By 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…)
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.
Modified Braden risk score proposed A study in Ostomy Wound Management states the risk classification of patients using Braden Scale scores should comprise three (rather than five) levels: high risk, with a total score ≤11; moderate risk, with a total score of 12 to 16; and mild risk, with a total score ≥17. The retrospective analysis of consecutively admitted patients…
End your year by checking out these resources for your practice. Sentinel event alert for falls As part of its sentinel event alert “Preventing falls and fall-related injuries in health care facilities,” The Joint Commission has assembled information and multiple resources, including: analysis of contributing factors for falls evidence-based suggestions for improvement Joint Commission requirements relevant to falls links to…
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. Here’s an overview of cutaneous candidiasis. Cutaneous candidiasis is an infection of the skin caused by the yeast Candida albicans or other Candida species. Here’s a snapshot of this condition.
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…
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.
By 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…
By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS As healthcare clinicians, our world is full of tasks to be completed. Some are new, but many are tasks we repeat every day and thus have become routine—things we could almost do in our sleep. But what’s routine for us may not be routine for our patients. For some patients, these…
By Ann-Marie Taroc, MSN, RN, CPN Are you using the wrong kind of medical tape on your patients? Although we strive to provide the safest care possible, some nurses may not realize that medical tape used to secure tubes and dressings can cause harm. The harm may stem from using the wrong product or using a product incorrectly, which can…
By 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…
Moldable skin barrier effective for elderly patients with ostomy
A study in Gastroenterology Nursing reports that compared to a conventional skin barrier, a moldable skin barrier significantly improves self-care satisfaction scores in elderly patients who have a stoma. The moldable skin barrier also caused less irritant dermatitis and the costs for leakage-proof cream were lower.
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. Every year, I present the opening session, called “The Buzz Report,” which focuses on the latest-breaking wound care news—what’s new, what’s now, and what’s coming up. I discuss new products, practice guidelines, resources, and tools from the last 12 months in skin, wound, and ostomy management.
In the January issue, I discussed some of the updates from my 2015 Buzz Report. Now I’d like to share a few more, along with some of my favorite resources. (more…)
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…)
By Rosalyn S. Jordan, RN, BSN, MSc, CWOCN, WCC, OMS; and Judith LaDonna Burns, LPN, WCC, DFC
About 1 million people in the United States have either temporary or permanent stomas. A stoma is created surgically to divert fecal material or urine in patients with GI or urinary tract diseases or disorders.
A stoma has no sensory nerve endings and is insensitive to pain. Yet several complications can affect it, making accurate assessment crucial. These complications may occur during the immediate postoperative period, within 30 days after surgery, or later. Lifelong assessment by a healthcare provider with knowledge of ostomy surgeries and complications is important. (more…)
Most patients are distressed to learn they need ostomy surgery to divert stool, urine, or both. Adapting to ostomy surgery can be difficult at best, even with today’s advanced technology and the wide assortment of ostomy supplies available. While recovering from the surgery itself, patients must learn how to contain or control feces or urine and how to minimize odor—without feeling like a social outcast.
This article reviews three types of ostomy surgery—colostomy, ileostomy, and urostomy. Subsequent articles will discuss ostomy management and treatment of stomal and peristomal skin complications. (more…)
In a busy wound clinic, quick and accurate differential diagnosis of edema is essential to appropriate treatment or referral for comprehensive care. According to a 2010 article in American Family Physician, 80% of lower extremity ulcers result from chronic venous insufficiency (CVI). In 2007, the German Bonn Vein Study found 100% of participants with active venous ulcers also had a positive Stemmer’s sign, indicating lymphedema. (more…)
