Wounds

Thomas Serena's picture
hyperbaric oxygen therapy

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.

Blog Category: 
Laurie Swezey's picture
wound care 101 - wound debridement

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

There are four main types of wound debridement: mechanical, autolytic, enzymatic, and surgical. Each form of debridement has its own advantages and disadvantages. Let’s take a look at each method individually:

Aletha Tippett MD's picture
stopwatch

by Aletha Tippett MD

Wound cleansing is an interesting dilemma. What? How can that be a dilemma? Everyone knows that you cleanse a wound before dressing it. This is what has been taught for years. Wound cleansing began in the late 19th or early 20th century once the germ theory was proposed and accepted, and hygiene was successful in reducing infections and death, and improving wound outcomes.

Michael Miller's picture

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 26

by Michael Miller DO, FACOS, FAPWCA, WCC

Every so often, in my readings of newspapers, articles, and while pleasure reading, or during conversations with friends and colleagues, I come across a word that smacks me right in the kisser. I was listening to a news commentary and this new buzzword nonchalantly emanated from the speaker's lips. It took me but a second before I realized what an insidiously powerful little devil it was. The speaker droned on about the current political scenario, the state of medical care, and then, in Judge Wapner-like reckoning described his presumed foes points as "counterintuitive." This unusual word "counterintuitive" has a definition that is both painfully simple and thought-provokingly powerful. Intuition is simply the perception of something using common sense. Adding "counter" to it moves it into the realm of mystery and suspense. Counter intuitive, something that is unlikely to be found correct when assessed and evaluated.

Blog Category: 
Margaret Heale's picture

Perspective of Nursing Care from Past to Future by Matron Marley

by Margaret Heale, RN, MSc, CWOCN

Well it's me again, Matron Marley. I got in through the door no problem today. My granddaughter dropped me off as she is doing some MDS training. I am feeling more comfortable as a volunteer now that I have visited a few times. When talking to the staff about their wanderer last time I was here and being reminded about the first recliner butt I saw, I wanted to drop back to the past again and tell you why I was so concerned.

American College of Hyperbaric Medicine's picture

by Christine Shettel, RN, BSN, WCC, DAPWCA, PWRC

Hyperbaric medicine has been used in wound care for over 50 years. As wound care professionals, we are saving patient’s lives, and preserving limbs utilizing Hyperbaric Oxygen Therapy (HBO). As health care professionals we understand the indications and benefits of HBO therapy, however, it’s important to follow clinical pathways and your local coverage determinations to ensure that we are placing the clinically appropriate patients in the chambers. It’s also important to understand what clinical documentation is required in order to qualify your patients for treatments to achieve optimal outcomes.

Blog Category: 
Aletha Tippett MD's picture

by Aletha Tippett MD

In reading through the recent WoundSource blog archives, I just had to write in support of Dr. Ron Sherman’s blog on our perception of maggot therapy. His blog was in response to a reader claiming "only inexperienced providers" use maggot therapy. Dr. Sherman's response to this reader was dead on target. As usual, he is very evidence-based and all-inclusive in his comments. I totally agree that the comment about inexperienced providers is insulting, and disrespectful of a tremendous resource.

Blog Category: 
Karen Zulkowski's picture

by Karen Zulkowski DNS, RN, CWS

Documenting wounds is always problematic for staff. It is important that wounds be assessed consistently both for measurement and characteristics. The use of pictures is also controversial. Pictures can help or hurt you if you are sued. However, consistent documentation of the wound, treatment and care planning that accompanies a picture would be useful.

While most of us go to the app store and download things we like, developing any app is actually time consuming. In working on our wound app we had many face-to-face meetings, calls, and trials of prototypes. Developers think differently than nurses so communicating what we wanted was interesting at best, and frustrating for our developer. However, we persevered and have the basic app model completed and will be adding the care planning piece soon.

Blog Category: 
Mary Ellen Posthauer's picture

by Mary Ellen Posthauer RDN, CD, LD, FAND

As the ethnic diversity in the United States continues to increase, clinicians should understand how food, culture and religious practices impact the nutrition interventions we recommend. According to the Census Bureau in 2010 Hispanics were the largest minority group in the US followed by African Americans and then Asians. Estimates are that by 2050 the minority population will reach 54% of the US population. The Hispanic population is anticipated to triple and the number of Asians will double.

Blog Category: 
Lydia Meyers's picture

by Lydia A Meyers RN, MSN, CWCN

Radiation necrosis can be defined as cell death as a result of high doses of radiation as used with aggressive tumors. The dead cells caused by the loss of blood flow can be located anywhere in line with the radiation treatments. This damage can cause wounds that will not heal, pain and skin that can be easily damaged. Radiation necrosis can be divided into the following classifications: acute, sub-acute and delayed complications. Acute damage is direct in-line damage as well as that in the surrounding area. The cells receive damage in the DNA structure enough to prevent mitosis. This damage does not last and can be treated by controlling the symptoms. Sub-acute damage is related to the treatment of lung cancer and mimics bronchitis. Another injury that can happen is related to temporary demylinization of the spinal cord and causes Lhermitte’s syndrome. With Lhermitte’s syndrome the patient suffers electric-like shocks in the legs when stretching the spine. Delayed injuries can happen from all types of treatments and from six months to many years after the initial treatment. This could also include acute injuries that were never resolved and became chronic injuries.