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Aletha Tippett MD's picture

By Aletha Tippett MD

If you care for wounds and have never encountered pyoderma gangrenosum, count yourself lucky. Drawing from my years of experience and the nearly 20,000 wounds I’ve cared for, pyoderma gangrenosum is the most difficult and most challenging. Fortunately it is rare. It can occur anywhere on the body, but most commonly is seen on the legs. It usually starts as a fairly innocuous injury, such as a nick while shaving the leg, or a chip thrown from weed whacking. Antibiotics are used, which are not effective. The wound continues to worsen and grow in size, and now is referred to a wound center or wound specialist.

Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

Microbiota are living organisms that coat the lining of the stomach, small intestine and the colon, which has the highest concentration. They serve as the front line of defense by protecting against incoming microbes, modulating the immune system, exerting anti-inflammatory activity and maintaining intestinal cell activity. While many factors disturb the intestinal microbiota such as age, stress, and poor hygiene, the wide spread use of broad-spectrum antibiotics has led to the increase and severity of Clostridium difficile (C. diff). C. diff is a spore-forming bacterium that releases toxins in the intestine, causing mucosal inflammation, intestinal damage and diarrhea.

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Aletha Tippett MD's picture

By Aletha Tippett MD

Once the individual has been thoroughly assessed for palliative care and his or her objectives and needs have been discussed, the wound care provider must determine the wound management strategy to follow. This strategy will depend upon the type of wound being treated for palliation. A summary of each type of wound and an appropriate palliative strategy are listed below, including factors such as removal of the wound cause, pain and drainage management, and odor control:

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Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWON

How did you acquire your knowledge and skills around the application of NPWT dressings? Most of us learned by observing another clinician doing dressing applications, or from a manufacturer's representative. We likely just imitated what they did, largely winging it. In my work over the past few years, I have been surprised to learn that many excellent clinicians have gaps in technical ability. This article is intended to review principles of NPWT dressing application to increase the accuracy of your techniques. These tips are distilled from principles that are typical of manufacturer guidelines. It is always recommended that you read and follow the manufacturer’s guidelines for the product that you are using.

Michael Miller's picture

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 18

By Michael Miller DO, FACOS, FAPWCA, WCC

One of the problems with writing a blog is not the lack of material on which to vent, vex or vociferate. Rather, I deal with the much desired situation in which there are simply so many aberrancies that appear before my now trifocaled vista, that I have to decide which of many potential entities to offend.

Paula Erwin-Toth's picture

By Paula Erwin-Toth MSN, RN, CWOCN, CNS

Winter weather is upon us and that brings a whole host of challenges. Our skin is more liable to experience dryness, cracking and breakdown. Everyone, especially older adults, are more vulnerable to falls due to slippery steps and walkways. Shoveling heavy, wet snow has been associated with increased risk of heart attacks. Just heading to the mailbox, grocery store or the doctor's office can spell disaster. All of these situations can combine for a 'perfect storm' for risk of skin breakdown at home and all healthcare settings.

Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

Frequently I am asked to review medical records to determine if an individual’s pressure ulcers failed to heal because of inadequate or inappropriate nutritional care. The majority of the cases involve long-term care facilities and the patients are older adults who had unintended weight loss (UWL) and pressure ulcers. After devoting 35 years as a consultant dietitian to nursing homes, I am well aware of the challenges faced by providers as they strive to provide care for our frail elderly.

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Joy Hooper's picture

By Joy Hooper RN, BSN, CWOCN

The appearance of a new stoma on a patient’s abdomen can be shocking for the patient, family members, caregivers, and even some healthcare professionals. Stomas presented in textbooks, educational literature, and diagrams often appear round and “budded.” Patients will sometimes see images of other stomas and compare it to the appearance of their stoma. If their stoma is flush with the skin on the abdomen or retracted they may feel the surgeon did a poor job. Actually, the patient's body can have just as much to do with the appearance of the stoma as the surgeons surgical technique does.

Lydia Corum's picture

By Lydia A Meyers RN, MSN, CWCN

In recent months, I have gained insight into a problem that appears to be universal across the continuum of care and across the country as I’ve worked in different facilities and in different capacities. I have found some people accepting of new information and others that feel they know it all and are unwilling to accept information from their professional peers. As those that know me well know, wound care is my passion. The only thing that hurts more than having a peer professional discount information is seeing the impact it can have on a patient and witnessing the resulting suffering - loss of limbs, loss of quality of life and loss of independence - all because the one making the wound care decisions couldn’t see beyond the end of their nose.

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David Hite's picture

By David Hite PhD

Diabetes, the leading cause of amputation of the lower limbs, places an enormous burden on both the individual and the health care system. It’s estimated that the annual cost for treating diabetic foot problems is over one billion dollars. During their lifetime, 15 percent of people with diabetes will experience a foot ulcer and about 20 percent of those will require amputation.

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