Treatment

A venous ulcer, also known as a stasis ulcer or venous leg ulcer, is a shallow wound that usually occurs on the sides of the lower leg, between the calf and ankle. Since venous ulcers often are slow in healing and frequently recur if not properly treated, it is important for health care providers to understand their diagnosis and treatment.

By Cheryl Carver LPN, WCC, CWCA, CWCP, FACCWS, DAPWCA, CLTC

This month's blog topic idea came about from a recent conversation with a middle-aged patient with paraplegia. She had a stage 4 pressure injury due to being in her wheelchair long hours, along with a low BMI. I made the comment, "I wish I could give you a fat transplant." She laughed. She then asked, "Well, why not?" Later that day the topic of fat grafting popped up on social media in a spinal cord injury group I follow. I ended up chatting with a few spinal cord injury folks that were serious about coming up with funds to get fat grafting done. They all had a fear of, or a previous history of pressure injuries. These folks with past pressure injuries had used advanced wound care dressings, support surfaces, high-end cushions, supplements, negative pressure wound therapy, a slew of antibiotics, and even flap closures.

by Thomas E. Serena MD, FACS, FACHM, FAPWCA

In 1950, J. Edgar Hoover published the first edition of the FBI’s most wanted list. Since that time, no less than 512 fugitives have been featured. Many surrendered after learning that their mug shots were hanging on every post office wall in the country. In medicine, we have an equally infamous public posting: The Office of Inspector General’s (OIG) work list. In 2017, it turns out that hyperbaric medicine services are "public enemy number one." But please, do not surrender just yet.

by Michel H.E. Hermans, MD

Undertreatment of medical issues is not necessarily bad: palliative care usually only treats symptoms but not the underlying cause of the symptoms which, if the patient wants this, is very appropriate. Remember, Hippocrates said something about suffering and while a disease may be not curable, suffering quite often may be treated with proper medication or other interventions (though, unfortunately, this is not always the case). We should not be worried to give somebody with terminal illness and in serious pain the proper type and amount of medication, even if there is a chance the patient would get addicted.

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Lower extremity venous insufficiency ulcers represent approximately 80% of the leg ulcers typically seen in wound care facilities. The following statistics help to bring home the seriousness and chronicity of this common health problem:

• Healing time for venous insufficiency ulcers averages 24 weeks
• Approximately 15% of these ulcers will never heal
• In 15 to 71% of cases of venous insufficiency ulcers, the ulcers represent a recurrent lesion
• It is estimated that the cost of treating venous insufficiency ulcers is 1 to 5 billion dollars every year

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

A wound that is too moist can be as detrimental to wound healing as a wound that is too dry. When a wound is too moist, the skin surrounding the wound, known as the periwound, can become macerated. Skin that is macerated is vulnerable to breakdown, leading to a possible increase in wound size.

What can be done to protect the vulnerable periwound? There are several prevention strategies that can be used to prevent maceration and further skin breakdown.

by the WoundSource Editors

Writing up a case report is an important professional activity in not only wound care, but in any other field as well. A case report records the details of the presentation of signs and symptoms, assessment, diagnosis, treatment and outcomes of a patient case or series of cases. Case reports typically describe an unusual presentation or complication relating to the patient's condition, or a new clinical approach to a common problem. The publication of a case report in a peer-reviewed journal, if that is your intent, is a great addition to your CV, especially if you are new to the profession.

By Robert Striks, Special Writer, Encompass HealthCare & Wound Medicine

There's a funny scene in the Marx Brothers movie, "Horse Feathers," where Chico tells Harpo how to escape from the room they are locked inside by using a rope. Chico instructs Harpo to tie one end of the rope to the bed and then throw the other end of the rope out the window. "Tie on the bed, throw the rope out the window," he repeats. Haplessly, Harpo takes the tie he was wearing around his neck, places it on the bed and then throws the entire escape rope out the window.

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

This article is designed to provide a review of cellulitis, an infection affecting the skin which can be life-threatening if not treated.

What is cellulitis?

Cellulitis is the term used to describe inflammation of the skin and subcutaneous tissues, most often caused by acute infection. The two most common pathogens associated with cellulitis are Streptococcus pyogenes and Staphylococcus aureus.

by Bruce E. Ruben MD

Part 2 in a series on infection management
For Part 1, click here

Our skin is our largest organ and performs a myriad of functions, including pain sensation, pressure sensitivity, temperature regulation and water conservation.

The skin is also our first line of defense against our physical and microbial environment. And although sheets and sheets of bacteria live harmoniously on the skin, it is still impenetrable to even the smallest protein molecules. Note: that's great information for the next time you purchase anti-wrinkle products that claim to get below the skin.