciitis can be fatal, sometimes within 48 hours.

The bacterial species group A Streptococcus, or group A strep, is the most common culprit behind necrotizing fasciitis. But the CDC’s latest warning points to an additional suspect, a type of bacteria called Vibrio vulnificus. There are only 150 to 200 cases of Vibrio vulnificus in the U.S. each year, but the mortality rate is high, with 1 in 5 people succumbing to the infection.

How do you catch flesh-eating bacteria?

Vibrio vulnificus primarily lives in warm seawater but can also be found in brackish water – areas where the ocean mixes with freshwater. Most infections in the U.S. occur in the warmer months, between May and October. People who swim, fish or wade in these bodies of water can contract the bacteria through an open wound or sore.

Vibrio vulnificus can also get into seafood harvested from these waters, especially shellfish like oysters. Eating such foods raw or undercooked can lead to food poisoning, and handling them while having an open wound can provide an entry point for the bacteria to cause necrotizing fasciitis. In the U.S., Vibrio vulnificus is a leading cause of seafood-associated fatality.

Why are flesh-eating bacteria infections rising?

Vibrio vulnificus is found in warm coastal waters around the world. In the U.S., this includes southern Gulf Coast states. But rising ocean temperatures due to global warming are creating new habitats for this type of bacteria, which can now be found along the East Coast as far north as New York and Connecticut. A recent study noted that Vibrio vulnificus wound infections increased eightfold between 1988 and 2018 in the eastern U.S.

Climate change is also fueling stronger hurricanes and storm surges, which have been associated with spikes in flesh-eating bacteria infection cases.

Aside from increasing water temperatures, the number of people who are most vulnerable to severe infection, including those with diabetes and those taking medications that suppress immunity, is on the rise.

What are symptoms of necrotizing fasciitis? How is it treated?

Early symptoms of an infected wound include fever, redness, intense pain or swelling at the site of injury. If you have these symptoms, seek medical attention without delay. Necrotizing fasciitis can progress quickly, producing ulcers, blisters, skin discoloration and pus.

Treating flesh-eating bacteria is a race against time. Clinicians administer antibiotics directly into the bloodstream to kill the bacteria. In many cases, damaged tissue needs to be surgically removed to stop the rapid spread of the infection. This sometimes results in amputation of affected limbs.

Researchers are concerned that an increasing number of cases are becoming impossible to treat because Vibrio vulnificus has evolved resistance to certain antibiotics.

How do I protect myself?

The CDC offers several recommendations to help prevent infection.

People who have a fresh cut, including a new piercing or tattoo, are advised to stay out of water that could be home to Vibrio vulnificus. Otherwise, the wound should be completely covered with a waterproof bandage.

People with an open wound should also avoid handling raw seafood or fish. Wounds that occur while fishing, preparing seafood or swimming should be washed immediately and thoroughly with soap and water.

Anyone can contract necrotizing fasciitis, but people with weakened immune systems are most susceptible to severe disease. This includes people taking immunosuppressive medications or those who have pre-existing conditions such as liver disease, cancer, HIV or diabetes.

It is important to bear in mind that necrotizing fasciitis presently remains very rare. But given its severity, it is beneficial to stay informed.The Conversation


Bill Sullivan, Professor of Pharmacology & Toxicology, Indiana University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Winning the battle of skin tears in an aging population

ON DEMAND webinar

Winning the battle of skin tears in an aging population

This April 25th, 2017 webinar overviews a significant challenge that healthcare providers encounter daily.

“Skin tears” may sound like a relatively minor event, but in reality, these injuries can have a significant impact on the quality of patients’ lives in the form of pain, infection, and limited mobility. The incidence of skin tears has been reported to be as high as 1.5 million annually, and with an aging population, this number is likely to go higher. In this webinar, experts will explain how nurses can use an evidence-based approach—including following practice guidelines to assess the wound and select the proper dressing—for managing skin tears and minimizing their negative effects.

 

Our Speakers

The skin tear challenge

Kimberly LeBlanc, MN, RN, CETN(C) Advanced practice nurse

Kimberly LeBlanc
MN, RN, CETN(C)
Advanced practice nurse, KDS Professional Consulting President, International Skin Tear Advisory Panel
An expert in skin tears, Kimberly will briefly set the stage by addressing the seriousness of skin tears and briefly addressing assessment such as classification.

The main focus will be on management, including goals of care, wound cleaning, wound bed preparation, and dressing selection.

Content will include information from the 2016 consensus statement on skin tears published in Advances in Skin & Wound Care.

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Tips and techniques for managing dressings for skin tears

Shannon Cyphers, RN, BSN, WCC Clinical Account Manager ConvaTec, Inc.

