Practice Accelerator

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Wound Tissue

by the WoundSource Editors

Successful utilization of the TIME model for wound bed preparation requires a working knowledge of chronic wound tissue types. In addition, building on this foundational knowledge is the development of accurate wound assessment skills. These components combined will assist the clinician in implementing the appropriate interventions for each wound.

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Moisture Management

by the WoundSource Editors

Before embarking on the journey of wound bed preparation, the goals for wound care should be carefully considered. A realistic look at the goals and expectations from the perspective of the patient as well as the wound care team is the first step in developing and implementing the appropriate plan of care.

Is the wound healable? This requires that the individual's body can support the phases of wound healing in an expected time frame. Treatment should be aggressive to prevent any delay in the healing process that would stall wound healing or lead the wound to become chronic. Is maintenance the goal? If so, then efforts should focus on keeping the wound from deteriorating by providing comprehensive wound care. Is hospice or palliative care the goal? If the wound is not expected to heal and the individual's body cannot support the phases of wound healing within an expected time frame, then comfort measures are more important than a cure. All parties should be on the same page with goals and objectives so they are working in tandem toward the best outcome for the individual patient.

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Edge Management

by the WoundSource Editors

For wound healing to occur, a complex, well-defined cascade of events must take place in the body’s natural host processes. When this cascade of events is disturbed, a wound can fall into a state of non-healing or chronicity. In clinical practice, chronic wounds such as pressure ulcers, vascular ulcers, and neuropathic wounds behave differently and may be extremely slow to heal. A chronic wound, by definition, is a wound that has failed to progress through the “normal” healing process or is not responsive to management in a timely manner.

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Bioburden in wounds

by the WoundSource Editors

Bioburden in chronic wounds can be a principal contributor to inflammation, clinical wound infection, and further delayed wound healing. Clinically diagnosing infection in chronic wounds can be problematic because most individuals susceptible to developing chronic wounds are subject to physiological states that often blunt typical infectious responses in various ways. These responses include pain, erythema, febrile state, leukocytosis, edema and increased wound exudate, wound odor, etc.

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by the WoundSource Editors

Bacterial load/burden: Presence of bacterial pathogens in an open wound contributing to wound chronicity and persistence of inflammatory cycle. There are several points along the spectrum of bacterial presence in chronic wounds: contamination, colonization, critical colonization, infection, and sepsis.

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Alginate: Highly absorptive, non-occlusive dressing derived from brown seaweed or kelp.

Antimicrobial dressing: Delivers a sustained release of antimicrobial agents to the wound, to eradicate bioburden.

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Socioeconomic Considerations When Choosing a Wound Dressing

by the WoundSource Editors

As wound care clinicians, we need to take into consideration many different factors in deciding on a treatment plan for our wound patients. Our patients should be evaluated on an individual basis. If we look at our patient’s socioeconomic status, we will find it varies from patient to patient Socioeconomic status clearly affects morbidity and mortality rates related to wounds. Wound management tends to be lower in quality and follow-up visits tend to be fewer in number when compared with patients with better economic status.

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Wound Dressing Selection

by the WoundSource Editors

Do you, as a wound care clinician, know the ingredients of the dressings you are using on your patients? Do you know brand names, or do you know dressing categories? There are over 6,000 dressings, and we as clinicians cannot possibly learn about every dressing. However, learning the categories of dressings, along with indications, can help simplify the puzzle. You first want to ask yourself what you are trying to do. Absorb exudate or donate moisture? Is there a biofilm contained in the wound? Is there a formulation or composition of the dressing that would work best?

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Wound Dressing Selection

by the WoundSource Editors

Selecting advanced wound care dressings is most effective when looking at the “whole” patient. If you are focusing only on the “hole” in the patient, you may not be enhancing the wound healing process as much as you had anticipated. In fact, you may be causing more harm to the wound without realizing it. Remember to always involve your patients in their treatment care plan, if possible. Your patients do not always share what is going on at home or economically. Let’s walk through a couple of case scenarios that may help you think outside the box when choosing a treatment plan for your patient.

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Wound Dressing Selection

by the WoundSource Editors

Dressing selections can be overwhelming for clinicians and providers in health care. There are now well over 6,000 wound care products on the market. Ideally, there would be a multifunctional smart dressing that could “do it all” readily available in all settings. Unfortunately, we as health care providers know, that definitely isn’t the case.