Wound Care 101

3M Health Care's picture
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Chronic wound care is challenging for the entire healthcare ecosystem, from clinicians to patients, and COVID-19 has only exacerbated those challenges. Patients are delaying primary care provider and wound clinician visits for ongoing guidance and therapy to reduce possible exposure to the virus. This is understandable, as many chronic wound patients are in the high-risk category if they become ill with COVID-19.1 They are also putting off elective surgeries, annual physicals, and basic preventive care, which can negatively affect long-term outcomes.

Emily Greenstein's picture
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Emily Greenstein, APRN, CNP, CWON, FACCWS

Wound care has evolved from treatments based on superstition to systematic, evidence-based care. The history of wound healing dates back to 2000 BCE. Various civilizations over the centuries had differing approaches to wound care.

WoundSource Practice Accelerator's picture

Human skin is home to many types of bacteria, fungi, and viruses that compose the skin microbiota or microbiome. As with microorganisms in the gut, these organisms have an important role in protecting from pathogens and breaking down natural products. The sheer quantity of life found in the skin microbiome is staggering. It often contains up to one billion microorganisms on a single square centimeter.

Becky Naughton's picture

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

As a wound care nurse practitioner, when I see granulation tissue start to form on a wound, I do a little happy dance. Granulation tissue is a sign that the wound is on its way past an often-stubborn inflammatory phase of healing and progressing into the building phase of proliferation. But what exactly is granulation tissue? And why does its presence indicate that the wound is healing? Let’s explore this a bit more.

Holly Hovan's picture

By: Holly M. Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Every year, on the first Saturday of October, we celebrate ostomy awareness day. This is a significant day. Ostomies truly are lifesavers for so many people, and it is important that we bring awareness, education, and support to our patients, peers, and community.

This year, the United Ostomy Associations of America (UOAA) is celebrated the 10th anniversary of National Ostomy Awareness Day (this event began in 2010). More information on this day and virtual events can be found here: https://www.ostomy.org/ostomy-awareness-day/

WoundCon Faculty's picture
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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.

Cathy Wogamon's picture

By Cathy Wogamon, DPN, MSN, FNP-BC, CWON

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:

WoundSource Practice Accelerator's picture
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

WoundSource Practice Accelerator's picture
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

Temple University School of Podiatric Medicine's picture

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.