Patient Issues

Cheryl Carver's picture

By Cheryl Carver, LPN, WCC, CWCA, DAPWCA, FACCWS

May is Mental Health Awareness Month and with the staggering statistics of one in four adults living with mental illness, I immediately was motivated to write a personal blog. I previously shared my son’s experience here in 2020, in “Wound Management Challenges in Prison Populations,” and discussed the importance of establishing a quality of wound care. I started thinking about the high number of incarcerated people with mental health issues, and it prompted me to conduct a bit more research. Given my son's dual diagnosis of schizophrenia and post-traumatic stress disorder (PTSD), I recall having a conversation with him during this time about debridement methods because advanced wound care would become extremely complicated. I immediately started educating him on possible dressings and debridement methods that could be used on his wound. This gave him an idea of what to expect and allowed him to decline certain treatments if he so preferred.

Christine Miller's picture

By Christine Miller, DPM, PhD

Benjamin Franklin famously stated, “An ounce of prevention is worth a pound of cure.” This statement was made in reference to the importance of fire prevention in 18th century Philadelphia, but it aptly applies to modern diabetic limb salvage. The multidisciplinary model for amputation prevention has been in place now for almost two decades, but how far have we really come? Recent literature suggests that there has not been a significant decline in reamputation rates for diabetic patients despite the team approach to care. Diabetes is a complex and aggressive disease that affects multiple organ systems and robs patients of sight, sensation, limb, and quality of life. Treating such an aggressive disease is challenging, to say the least, and often the desired outcome is not achieved.

Heidi Cross's picture

By Heidi Cross, MSN, RN, FNP-BC, CWON

As detailed in my last few blogs, nutrition plays a huge role in risk for skin breakdown as well as healing of wounds. Just about ALL wound litigation involves nutrition in one way or another, be it diabetes control (or lack thereof) or weight loss, which occurs often in patients with dementia and toward end of life, or general malnutrition.

WoundSource Practice Accelerator's picture

Complex wounds require increased attention, time, and resources to treat. Certain populations, including pediatric patients, immunocompromised patients, and older adults, are at higher risk of developing complex wounds as a result of age or comorbidities. For these populations, a multidisciplinary approach is required for the most effective wound care. Additionally, comprehensive documentation and standardized wound assessments can help clinicians identify areas of concern quickly and proactively given the unique needs of the population.

Dianne Rudolph's picture

Dealing with patients who either can’t or won’t participate in their care can be a challenge for health care providers across all settings. In wound care, this lack of participation can result in greater financial costs, diminished quality of life, and suboptimal clinical outcomes. This is part one of a two-part series on noncompliance in wound care patients. Part one addresses possible reasons for noncompliance. In part two, strategies to address these issues and increase patient participation are discussed.

WoundSource Practice Accelerator's picture

When working with a person who has been living with a chronic wound, it can be frustrating to try to figure out why the wound isn’t closing as the wound healing model would predict. Not all patients follow the “traditional” timeline. The wound may not progress neatly through the four phases of wound healing as expected. There may be an underlying issue that is preventing the wound from healing. How, as clinicians, can we address this? Can we actually expect closure of this wound based on the specific patient’s condition, or should we consider a palliative approach?

Holly Hovan's picture

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

Refractory wounds comprise a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone, as discussed in previous blogs. Wounds that fail to heal not only impact quality of life, but also impose a significant physical, psychosocial, and financial burden. Additionally, individuals with refractory wounds often experience significant morbidity, and sometimes mortality. Wound infections and amputations are common in this population, and chronic conditions often exist as well.

WoundSource Practice Accelerator's picture

Patient education should be a priority to empower patients to care for themselves and improve patient outcomes. Involving patients in their own care can help them to understand about their wound and be more adherent to the overall treatment plan. Remember to involve the caregiver or family if applicable. Ask your patient questions about who will be changing the dressing so the appropriate parties can be involved.

Cheryl Carver's picture

By Cheryl Carver, LPN, WCC, CWCA, DAPWCA, FACCWS

I have again been inspired by my son to blog on a not so talked about topic, scar tissue pain. I have had patients through the years report scar pain, and I admit I did not know too much about it. I decided to dive into this topic a bit more when my son started experiencing frequent pain in his chest. He had a traumatic injury to the chest 14 months ago that healed in six weeks. There is a large amount of thickened traumatic scar tissue because of the depth of the injury. The pain started approximately two months after the wound healed, and he described it as a sharp stabbing pain that would take his breath away.

Cathy Wogamon-Harmon's picture

By Cathy Wogamon, DNP, MSN, FNP-BC, CWON, CFCN

Many questions arise and confusion develops when wound care providers mention Kennedy terminal ulcers (KTUs). Because these wounds are not frequently seen, and because they develop rapidly and observation ends abruptly with the death of the patient, wound care providers may have never observed a KTU, even in a long career in wound care. Although the literature reveals that there is a lack of knowledge regarding the exact cause of a KTU, let’s look at the facts currently known from published resources.