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Holly Hovan's picture

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

We have all heard the saying: a dry cell is a dead cell… we know that a moist wound bed is most conducive to healing. If a wound is too dry, we add moisture… and if a wound is too wet, we try to absorb the drainage. There must be a balance of moist and dry to promote an optimal healing environment. Much like a dry cell is a dead cell, a wound that is too moist often has delayed wound healing.

WoundSource Editors's picture

The use of wet-to-dry dressings has been the standard treatment for many wounds for decades. However, this technique is frowned on because it has various disadvantages. In this process, a saline-moistened dressing is applied to the wound bed, left to dry, and removed, generally within four to six hours.

Elizabeth Faust's picture
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By Elizabeth Faust, MSN, CRNP, CWS, CWOCN-AP, DAPWCA

As I reflect on 2020, and I try to think of words to describe it, connected is not a word that I would use. If nothing else, last year isolated us mentally, physically, and emotionally. I have said for years that wound care clinicians often work in silos. Some institutions have only one wound care provider. Even at the larger institutions, the depth of the work to be done may not allow for a team approach. Now there are additional infection prevention guidelines. Wound care specialists are split into teams, clinicians are trying to limit exposure, and telehealth is on the rise. Additionally, our vendor and sales representatives are unable to come in and help us in person. Even when we do get to collaborate with other clinicians or vendors, it is behind masks and goggles, six feet away, or even over the phone. The sense of connection is lost, or perhaps dwindling.

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Holly Hovan's picture
Wound Drainage

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

Wound assessment is one of the initial steps in determining the plan of care, changes in treatment, and the choice of key players in wound management. However, wound assessment needs to be accurately understood and documented by frontline staff to paint a true picture of what is happening with the wound.

WoundSource Editors's picture

Compression therapy is a well-established treatment modality for a number of conditions, including venous disorders, thrombosis, lymphedema, and lipedema. It is also very effective in treating various kinds of edema.1 Based on patient diagnostic data, many patients with these conditions can benefit from targeted compression therapy.

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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.

Temple University School of Podiatric Medicine's picture

By Temple University School of Podiatric Medicine Journal Review Club

Hard-to-heal wounds, such as diabetic foot ulcers, pressure injuries, and venous leg ulcers, comprise a significant portion of health care visits, and these wounds place a physical and economic burden on many patients. These hard-to-heal wounds are defined as wounds with stagnant or delayed stages of healing that fail to resolve within eight weeks. Finding ways to accelerate this healing process is of great importance because it can reduce the physical and economic burden on patients, as well as decreasing costs for health care facilities. Matrix metalloproteinases (MMPs) are endopeptidases, which are involved in many healing processes, including the cell signaling processes, migration processes, angiogenesis, and the degradation of extracellular proteins. These mechanisms are necessary for the wound healing process by breaking down damaged tissue. In the late stages of healing, when breaking down of tissue is no longer necessary, tissue inhibitors of metalloproteinases down-regulate MMPs. In hard-to-heal wounds, this process is thrown off balance, with delays in the subsequent stages of healing. In an attempt to restore this balance, MMPs have been investigated for their role in wound healing through MMP-inhibiting wound dressings. There have been a number of consequential reviews done using current market wound dressings, such as oxidized regenerated cellulose/collagen and Technology Lipido-Colloid with nano-oligosaccharide factor (TLC-NOSF).

Alton R. Johnson Jr.'s picture

By Alton Johnson Jr., DPM, CWSP

Since my last blog post, I was fortunate enough to turn 32 years old. To many of us, turning 32 years old does not seem like much of a big deal, but as an African American man, it is, because the average life expectancy of a Black man in America is 75 years, which is the lowest life expectancy of all ethnicities in America. Essentially, in five years, I will be statistically at my midlife. It is with that mind that I work tirelessly for all patients, but I try to emphasize to African American patients the importance of wound healing, diabetes management, and overall healthy well-being.

WoundSource Practice Accelerator's picture

Wound photo documentation captures a visual reference and helps provide a timeline for healing status for the patient’s medical record. Pictures in wound care can be used to ensure accuracy of measurements, to encourage objective assessments, to reduce the risk of misinterpreting the cause of the wound, as a teaching resource to both patients and new clinicians, and to encourage the use of evidence-based practices. In providing wound care from a distance such as through telewound services, wound photos are taken to help in diagnosis and treatment. The quality of the photo may vary depending on the person taking the photo (clinician, caregiver, patient). However, the emphasis is on using the photo in conjunction with the patient’s clinical wound descriptions and medical history, thereby evaluating the wound, treatment plan, and healing progress. Clinical documentation is a legal, moral, economic, and professional responsibility. Wound photos supplement the written record but should never replace it. Despite the value of wound photography, not all health care settings provide wound photo documentation software or include this as a part of their wound care policies and procedures. The facility or agency should always discuss this issue with the risk manager or legal counsel because each state has its own rules on the use of images.

WoundSource Practice Accelerator's picture

Benchmarking: Benchmarking is using published wound outcomes reported by others as a framework within which to assess your facility’s outcomes and potential need for improved care.

Chronic wound: A chronic wound is a wound that has failed to progress towards healing in 30 days or more. There are varying factors that can cause a wound to stall, such as infection or a prolonged inflammatory phase. It is important to document the wound’s progress, any stalling factors, and interventions put into place to restart the healing cascade.

Digital wound measuring tool: Digital wound measuring tools include devices that may provide two- or three-dimensional assessment (length, width, depth, surface area) of a wound with electronic medical record software integration and may not require physical contact.