Let’s face it, dressing selection can be overwhelming for clinicians because of the plethora of products that are in the wound care market space. If only there were a multifunctional smart-dressing that could be used on every wound etiology. It would make managing wounds much easier. Practical knowledge of dressing categories, functionality, appropriateness, and reimbursement is key in dressing selection.

By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

“Top-down skin injuries” is an increasingly common term used to describe superficial cutaneous injuries. Top-down injuries result from damage beginning at the skin’s surface or the soft tissue. In contrast, “bottom-up injuries” are often the result of ischemia. Top-down injuries usually result from mechanical forces, inflammation, or moisture. Common top-down injuries are moisture-associated skin damage, skin tears, and medical adhesive–related skin injury (MARSI). In this blog, I focus on assessing, defining, and preventing MARSI.

Chronic wounds of the lower extremities impose an increasing burden on health care providers and systems, and they can have a devastating impact on patients and their families. These wounds include diabetic ulcers, venous ulcers, arterial ulcers, and pressure injuries. The estimated socioeconomic cost of chronic wounds is 2% to 4% of the health budget in Western countries. Moreover, patient mortality in individuals with chronic wounds has been estimated at 28% over a two-year period, significantly higher than the 4% mortality rate reported for 75 to 79 year-olds without chronic wounds.

Chronic and complex wounds of the lower extremity frequently recur. It is difficult to determine the precise recurrence rate across patients with different lower extremity wound types, including diabetic foot ulcers, arterial ulcers, pressure injuries, and venous ulcers. However, we know that recurrence rates are high; nearly 40% of patients with an ulcer will develop a recurrence within one year of healing. This percentage is 60% at three years after healing and 65% at the five-year mark.