Shannon Cyphers
RN, BSN, WCC

Clinical Account Manager, ConvaTec, Inc.
Shannon will present wound and skin care product applications to help manage skin tears.

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Submit below to view the Webinar and download Slidedeck

Questions or comments?  Please contact [email protected]

*By downloading this (product) you are opting in to receiving information from Healthcom Media and Affiliates. Or the details, including your email address/mobile number, may be used to keep you informed about future products and services.
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Educational Webinars

Healing Wounds with Collagen: Knowing the Difference Makes All the Difference

Healing Wounds with Collagen: Knowing the Difference Makes All the Difference

This 30-minute presentation features learning opportunities that will provide in-depth instruction and demonstration in wound care treatments. After this webinar, the learner will be able to:

  • The Indications and Contraindications for Collagen
  • What a Wound Wants and Needs; and Why
  • Considerations of Collagen in Treating & Healing Wounds

Innovations in Wound Care: The role of wound cleansing in the management of wounds

Skin Damage Associated with Moisture and Pressure

This 30-minute presentation features learning opportunities that will provide in-depth instruction and demonstration in wound care treatments. After this webinar, the learner will be able to:

  • Identify the role of proper wound cleansing
  • Discuss how to select and use non-toxic wound cleansers
  • Describe advantages of collagen for managing a chronic wound

Skin Damage Associated with Moisture and Pressure

Skin Damage Associated with Moisture and PressureTips for how to differentiate and goals for protection and management. At the end of the webinar you will be able to:

  • Identify how wounds are classified according to wound depth and etiology
  • Describe the etiology of pressure injury and incontinence-associated skin damage (IAD)
  • Understand evidenced-based protocols of care for prevention and management of IAD and pressure injuries
  • Recognize and describe NPUAP-EPUAP Pressure Injury Classification System
  • Understand appropriate ConvaTec products that can be used for prevention and treatment of IAD and pressure injuries

Winning the battle of skin tears in an aging population

CFO/CNO Partnership for Workforce Management Outcomes: Benefits of Acuity-based Staffing

"Skin tears" may sound like a relatively minor event, but in reality, these injuries can have a significant impact on the quality of patients' lives in the form of pain, infection, and limited mobility.

The incidence of skin tears has been reported to be as high as 1.5 million annually, and with an aging population, this number is likely to go higher.

In this webinar, experts will explain how nurses can use an evidence-based approach -- including following practice guidelines to assess the wound and select the proper dressing -- for managing skin tears and minimizing their negative effects.

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Control your claims: Pressure ulcer/wound care management

Diabetic Foot Ulcers

One of many dreaded tags from a Centers for Medicare & Medicaid Survey is F-Tag 314 — Pressure ulcers.

CMS writes, “Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.” (more…)

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Webinars

Winning the battle of skin tears in an aging population

"Skin tears" may sound like a relatively minor event, but in reality, these injuries can have a significant impact on the quality of patients' lives in the form of pain, infection, and limited mobility.

The incidence of skin tears has been reported to be as high as 1.5 million annually, and with an aging population, this number is likely to go higher.

In this webinar, experts will explain how nurses can use an evidence-based approach -- including following practice guidelines to assess the wound and select the proper dressing -- for managing skin tears and minimizing their negative effects.

[thrive_lead_lock id=’10942′][/thrive_lead_lock]

Skin Damage Associated with Moisture and Pressure

• Identify how wounds are classified according to wound depth and etiology

• Describe the etiology of pressure injury and incontinence- associated skin damage (IAD)

• Understand evidenced-based protocols of care for prevention and management of IAD and pressure injuries

• Recognize and describe NPUAP-EPUAP Pressure Injury Classification System

• Understand appropriate ConvaTec products that can be used for prevention and treatment of IAD and pressure injuries

[thrive_lead_lock id=’10974′][/thrive_lead_lock]

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Jim Nabors Would Just Cry

jim nabors

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…)

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Breaking silos: Effective wound healing means treatment across the continuum

Around 6.5 million patients in the U.S. suffer from chronic wounds, such as pressure injuries or ulcers. Treatment costs $25 billion each year, representing a sizable and growing problem. Despite the wide impact of chronic wounds, it’s rare to see specialized, effective wound care delivered across the care continuum.

A chronic non-healing wound is a surrogate marker for illness. These patients require holistic management of their co-morbidities and continuity across care settings.

Despite this, a great deal of emphasis has been placed on treating wounds as singular events, managed topically with expensive dressings and support surfaces. This is only a small part of wound healing.

