Skin Conditions/Skin Care

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

Peristomal pyoderma gangrenosum (PPG) is a somewhat uncommon and challenging condition to diagnose and treat, as no evidence-based guidelines or standard treatments exist. PPG can occur after the surgical placement of an ostomy, impacting approximately 0.5 to 1.5 people per million annually, and accounts for 15% of pyoderma gangrenosum cases. Effective management of PPG requires local and often systemic immunosuppression and topical wound care, which is compatible with being applied beneath an ostomy pouch.

By Cathy L. Harmon, DNP, MSN, FNP-BC, CWON, CFCN

According to the definition from the International Skin Tear Advisory Panel (ISTAP), “a skin tear is a traumatic wound caused by mechanical forces, including removal of adhesives. Severity may vary by depth (not extending through the subcutaneous layer).”

Elizabeth Day Dechant, BSN, RN, CWOCN, CFCN

Diaper rash, more officially known as incontinence-associated dermatitis (IAD), affects hospitalized and incontinent patients of all ages. In my years as a WOC Nurse in a pediatric hospital, IAD has been by far the most frequently treated condition. However, outside of a health care setting, IAD is the most common skin problem in infants and young children who are not yet toilet trained. Diaper rash has plagued babies and new parents for centuries, yet its treatment remains highly debated. For the purpose of this article, I am focusing on the prevention and treatment of diaper rashes in infants and young children, although the principles of topical treatment discussed here apply to all patients.

By Jeffrey M. Levine, MD, AGSF, CWSP

The malodor that emanates from some wounds has been recognized throughout human history, as starkly demonstrated in the ancient Greek play named after the principal character, Philoctetes. Written by Sophocles in the fifth century BCE, Philoctetes (pronounced fil-ok-tee’-teez) was a warrior of outstanding marksmanship who set out to win the hand of Helen of Troy, considered the most beautiful woman in the world. On the journey, his foot was bitten by a snake. The bite caused a chronic, painful wound that emitted such a foul odor that his fellow soldiers abandoned him on the deserted island of Lemnos.

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.

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

Many of us will eventually take on a caregiver role in one form or another. According to the 2020 update, the number of family caregivers in the United States increased by 9.5 million between 2015 and 2020. More than one in every five Americans is now a caregiver in their own home. Because of our aging population, there is an associated increase in demand for caregiving, and there should be an emphasis on education and support for this population.

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

The literature suggests that patients with a high degree of adiposity are more at risk for inflammatory conditions, and the numbers of these patients continue to rise. Increased adipose tissue may impact activities of daily living, continence, and overall quality of life (QoL), among other complications. Abdominal (central) obesity may be associated with incontinence, mechanical and neurogenic changes (chronic strain or weakening of nerves in the pelvic area), and skinfold inflammation or irritation.

By the WoundSource Editors

To understand the concepts of a wound and wound healing, we must examine the skin and its pathophysiology, as well as its unique structures and functions. Skin care and wound management must be grounded in a comprehensive knowledge base of the structure and functions of the skin. The skin is the largest organ of the body, covering approximately 18 square feet and weighing about 12 pounds, or up to 15% of total adult body weight. It requires one-third of an individual’s circulating blood volume to sustain it. Normal surface skin temperature is 92 degrees, compared with a core body temperature average of 98.6 degrees.

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

The purpose of this blog is to bring special attention to common dermatologic conditions connected with drug addiction. Although drugs are well known for their significant impact on all body organs (liver, bladder, stomach, and kidneys), various physical manifestations of drug use are often unknown or underrecognized. Many clinicians and even dermatologists fail to see the many symptoms of drug misuse in the skin. Skin lesions caused by substance use may be induced by the drug itself, an allergic reaction, the drug administration method, or any contaminants or infectious agents that may have been mixed in with the drug. It is possible to identify substance users based on the shape and pattern of their skin conditions. Clinicians can learn these signs to better help patients.

Jeffrey M. Levine MD, AGSF, CMD, CWSP

My colleagues, Barbara Delmore PhD, RN, CWCN, MAPWCA and Jill Cox PhD, RN, APN-c, CWOCN, and I have written a paper,¹ available electronically ahead of print, that reviews the skin failure concept, defines related controversies, and proposes a model for its pathogenesis. Like all other organs, skin can fail; however, experts continue to grapple with definitions, causative factors, and manifestations.