Wound Care 101

Heroes are regular folks put into a circumstance they did not ask for. Faced with the impossible, they pull off the improbable. You know – Harriet Tubman, Captain Chesley "Sully" Sullenberger and his Co-pilot Jeff Skiles, first responders during 9/11, Veterans. 2020 also has its heroes. This year has been designated the Year of the Nurse and Midwife by the World Health Organization in honor of Florence Nightingale's birth in 1820. Little did we know when it was announced in 2019 that our biggest professional challenge was right around the corner.

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS Wound irrigation, when performed properly, can enhance wound healing. It is not as simple as pouring normal saline over a wound prior to dressing it – it must be performed properly in order to get the most out of this frequently misunderstood intervention.

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.

Ballistic wounds are those attributed to trauma from firearms. Worldwide, these injuries resulted in approximately 270,000 deaths in 2016 alone.

By Michel H.E. Hermans, MD How should I treat a patient with a partial-thickness burn on less than 10% of their body but poor vascularity? It is not possible to give a specific answer to this question because burns larger than 10% could be anywhere from 11% to 99%. As mentioned in the presentation, larger burns cause burn disease with all its potential complications. “Poor vascularity” is a bit vague. If it is the result of diabetes, then the disease itself, including the typical microvascular problems, will contribute to poorer healing. On the other hand, peripheral arterial disease usually does not have a significant impact on the healing of partial-thickness burns unless occlusion is very severe.

Communication issues have arisen in the wound care world while providing care during the coronavirus disease 2019 (COVID-19) pandemic. Many of our older adult patients may already have hearing issues and rely on reading lips, which is impossible with the recent advent of masking and face shields. In addition to the masks, it is often difficult for patients to differentiate who is who when we are all in full protective gear. How can we make communicating with our patients less difficult during these trying times? Here are a few suggestions:

by the WoundSource Editors In approaching the management of a chronic wound, the first step in developing a treatment plan that will combat chronicity and promote healthy healing of damaged tissue begins with understanding the different types of wounds.

by the WoundSource Editors The returning wound patient is in for reassessment. They are positioned for maximum visualization of the wound. You remove the dressing. Clean the wound. After a few additional steps, it's time to measure the wound's progress. Using your measurement tool, you take careful note of the wound’s measurements. In comparing the measurement with the previous visits, you realize that the wound has stalled out.

By Heidi Cross, MSN, RN, FNP-BC, CWON In my recent WoundSource webinar, I discussed the topic of chronic wound etiology and management. The webinar is still available for viewing on WoundSource.com. Chronic wounds are vexing and frustrating to manage; they can be expensive and are a huge source of morbidity and mortality. Infection prevention is a key part of chronic wound management, with recognition of the role that biofilms play.