Dressings

Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWON

I am frequently asked for solutions relating to maceration to periwound skin in wounds being treated with negative pressure wound therapy (NPWT). As a clinician practicing in the outpatient and home care settings, it was not unusual for patients to have to take a "holiday" from negative pressure. Treatment was often put on hold for several days to allow skin to recover. Putting negative pressure on hold not only caused a potential delay in forward progress in the wound, but it also created the need for increased dressing change visits for the home care patient. While maceration is reported in wounds located anywhere on the body, it seems to be most prevalent on skin of the lower extremity.

Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWON

Negative Pressure Wound Therapy (NPWT) has become standard of care for many wound types. Any clinician who works with NPWT dressings will report that a significant number of wounds will develop a malodor, commonly referred to as a “VAC stink.” In response to malodor, clinicians often opt to give the wound a NPWT holiday, which can delay wound closure. In thi article we will look at factors that contribute to malodor, and interventions that might reduce it.

Aletha Tippett MD's picture

By Aletha Tippett MD

With a theme this month of dressings, I think it is time to give gauze its rightful due. There are a number of wound care providers who would say that “gauze has no cause”. Of course, this is said because of the understanding that moist gauze dries out when on a wound, leading to “wet to dry”, which is a major no-no according to CMS. This wet-to-dry results in debridement of viable tissue. It is also because of the belief and practice that a gauze dressing needs to be changed daily, and with all the cost-consciousness, this makes it more expensive than a once-a-week higher end dressing. However, in real life, how often does a once-weekly dressing actually last the full week, especially on a sacral or buttock wound?

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Laurie Swezey's picture

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

There are more than 3,000 types of wound dressings available on the market today, and more are being launched every day. Although there are a number of protocols and algorithms available to help with the selection of wound dressings,1,2 and individual facilities are likely to have their own dressings of choice, the decision can still seem overwhelming. Even the most seasoned wound care practitioner can find it difficult to assess the advantages and disadvantages of each dressing available and to make the appropriate choice for a particular patient. Rather than consider each dressing in isolation, a useful technique can be to mentally place each type of dressing on a continuum of occlusion.3

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Kathi Thimsen's picture

By Kathi Thimsen RN, MSN, WOCN

In follow up to comments and additional considerations of products, ingredients, and clinical practice, it is important to discuss several aspects of the topic. This blog has served thus far as a primer for the evolution of products both on the market today and currently under development.

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Kathi Thimsen's picture

By Kathi Thimsen RN, MSN, WOCN

Practicing skin and wound care requires the clinician to have many tools to address the myriad of issues related to patient management. Maintaining the integrity of a bandage, device, or skin edge all require operational understanding of the sticky aspect of wound care: adhesives.

Kathi Thimsen's picture

By Kathi Thimsen RN, MSN, WOCN

Hydrogel dressings were one of the first wound care products to change the practice of drying out wounds using caustic agents. Hydrogels drove home the advanced theory of Dr. George D. Winter, referred to as “moist wound healing.” Winter was the scientist that identified and validated the theory that by providing a moist wound environment, the outcomes for patients were those of faster healing and stronger regenerated wounds tissue, with less scarring and pain.

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Diane Krasner's picture

From The Clinical Editor

By Diane Krasner PhD, RN, CWCN, CWS, MAPWCA, FAAN

Introduction

The push towards safety by regulators and payers reflects the evidence that safe healthcare practices have numerous benefits – from reducing sentinel events to improving quality outcomes and helping to avoid litigation (1, 2, 3, 4). The wound care community has been slow to adopt the safety mantra . . . but the time has come to put your “safety lenses” on and to view wound prevention and treatment as a safety issue.

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Laurie Swezey's picture

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

The sheer number of dressings available makes choosing the correct dressing for clients a difficult proposition. Clinicians today have a much wider variety of products to choose from, which can lead to confusion and, sometimes, the wrong type of dressing for a particular wound. Knowing the types of dressings available, their uses and when not to use a particular dressing may be one of the most difficult decisions in wound care management.

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