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Gregory Schultz's picture
Biofilm Frequently Asked Questions

By Gregory Schultz, PhD

In my recent WoundSource webinar on the assessment and treatment of chronic wounds and biofilms, I discussed the pathogenesis of chronic wounds and offered a biofilm-based wound care protocol to promote healing.

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WoundSource Practice Accelerator's picture

by the WoundSource Editors

Epidermis: the outer layer of the skin, which is the protective layer against the outside elements.

Epithelialization: the growth of the epidermis over a wound during the remodeling stage.

Granulation: condition occurring in a full-thickness wound where the growth of small vessels and connective tissue forms “scaffolding” as the wound rebuilds.

WoundSource Practice Accelerator's picture
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by the WoundSource Editors

There has been extensive research on how to prevent skin care-related skin breakdown, and most research agrees on a few main components. Eliminating skin contact with sweat, urine, and stool reduces the risk of maceration and incontinence-associated dermatitis and thereby helps to prevent or minimize skin breakdown. Proper mattress selection and offloading devices are important for minimizing the impact of weight on bony prominences. Nutritional therapy is also a key component of maintaining skin integrity. This is because this therapy supplies nutrients that the body requires, as well as hydration. Turning, repositioning, and avoiding the impact of shear force when adjusting the patient are important to eliminate mechanical forces that can break down the tissue. Most importantly, having a consistent method to assess skin integrity and using a validated scale such as the Braden Scale for Predicting Pressure Sore Risk® (Braden Scale) are the most effective methods of tracking changes and implementing the necessary interventions based on the area or areas of deficiency.

WoundSource Practice Accelerator's picture

by the WoundSource Editors

Those working with at-risk populations must be aware of how to address the skin care needs of our patients and prevent pressure ulcers and injuries. At-risk populations, such as older adults, persons who are incontinent, pediatric patients, immobile patients, post-operative patients, and those with chronic disease processes and spinal injuries, for example, are most at risk for developing pressure ulcers. Those patients who have comorbidities such as obesity, diabetes, and cardiovascular disease are at additional risk.

WoundSource Practice Accelerator's picture

by the WoundSource Editors

Periwound skin management is just as important as wound bed preparation in wound healing. The goal of periwound management is to maintain an optimal moist wound healing environment while preventing skin breakdown and infection. Skin is more vulnerable in patients with certain comorbidities and conditions. Periwound skin breakdown is just one of the culprits that delay wound healing and increase pain. It is important to identify conditions and risk factors early in your wound assessment to help prevent any risk of wound progress declination.

WoundSource Practice Accelerator's picture

by the WoundSource Editors

The skin is the largest organ of our body, covering 18 square feet and weighing approximately 12 pounds. Despite positive characteristics, the skin is always susceptible to and at risk of injury and breakdown. Maintaining skin integrity equals maintaining skin health, and this includes people of any age. Older adults are at a higher risk because of the skin aging process. As skin ages, the junction between the epidermis and dermis thins and flattens, reducing circulation. Moisturizing factors in older adults also reduce, thus causing dry, flaky skin and increased risk of skin breakdown.

Kelly Byrd-Jenkins's picture
Outpatient Wound Care

by Kelly Byrd-Jenkins, CWS

What you do in the outpatient center is not easy, and not everyone is doing it. In many cases, they'd prefer to let us decipher this challenging demographic's path to healing. Patients we're entrusted to serve are complex in their needs, diagnoses, and compliance with our treatment plans. We see them frequently, often over extended periods of time, and due to the very nature of their mixed, long-standing wound etiologies, we don't always get to see complete and total healing for quite some time. These are etiologies we aren't managing, but must factor in to be effective. Considerable time is spent equipping these patients for personal success by coordinating resources and providing education. And for the patient whose end goal is stability, we recognize that outcome as success each time we see them.

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Fabiola Jimenez's picture
Education

By Fabiola Jimenez, RN, ACNS-BC, CWOCN

I recently celebrated 30 years in nursing and completed my fourth year as a certified wound, ostomy and continence nurse. Since I took my current position in November of 2014, I have conducted Annual Skin Care Skin Fairs, usually in the fall. In the spring, to coincide with Nurses' Week, I join the hospital nursing educator and host the mandatory equipment fair where the staff is required to put hands on the various equipment we use in patient care. Twice a month during nursing orientation I present the products used for skin care, basics of wound care, and ostomy care. The staff is encouraged to return during subsequent months during new staff orientation and reinforce skills with which they do not feel comfortable.

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Cheryl Carver's picture
Heart Health

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

With the millions of people living with chronic wounds, there are also millions of people living with cardiovascular disease. Every year, there are approximately 670,000 Americans diagnosed with heart disease. This equals more than one person diagnosed each minute! The skin may be the largest organ, but the heart is most vital in circulating oxygen and nutrient-rich blood throughout your body. A healthy heart is a leading factor in wound healing. Cardiovascular diseases that impede healing include peripheral arterial disease, coronary artery diseases, heart failure, and other heart and vessel issues that can inhibit blood, oxygen, and nutrition in wound healing.

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Holly Hovan's picture
Medical Device Related Pressure Injury

by Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP

Recently, one of my awesome staff nurses coined a phrase that stuck with me—Mr. DoctoR Pressure Injury (MDRPI), also known as medical device-related pressure injury. MDRPIs are a common yet usually preventable problem. We wanted to raise awareness of MDRPIs for World Wide Pressure Injury Prevention Day in November of 2018, and one of our staff nurses was quite creative in doing so! She thought of using a doctor’s briefcase with medical devices inside, many of which can and do cause pressure injuries. Being creative and using acronyms are great ways not only to engage staff, but also to be sure that they remember the information provided to them. Additionally, hands-on props and interactive stations require engagement, which appeals to many different types of learners.