Wound Care 101

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Preventing Cross-Contamination

Surgical site infections (SSIs) are wound infections that occur after invasive surgical procedures. Depending on the location of the wound and the level of post-operative care that the patient receives, the risk of developing an SSI can be as high as 20%,1 although across all patients undergoing inpatient procedures in the United States, the rate of SSI occurrence is between 2% and 4%.2

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Preventing Post-Operative Complications

Surgical complications impact many patients every year, and when post-operative complications occur, they can disrupt the normal healing cycle and introduce new challenges in patient care. It is estimated that between 3% and 27% of surgical patients have unforeseen complications related to their surgical event.1

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By Temple University School of Podiatric Medicine Journal Review Club

An appropriate timeline to initiate biofilm-based wound care (BBWC) has been a topic of question since the incorporation of biofilm therapy was introduced. In hard-to-heal delayed wounds, it is largely agreed upon that biofilms are a significant barrier to healing, and that removal is essential. By definition, hard-to-heal wounds are wounds that have failed to respond to evidence-based standard of care and contain biofilm. Biofilms are polymicrobial communities residing in an extracellular matrix produced by bacteria, which is well-hydrated and resistant against antimicrobial agents and host defenses. Biofilm can form within hours, can reach maturity within 48-72 hours, and has the ability to regrow within 24-48 hours. A first critical step to BBWC is debridement, though it requires additional suppression methods, as well as considerations of a patient’s risk factors. Risk factors include peripheral vascular disease, infection, diabetes, and pressure off-loading, which encourage biofilm development by delaying wound healing. Risks and costs with early BBWC are most likely less than those associated with biofilm-related wound complications. Thus, in March 2019, a panel of nine experts met in London for an Advisory Board Meeting, where they developed solutions to barriers preventing early BBWC and methods of appropriate “wound hygiene” for all health professionals. They reconvened in the summer of 2019 to create a clinical consensus document published in the Journal of Wound Care supported by ConvaTec Limited.

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By the WoundSource Editors

Collateral circulation: A collateral blood vessel circuit that may be adapted or remodeled to minimize the use of occluded arteries. Collateralization may offset some of the physiological signs of peripheral artery disease, such as maintaining a normal capillary refill.

Critical limb ischemia: A severe form of peripheral arterial disease in which a severe blockage of the arteries of the lower extremities reduces blood flow. It is a chronic condition that is often characterized by wounds of the lower extremity.

Dependent rubor: A light red to dusky-red coloration that is visible when the leg is in a dependent position (such as hanging off the edge of a table) but not when it is elevated above the heart. The presence of dependent rubor is often an indicator of underlying peripheral arterial disease. When the leg is raised above the level of the heart, its color will normalize.

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By Miranda Henry, Editorial Director of WoundSource

Whether meeting with patients via telehealth at your home-based office or doing rounds at the clinic, WoundSource is still there to provide you with the most trusted and up-to-date wound care education and product information.

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By Catherine T. Milne, APRN, MSN, ANP/ACNS-BC, CWOCN-AP

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.

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By the WoundSource Editors

Studies have shown significant value in moist wound healing as opposed to treatment of wounds in a dry environment, and clinical evidence has supported this view for many years. Moist wound healing has been shown to promote re-epithelialization and can result in a reduction of scar formation because a moist environment keeps new skin cells alive and promotes cell regrowth. Treatment of wounds in a moist environment additionally shows promise for the creation of a microenvironment conducive to regenerative healing without scar formation. For these reasons, clinicians often select dressings that will create and manage a moist wound environment.

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Margaret Heale's picture

By Margaret Heale, RN, MSc, CWOCN

Nurses week, which took place in May, may have fallen a little flat this year, as employers were not able to gather staff and celebrate as they might otherwise have done, but the caring continues. As a group, we have been recognized as essential. In managing wounds, nurses play a vital role in supporting patients' progress toward healing, as well as prevention. It is likely our recognition will last a while, as generally nurses come out on top in polls that ask which profession is the most trusted and caring. Unfortunately, our assistant colleagues, who care just as much, don't do so well when it comes to their pay packet.

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Chronic Wounds

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.

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Edema

By the WoundSource Editors

Edema is swelling that occurs when there is an excessive amount of fluids within the intracellular space, typically within subcutaneous tissues. Edema is more commonly experienced in the lower extremities and other areas that are farther from the heart. Edema may be dependent, caused by gravitational forces on the fluids that are greater than the mechanisms designed to overcome these forces. Edema may also be generalized throughout the entire body or localized, restricted to a single area.

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