Dressings

WoundSource Practice Accelerator's picture

For the wound healing process to be successful, it must pass through four stages: hemostasis, inflammation, proliferation, and remodeling or maturing. Wound healing requires inflammation, but it can be detrimental if it is persistent or encouraged by other factors, such as infection. It is during this phase that wound healing is most likely to stall.

Emily Greenstein's picture

By Emily Greenstein, APRN, CNP, CWON, FACCWS

After attending the Spring Symposium for Advanced Wound Care and hearing many great lectures, I got to thinking, “What are the pillars of chronic wound care?” We have all heard of the concept “look at the whole patient and not the hole in the patient.” Heck, I have even written about it. But we also need to have a good foundation for how to implement this phrase or where to even start. I did a quick Internet search and came up with some interesting articles that talked about the basics of wound care and management. I found discussions on everything from maintaining a moist wound environment to being financially responsible. All of this information leads me to the concept of developing easy-to-understand pillars or categories to consider when caring for a patient with a chronic wound.

Becky Naughton's picture

By Becky Naughton, RN, MSN, FNP-C, WCC

I’m sure we’ve all hit that point in our wound care careers where we’ve had that one patient who’s wound just doesn’t seem to respond to any treatment. You’ve tried everything that you can think of—state-of-the-art dressings, advanced cellular products, regular debridement, and even hyperbaric oxygen. But despite all of this, the wound seems stuck. This is what’s known as a recalcitrant wound, a wound that fails to progress through the phases of wound healing in a typical timeline and becomes “stuck.” A wound that does not decrease in size by 30% in 3 weeks or by 50% in 4 to 5 weeks is considered recalcitrant. This is significant because wounds that don’t show improvement in size by 50% in 4 weeks have a 91% chance of not healing in 12 weeks.

Margaret Heale's picture

By Margaret Heale, RN, MSc, CWOCN

It is important for nurses to strive toward excellence. Our patients deserve the best we are able to give, and sometimes we need to look critically at how we care and how we might improve outcomes. In theory, we update practice because we read research that indicates a change needs to be incorporated into what we do. More often, maybe we follow a colleague and like what we see, or the patient indicates a preference and we change an approach. It may be that a company representative visits and what they say makes sense, has the support of management, and we gladly (or not) incorporate a product into our practice. Looking at a standard of practice and reflecting on how we measure up require honesty and an openness that some might shy away from. Such reflective practice, combined with clinical supervision, leads to high-quality care and is an excellent method of reviewing, updating, and improving practice for patients with problems of the lower leg.

Cathy Wogamon-Harmon's picture

by Cathy L. Wogamon, DNP, MSN, FNP-BC, CWON, CFCN

The periwound is generally defined as the area from the wound edge to 4 cm beyond circumferentially. Breakdown of the periwound can adversely affect wound healing even if the wound itself is doing well. After the initial assessment of the wound bed and edges, one should direct their assessment to the periwound. Generally speaking, there are three major conditions (other than intact) in which you may find the periwound: damaged from trauma, too moist, or in an inflammatory state.

It is well known that chronic and hard-to-heal wounds have created a global crisis. Delayed healing in these wounds is often associated with biofilm, and antimicrobial dressings can be effective in managing bioburden in chronic wounds. For the use of antimicrobial advanced wound care dressings to be successful in chronic wound care, however, clinicians must have practical knowledge of dressing formats and options, dressing indications and applications, the principles of antimicrobial stewardship, and care planning for specific wound types.

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WoundSource Editors's picture

Collagen is a natural fibrous protein of the extracellular matrix. It contains three proteins wrapped around each other to form a triple-helix structure. Collagen is a biocompatible structural protein that is ideal for tissue engineering and regenerative purposes.

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WoundSource Practice Accelerator's picture

Wound healing is often accompanied by bacterial infection. Many clinicians use antibiotics to treat wound infections. However, the overreliance on antibiotics is becoming an increasing concern for many global health organizations because it contributes to widespread antibiotic resistance. Excessive use of synthetic antibiotics leads to drug resistance, which poses a substantial threat to human health.

Cheryl Carver's picture

Let’s face it, dressing selection can be overwhelming for clinicians because of the plethora of products that are in the wound care market space. If only there were a multifunctional smart-dressing that could be used on every wound etiology. It would make managing wounds much easier. Practical knowledge of dressing categories, functionality, appropriateness, and reimbursement is key in dressing selection.

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Holly Hovan's picture

By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

“Top-down skin injuries” is an increasingly common term used to describe superficial cutaneous injuries. Top-down injuries result from damage beginning at the skin’s surface or the soft tissue. In contrast, “bottom-up injuries” are often the result of ischemia. Top-down injuries usually result from mechanical forces, inflammation, or moisture. Common top-down injuries are moisture-associated skin damage, skin tears, and medical adhesive–related skin injury (MARSI). In this blog, I focus on assessing, defining, and preventing MARSI.