Education

Fabiola Jimenez's picture
Nurse helping to educate coworker

by Fabiola Jimenez, RN, ACNS-BC, CWOCN

I consider the art of communication one of my greatest deficits as a health care professional. Learning about words and how we communicate sparks my interest. How amazing is it that someone can understand exactly what we are saying, since what we hear is influenced by perception, context, time, tone of voice, and so much more? I can easily relate to the Bible story about the Tower of Babel. At times I feel like I am living it. I am very interested in learning ways in which I can communicate better and share with everyone what I know and feel about wound care and the opportunity to do it all within the wound, ostomy, and continence (WOC) role.

Blog Category: 
Martha Kelso's picture
Frequently Asked Questions

by Martha Kelso, RN, HBOT

On July 24, 2018, I presented a webinar on the topic of the TIME (tissue management, infection or inflammation, moisture balance, and edge of wound) model of wound bed preparation as part of WoundSource's Practice Accelerator series on wound bed preparation. Preparing a wound for healing is key to ensure that chronic wounds convert to healing wounds. The TIME mnemonic for wound bed preparation assists clinicians and bedside nurses to think critically when making decisions on treatment options.

Blog Category: 
Marta Ostler's picture
Keywords: 
Wound Dressing Selection Facts and Questions

By Marta Ostler, PT, CWS, CLT, DAPWCA

On June 28, 2018, I presented a webinar on the topic of wound dressing selection as part of WoundSource's Practice Accelerator series on Wound Dressings 101. Choosing an appropriate wound dressing for your patient can be a difficult task; however, understanding this important step in the wound healing cascade is integral to maintaining and achieving healing outcomes for our patients with chronic and acute wounds.

Blog Category: 
Janet Wolfson's picture

by Janet Wolfson, PT, CLWT, CWS, CLT-LANA

In March of 2017, regular readers of this blog may recall "Making a Daily Difference in Preventing Pressure Injuries." I imagined a wonderful facility where staff went about their duties with a corner of their brain always attentive to how patients' diagnoses, activities, and comorbidities could affect the tendency to develop a pressure injury (ulcer). Magically, the appropriate prevention occurred.

Blog Category: 
Aletha Tippett MD's picture
Tetanus Immunization

by Aletha Tippett MD

Tetanus is a multisystem disease that occurs worldwide and is caused by the bacterium Clostridium tetani. This bacterium is present in feces and soil. Tetanus has been mostly eradicated in the United States because of childhood immunization; however, there have been reported cases among immigrants, as well as young adults who partake in higher-risk behaviors such as body piercing and tattooing and those who fail to maintain adult booster immunization. Other risk factors include diabetes or chronic wounds. It is fatal in approximately 10% to 30% of cases. Tetanus can be localized (with muscle contractions in the part of the body where the infection began) or generalized (affecting the entire body). Most reported tetanus cases are generalized.

Blog Category: 
Temple University School of Podiatric Medicine's picture
Temple University

Diabetic foot ulcers do not always respond well to conventional wound healing methods for a multitude of reasons. Fibroblasts in people with diabetes have decreased migration and proliferation potential as a result of increased metalloproteinase levels in the wound bed of diabetic foot ulcers. These patients are also prone to bacterial infection within the wound because of the immunocompromised status of a patient with diabetes. Negative-pressure wound therapy (NPWT) can mediate these issues. The precise mechanism of action of NPWT is not clearly defined, but some possibilities have been conceptually determined. NPWT stimulates cell activity and migration, decreases bioburden in the wound by removing fluid, and reduces edema. However, the authors theorized that the increased pressure induced by NPWT on the skin could cause decreased tissue oxygenation in the wound bed.

Blog Category: 
Janet Wolfson's picture
Lymphedema patients doing yoga

by Janet Wolfson PT, CLWT, CWS, CLT-LANA

For a long time, it was debated whether patients with lymphedema should partake in an exercise regimen. Today, fears of overloading the lymphatic system and of causing injuries have been resolved by research findings; however, there are precautions to take, and some types of exercise are more beneficial than others. When done correctly, these exercises can improve strength, quality of life, and ability to care for oneself and others, increase range of motion, decrease pain, and even reduce edema. Lymphedema-specific programs have been developed by wonderfully creative and knowledgeable people, too. As always, patients must consult with a health care provider before embarking on a new exercise regimen. If you are managing a patient who lacks strength or full range of motion, has difficulty in daily activities, or has problems walking, therapists can help develop a safe program and improve deficits to work up to a recreational exercise program.

Blog Category: 
Margaret Heale's picture
Wound Research Data Review Including Outliers

by Margaret Heale RN, MSc, CWOCN

When looking at randomized controlled trials one of the first things you read is a one liner, "subjects were matched," and there may be a list that includes stage of pressure injury, size of wound, age, sex, and a myriad of other things somebody decided to include. There may also be exclusion criteria such as uncontrolled blood sugar, obesity, and being over 60 years old. It makes sense to do this, and there is no doubt that once you have got homogenous groups and compare the outcome of one with another, after whatever intervention you wish to discover the worth of, the result may look gratifyingly convincing.

Blog Category: 
Janet Wolfson's picture
Lymphatic System

by Janet Wolfson PT, CLWT, CWS, CLT-LANA

Manual lymphatic drainage (MLD) was developed by Emil and Estrid Vodder in the 1930s. They dedicated their lives to the study of lymphatic anatomy and physiology. Since then, others have modified the original techniques, including Foeldi, Leduc, Casley-Smith, and Bjork. They all involve manual contact with the client, deep diaphragmatic breathing, stimulation of the lymph nodes, and movement of fluid from proximal and then distal areas. The manual contacts are slow, gentle, and rhythmic. Practitioners are typically occupational or physical therapists, physical and occupational therapy assistants, nurses, massage therapists, and physicians. Many practitioners, after a required 135-hour training program, complete the Lymphedema Association of North America (LANA) certification exam.

Blog Category: 
Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

Evolving negative pressure wound therapy (NPWT) technology including instillation therapy, nanocrystalline adjuncts, and portable systems can further improve results if used with correct indications. In diabetic foot management, NPWT has had a significant impact on limb salvage. However, it is important to emphasize that diabetic foot management is a multidisciplinary effort, and NPWT is only one of the essential tools in overall management. Successful outcome is heavily dependent on all treatment modalities, including adequate wound debridement, appropriate antibiotic therapy, optimization of healing markers, and meticulous wound monitoring.

Blog Category: