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WoundSource Practice Accelerator's picture

Delayed wound healing occurs in various wound types and in patients with significant comorbidities. Hard-to-heal wounds have proven to be a challenging and worldwide crisis resulting in high financial burdens.

WoundSource Practice Accelerator's picture

Biofilms are found in the majority of chronic wounds and pose a critical health threat, causing nearly 80% of refractory nosocomial infections. They also have a damaging virulence mechanism, which induces resistance to antimicrobials and evasion from the host’s immune system. Over 90% of chronic wounds contain bacteria and fungi living within a biofilm construct. Biofilms have been reported as major contributing factors to a multitude of chronic inflammatory diseases. Given the resistance of the bacteria, biofilms increase the risk of infection and cost the health care system millions of dollars annually. Clinicians should have practical knowledge of the role and impact that biofilms play in impeding chronic wounds, thus leading to risks of complications such as infection.

WoundSource Practice Accelerator's picture

Wound debridement is a critical strategy in treating hard-to-heal wounds. It is a process that expedites healing by removing necrotic tissue, non-viable tissue, and foreign material. It can also be used to manage biofilm to prevent infection. Debriding a wound exposes the healthy underlying tissue to promote healing. There are several methods of debridement. Determining the best option will depend on the health care setting as well as the characteristics of the wound being treated.

Diane Krasner's picture
wound care documentation

By Diane L. Krasner, PhD, RN, FAAN

Scope of Practice and Standards of Practice guide nurses and other members of the interprofessional wound care team in caring for patients with wounds. Documentation in the medical record is a key aspect of the standard of practice and serves to record the care delivered to the patient or resident. Your documentation should follow your facility guideline for documentation. Accurate documentation helps to improve patient safety, outcomes, and quality of care.

This WoundSource Trending Topic blog considers general wound documentation dos and don'ts and presents 10 tips for success. Good, better, and best documentation examples are included for each tip.

Temple University School of Podiatric Medicine's picture
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By Temple University School of Podiatric Medicine Journal Review Club

One of the most severe complications of the diabetic foot is diabetic osteomyelitis. The diagnosis of diabetic foot osteomyelitis requires clinical suspicion of infection, and an associated soft tissue infection only increases the likelihood of confirming diabetic foot osteomyelitis. That said, there are still challenges in the diagnosis of osteomyelitis, such as a bone infection without the clinical manifestations of infection. This occurs in approximately half of all hard-to-heal osteomyelitis cases. Currently, the tests used to confirm a diagnosis of diabetic foot osteomyelitis include a probe-to-bone test, radiography, magnetic resonance imaging (MRI), and bone biopsy. Laboratory tests are also used to confirm the diagnosis of diabetic foot osteomyelitis, with the most important biomarker being erythrocyte sedimentation rate (ESR).

Margaret Heale's picture

By Margaret Heale, RN, MSc, CWOCN

I had shopped before lockdown and had not needed to go to a supermarket for a while. Before my first big shopping event, I came across this online video: preventing your kitchen getting contaminated from your shopping. I smiled at the thought of people trying to use an aseptic technique in their kitchen while trying hard not to contaminate the kitchen, its contents, or themselves with imagined glitter (or coronavirus).

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WoundCon Faculty's picture

By: Karen Bauer, NP-C, CWS

How often should ankle-brachial indexes (ABIs) be repeated? If someone has a stage 3 pressure injury to the top of the foot, should compression be held on that extremity?

The Wound, Ostomy and Continence Nursing Society guidelines suggest ABIs every 3 months routinely, while the Society for Vascular Surgery guidelines recommend that post endovascular repair, ABIs are done at 6 and 12 months (then yearly). For open revascularization, surveillance studies can be at 3, 6, and 12 months. Ultimately, many factors play into this. If the ulcer is closing and the limb remains stable, you might forgo frequent ABIs, but if the ulcer is not closing, or the patient has new or persistent ischemic symptoms, you should check ABIs more frequently. As far as compression with a dorsal foot pressure injury is concerned, as long as arterial status has been ascertained, compression can be utilized. The original source of pressure should be removed (shoe? ankle-foot orthotic?). If there is a venous component, cautious compression will aid in ulcer resolution.

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WoundSource Editors's picture

In a recent survey, we asked our WoundSource Editorial Advisory Board members what outdated wound care practices they continue to see in the field. Depending on what health care setting clinicians work in, there are specific guidelines, policies, and procedures that may impact standard of care. Our board members come from a variety of backgrounds, so their answers varied based on their areas of expertise, but there were a few practices that they could all agree should be left in the past. Do you still use any of these?

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WoundCon Faculty's picture

By: Mary Brennan, RN, MBA, CWON, Karen Lou Kennedy-Evans, RN, FNP, APRN-BC, and Diane Krasner, PhD, RN, CWCN, CWS, MAPWCA, FAAN

What is the best way to differentiate between a Trombley-Brennan terminal tissue injury (TB-TTI) and deep tissue injury (DTI)?

Mary: This is the most challenging because these injuries resemble one another. The difference is that a TB-TTI does not evolve as a DTI does. There may be an increase in surface area but no change in the appearance or type of tissue. A TB-TTI will look the same in color and appearance on day 3 or 5 as it does on day 1.

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