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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

Heidi Cross's picture
Nutrition Management

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

"Defendants failed to provide adequate nutrition to prevent plaintiff from suffering severe malnutrition and weight loss. This allowed the development of a severe pressure ulcer, numerous infections, and dehydration and malnutrition. Had defendants provided proper care, the pressure ulcer, infections, and malnutrition and dehydration would not have occurred."

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WoundCon Faculty's picture
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By Catherine T. Milne, APRN, MSN, ANP/ACNS-BC, CWOCN-AP and Jayesh Shah, MD, MHA

We are pleased to announce that registration for WoundCon Fall 2020 is now open to all licensed health care professionals at www.WoundCon.com. WoundCon Fall 2020 will be held on November 13, 2020 from 8AM to 6:30PM US EST and will offer up to 13.5* hours of CE/CME credit.

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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.

WoundSource Editors's picture

By Samantha Kuplicki, MSN, APRN-CNS, AGCNS-BC, CWCN-AP, CWS, RNFA

Should pain management interventions be put in place before debriding a venous ulcer?

Without question, yes. Any comprehensive wound treatment plan must include a thorough pain assessment, accounting for cyclical and non-cyclical pain sources. This will best guide interventions based on patient’s unique history, which can potentially include complicating factors such as complex personal pain management secondary to chronic pain, inability to tolerate specific interventions because of existing comorbid conditions, limited financial or social resources, etc. Multimodal pain management is standard of care, using the least invasive options and beginning pharmacologic therapy with the lowest necessary dosage possible.

Paula Erwin-Toth's picture

Paula Erwin-Toth, RN, MSN, FAAN

Hello to my wound care colleagues around the world. As I write this blog, the news relating to the results of COVID-19 continues to provide evidence of the profound impact this pandemic has had on those suffering from the disease and the negative impact shut downs and quarantines have had on the health of people with chronic illnesses. We, as health care providers, are under tremendous stress as many of us have been re-deployed to maintain and support the overwhelming challenges of front-line health care providers serving patients with COVID-19. We, too, are on the front lines helping to maintain skin integrity in critically ill patients who are often intubated and placed in the prone position. The physical, emotional, and financial strains on patients, health care providers, businesses, and governments are going to affect us for years to come.

Alton R. Johnson Jr.'s picture

By Alton R. Johnson Jr., DPM

It all started with a phone call at close to midnight on a Saturday night from my physician’s phoneline app. It was an established wound care patient calling me to state that his negative pressure therapy device went awry. He was requesting advice to resolve the issue. Out of these growing concerns, he stated that if there was no solution, he would be immediately reporting to our hospital emergency room, which was not his preference in such a situation. In response, I simply informed the patient it was safe to turn off the device and that I would make a home visit to him at 5 o’clock the next morning. With a sigh of relief, he agreed to the plan.

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Temple University School of Podiatric Medicine's picture

By Temple University School of Podiatric Medicine Journal Review Club

Venous leg ulcerations (VLUs) are a common and often chronic pathology, and these wounds diminish the quality of life and increase the financial burden for affected patients. A recent article estimates that up to 3% of the U.S. population suffer from VLUs. A venous leg ulcer can be severely painful and may decrease a patient’s quality of life by affecting sleep, mobility, activities of daily living, and even result in social isolation. A 1994 paper proposed that approximately 65% of patients felt financially affected by a VLU, and this number is likely to have increased as a result of rising healthcare costs. The prevalence and chronic nature of the venous leg ulceration has motivated physicians to research novel techniques to heal ulcers successfully and in a timely manner.
Acellular dermal matrices have been utilized to treat diabetic foot ulcers with favorable outcomes.4 This study investigated the efficacy of a specific acellular dermal matrix for VLUs.

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WoundSource Practice Accelerator's picture

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.