Skin Conditions/Skin Care

By the WoundSource Editors

Maceration occurs when skin has been exposed to moisture for too long. A telltale sign of maceration is skin that looks soggy, feels soft, or appears whiter than usual. There may be a white ring around the wound in wounds that are too moist or have exposure to too much drainage.

By the WoundSource Editors

The World Health Organization declared COVID-19 a pandemic on March 11, 2020. Whether you are a provider or a frontline health care professional, we are experiencing a worldwide increase in “unavoidable” medical device–related pressure injuries (MDRPIs) during the current COVID-19 pandemic. Health care workers are challenged with a higher risk of pressure injury development secondary to prolonged wear time of the N95 mask, face shield, and goggle personal protective equipment (PPE). The intensity of one or more factors of pressure, moisture, shear, and friction influence pressure injury risk.

By Becky Naughton, RN, MSN, FNP-C, WCC

If you've ever had a painful red bump after shaving, you've probably chalked this up to razor burn or an ingrown hair. After an irritating day or so, the bumps will likely fade and disappear on their own, and you don't give it any more thought. But what if these bumps just kept growing and became more and more painful? And even worse, what if they developed in sensitive areas such as the axilla or the groin? What if these bumps got so bad, they eventually opened, started to drain, and even formed tracts under the skin? Not only are these bumps painful, but they are also embarrassing. Forget about wearing a sleeveless shirt or bathing suit in the summer. Would people think you had a horrific contagious disease? You go to doctor after doctor, but no one has been able to treat this successfully. The bumps may disappear for some time but then suddenly reappear. They may leave scars that seem to open and close persistently, and at times they may become infected, requiring antibiotic therapy. Finally, you get the diagnosis for this awful condition: hidradenitis suppurativa (HS).

By Lauren Lazarevski RN, BSN, CWOCN

Calling the COVID-19 pandemic an "unprecedented time" is an understatement. In this time of uncertainty, predicting what to expect can provide some comfort via preparation for the future. We can presume several implications for wound care professionals, based on the clinical course and community response to our evolving situation. Wound care health professionals should be prepared for some unique circumstances on the other side of the curve.

By the WoundSource Editors

Pressure injuries are a significant risk for patients and pose a tremendous clinical challenge to medical providers. Serious pressure injuries can present a substantial threat to patients' survival when comorbidities are present, and even less serious pressure injuries can negatively affect a patient's comfort and well-being. Although some pressure injuries are unavoidable, best practices in patient skin care can greatly reduce the risk in many circumstances, with some research demonstrating that up to 95% of pressure injuries are preventable.

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

Worldwide Pressure Ulcer/Injury Prevention & Awareness Day is November 21st. This day is considered pretty much a holiday at my home. I have Stop Pressure Ulcer tee shirts, and I order a cake or STOP sign cookies every year from the bakery in memory of my mother. To some it might sound crazy, but my life was strongly impacted forever in 1996 after my mother passed away in my arms at only 47 years old because of complications of diabetes and what was called at that time "multiple decubitus." The image and smell will never leave my mind. It changed my life forever as a daughter, a caregiver, and later as a wound nurse. I needed more answers to heal my heart. How could my mother acquire such horrible wounds while at the hospital to get better? My mind was twirling nonstop with the 5Ws. Who, what, when, where, why? So, then it began. I wanted to learn everything I could. This ended up being sort of my therapy, which transitioned into my passion and purpose.

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

Ms. EB, a frail 82-year-old woman admitted to a long-term care facility, had a complex medical history that included diabetes, extensive heart disease, ischemic strokes with left-sided weakness and dysphagia, dementia, kidney disease, anemia, chronic Clostridium difficile infection, and obesity. Her condition was guarded at best on admission, and she had a feeding tube for nutrition secondary to dysphagia. Despite these challenges, she survived two years at the facility.

By the WoundSource Editors

The prevalence of pressure injuries among certain high-risk patient populations has made pressure injury risk assessment a standard of care. When utilized on a regular basis, standardized assessment tools, along with consistent documentation, increase accuracy of pressure injury risk assessment, subsequently improving patient outcomes. Conversely, inconsistent and non-standardized assessment and poor documentation can contribute to negative patient outcomes, denial of reimbursement, and possibly wound-related litigation.

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

As a Director of Nursing, your assessment skills must be tiptop. How are the skills of the staff you are entrusting with the care of our older residents in long-term care? Have you given the staff the tools and time required to accomplish comprehensive and compassionate assessments?

By Margaret Heale, RN, MSc, CWOCN

Not very long ago, when working in an in-patient rehab center, I was shocked to discover patients calling the adult incontinence garments "hospital underwear." We were making good inroads into reducing the use of these products with the hope that if we used less it would be possible to acquire higher-quality products that would function optimally for patients who really needed them. It was of concern that some facilities had become diaper-free because many of our patients benefited from briefs, particularly as a "just in case security blanket" and we felt it was unrealistic for our patient population to be brief-free.