Education

Martin Vera's picture
Wound Assessment

By Martin Vera, LVN, CWS

Throughout my career I have been lucky enough to be part of several nursing branches: home health, long-term care, acute care, long-term acute care hospital, hospice, and even a tuberculosis hospital; wounds have no limitations on where they will appear. As a passionate clinician, teaching, coaching, and mentoring have become a huge part of what I do, as is true for most clinicians. We are teachers, coaches, and mentors driven by passion and wanting to help and put in our “two clinical cents” or “stamp” on the industry. I frequently converse with clinicians in my area, all part of SWAT (skin and wound assessment team), and talk about how it takes a village. I especially enjoy talking with my good friend and mentor Jesse Cantu, RN, BSN, CWS, FACCWS, who is a passionate clinician with a fire that gets you all excited—those who know him know what I am talking about.

Susan Cleveland's picture
Support Surfaces for Special Populations

By Susan Cleveland, BSN, RN, WCC, CDP, NADONA Board Secretary

Certain patient populations—such as the critically ill, those with spinal cord-injuries, and bariatric individuals—need special interventions and support surfaces to prevent pressure ulcers. These recommendations address the unique needs of these special populations in relation to pressure redistribution, shear reduction, and microclimate control.

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Susan Cleveland's picture
Support Surfaces

By Susan Cleveland, BSN, RN, WCC, CDP, NADONA Board Secretary

On occasion there are Administrators or a Director of Nursing who are amazed (not surprised) that despite their use of pressure-“relieving” mattresses and chair cushions, their facility is still experiencing in-house acquired pressure ulcers. Of course, a teaching moment presents itself, and the lesson begins. The items referred to are going to “redistribute” pressure, not relieve it, so there is either a lack of understanding or a misuse of terminology, and clarification is necessary

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WoundSource Practice Accelerator's picture

by the WoundSource Editors

Acute Wound: A wound that is following a predicted pattern of healing that should result in complete functional closure.

Chronic Wound: A wound that has failed to re-epithelialize after three months, usually because of failure to progress past the inflammatory phase of wound healing.

WoundSource Practice Accelerator's picture
Evaluating Patient Risk Factors

by the WoundSource Editors

Surgical site infections (SSIs) are the most prevalent surgical wound complications, comprising approximately 15% of all health care–associated infections, with more than 500,000 reported yearly. Preventing SSIs is perhaps the best way to prevent further surgical wound complications. There is not a large, differentiable list of subsets of surgical wound complications that are treated with separate, discrete interventions; many complications, such as wound dehiscence, are direct results of SSIs. As such, an overview is provided with strategies to manage and prevent SSIs.

WoundSource Practice Accelerator's picture
Surgical Wound

by the WoundSource Editors

The Centers for Disease Control and Prevention (CDC) estimate approximately 30 million surgical procedures are performed annually in the United States. Advances in technology have afforded patients options such as minimally invasive surgery, commonly known as laparoscopic or arthroscopic surgery, which tend to result in much smaller (1cm–2cm) incisions. However, some procedures necessitate larger incisions of varying size, potentially 10cm,–20cm or greater, depending on type of procedure, body habitus, and anatomic area involved. These longer incisions create larger surgical wounds with greater potential for chronicity and complications.

Margaret Heale's picture
Clean Technique

By Margaret Heale, RN, MSc, CWOCN

Having read a recent article on clean versus sterile dressing technique, commenting again on this issue seems highly appropriate. The conclusion of the paper essentially is that a clean technique for acute wound care does not affect the incidence of infection. There is insufficient evidence in the literature relating to chronic wound care. I particularly appreciated the comment that nurses need to decide which approach to have by using critical thinking skills. I was reminded of a visit to a patient to utilize a fancy new dressing that I had never used before.

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WoundSource Practice Accelerator's picture

by the WoundSource Editors

Callus: Localized area where the stratum corneum is thickened, typically found bordering ulcerations on the plantar, medial, and lateral surfaces of the foot; in the setting of diabetic foot ulcer , this indicates an area of repetitive external pressure or trauma.

Cellular and/or tissue-based product : Engineered products created to promote biological repair or regeneration of wound tissue by providing signaling, structural, or cellular elements with or without systems that contain living tissue or cells.

WoundSource Practice Accelerator's picture
Diabetic Foot Ulcer Prevention

by the WoundSource Editors

Comprehensive treatment of diabetic foot ulcers (DFUs) includes moist local or topical wound care, serial sharp debridement, treatment of infection, mechanical offloading, glycemic control, nutritional management, and overall chronic disease management. These facets of therapy are best addressed by an interdisciplinary approach.

If we understand the principles of healing, what can we do to prevent the pathologic process of DFUs? Instituting measures to prevent development of DFUs can decrease morbidity and mortality. There are several organizations with guidelines for prevention of DFU and subsequent complications including amputation, infection, and loss of independence. This article will review the highlights of some of the most recent guidelines for DFU prevention.

Cheryl Carver's picture

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

As it stands now, we have 1.6 million nursing home residents in the United States; that number is expected to double by the year 2030. Bringing advanced wound care to the long-term care arena is becoming more common throughout the country. Physician-based wound groups can bring their expertise to the patient's bedside, thereby saving the patient pain during transport to the wound center and lowering costs. However, certain procedures—such as total contact casting and bioengineered skin substitutes—cannot be performed at the bedside because of billing and reimbursement guidelines.

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