As a physician focused solely on wound care, I have learned that we must shift the focus from simply treating the wound to treating the wounded patient. The impact in the post-acute care setting in particular is worthy of evaluation and discussion, as up to 29% of patients in long-term care facilities will experience a pressure ulcer, posing serious legal, financial, and staffing implications.

For those providers working outside long-term care, there is little understanding of challenges facing LTC providers. Acute providers do not often ask, for example, how are my LTC partners reimbursed? How are they staffed? What are the requirements and regulatory pressures they face? Asking these questions would facilitate a more productive dialogue with a focus on collaborative prevention, rather than waiting until a chronic wound occurs in the LTC setting.

Creating an integrated wound care community

To address the needs of the present and growing population of patients with chronic wounds, Healogics developed an integrated wound care community model, to coordinate the wound healing process across all care settings. The program utilizes Healogics Specialty Physicians, a subspecialty group of physicians and providers with extensive training solely focused on wound care.

HSPs provide expert inpatient consultation and ensure safe transition of patients out of the hospital into the appropriate care setting. Because HSPs see the patient regardless of post-discharge venue, patients receive the same quality of care whether they are going home, to a skilled-nursing, assisted living, or LTC setting. Because chronic wounds are surrogate markers for illness, we have realized it’s essential to have an integrated, multi-setting, and multi-disciplinary process to treat the patient and their co-morbidities.

Data collected at a pilot IWCC site in the Midwestern U.S. from 2014 to 2016 revealed very positive trends for chronic wound patients. In the acute care setting, the average length of stay decreased from 9.41 days to 5.64 days, and total cost of care per patient was reduced from $10,670 to $7,248.

We’re excited by these promising results, which were revealed at the American College of Wound Healing and Tissue Repair Conference last December. We look forward to refining and expanding the model by helping our partners in acute and LTC settings standardize their practices, use evidence-based clinical guidelines, mobilize technologies and processes, and pay critical attention to patient safety and value-based outcomes.

When it comes to wound healing, no venue of care should operate alone—an integrated solution that creates continuity for the patient is critical. There are four things LTC facilities can do to break down the silos:

Read more at McKnight’s

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Managing chronic venous leg ulcers — what’s the latest evidence?

Managing chronic venous leg ulcers — what’s the latest evidence?

Chronic venous leg ulcers (CVLUs) affect nearly 2.2 million Americans annually, including an estimated 3.6% of people over the age of 65. Given that CVLU risk increases with age, the global incidence is predicted to escalate dramatically because of the growing population of older adults. Annual CVLU treatment-related costs to the U.S. healthcare system alone are upwards of $3.5 billion, which are directly related to long healing times and recurrence rates of over 50%.

CVLUs are not only challenging and costly to treat, but the associated morbidity significantly reduces quality of life. That makes it critical for clinicians to choose evidence-based treatment strategies to achieve maximum healing outcomes and minimize recurrence rates of these common debilitating conditions. These strategies, which include compression therapy, specialized dressings, topical and oral medications, and surgery, are used to reduce edema, facilitate healing, and avert recurrence. (more…)

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Management of Patients With Venous Leg Ulcers

It is well documented that the prevalence of venous leg ulcers (VLUs) is increasing, coinciding with an ageing population. Accurate global prevalence of VLUs is difficult to estimate due to the range of methodologies used in studies and accuracy of reporting.1 Venous ulceration is the most common type of leg ulceration and a significant clinical problem, affecting approximately 1% of the population and 3% of people over 80 years of age2 in westernised countries. Moreover, the global prevalence of VLUs is predicted to escalate dramatically, as people are living longer, often with multiple comorbidities. Recent figures on the prevalence of VLUs are based on a small number of studies, conducted in Western countries, and the evidence is weak. However, it is estimated that 93% of VLUs will heal in 12 months, and 7% remain unhealed after five years.3 Furthermore, the recurrence rate within 3 months after wound closure is as high as 70%.4-6 Thus, cost-effective adjunct evidence-based treatment strategies and services are needed to help prevent these ulcers, facilitate healing when they occur and prevent recurrence.

The impact of a VLU represents social, personal, financial and psychological costs on the individual and further economic drain on the health-care system. This brings the challenge of providing a standardised leg ulcer service which delivers evidence-based treatment for the patient and their ulcer. It is recognised there are variations in practice and barriers preventing the implementation of best practice. There are patients not receiving appropriate and timely treatment in the initial development of VLUs, effective management of their VLU and preventing recurrence once the VLU has healed.

Health-care professionals (HCPs) and organisations must have confidence in the development process of clinical practice guidelines and have ownership of these guidelines to ensure those of the highest quality guide their practice. These systematic judgments can assist in policy development, and decision making, improve communication, reduce errors and improve patient outcomes.

Read more at Journal of Wound Care

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