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Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWON

Negative Pressure Wound Therapy (NPWT) has become standard of care for many wound types. Any clinician who works with NPWT dressings will report that a significant number of wounds will develop a malodor, commonly referred to as a “VAC stink.” In response to malodor, clinicians often opt to give the wound a NPWT holiday, which can delay wound closure. In thi article we will look at factors that contribute to malodor, and interventions that might reduce it.

Sue Hull's picture
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Part 3 in a series examining the reduction of facility costs and the continuation of quality care

For Part 1, Click Here
For Part 2, Click Here

By Sue Hull MSN, RN, CWOCN

After recognizing that wound care is expensive, North Mississippi Medical Center (NMMC) assessed the situation to discover possible reasons for why advanced wound care was costing so much. Then they standardized processes, education and products. So, the question is, what happened? Did they reduce costs? If so, did patient care suffer?

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Laurie Swezey's picture
wound tunneling, undermining

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Tunneling wounds can be difficult to heal and often take several weeks to months to close. The following will discuss tunneling wounds and how negative pressure wound therapy can be used to heal them.

Michael Miller's picture

em>By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 12

There are many colloquialisms we use to describe a variety of situations. When someone appears to make a real commitment, we call it “full bore” or “going whole hog” or to use the gambling epithet, “all in”. Commitment is an important part of what we as health care practitioners stand for. You have all read ad infinitum, ad astra, ad mortem of my strongest belief that patients must take an equal role in their care. We provide the recommendations, the rationale and the risks (and benefits, of course) and they decide which of our offerings best suits their beliefs, their desires and for better or worse, their purses. The marketing profession has made millions of consumers purchase items they do not need based on the sex appeal of the turn of a phrase, changing a question of doubt into “iron clad”.

Paula Erwin-Toth's picture

Part 1 in a series discussing the challenges and opportunities in patient/family education

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

Mr. Gillan is a 72 year old man with venous insufficiency. He presents with a venous ulcer on his left lower leg. He has several co-morbid conditions including hypertension, cataracts, and osteoarthritis which includes his hands. His primary caregiver is his 74 year old wife who suffers from diabetes and mild dementia. They do not have any family living nearby. He is being discharged to his home with a primary wound dressing and compression wraps. His discharge instructions include requests for Home Care nursing and follow up with vascular medicine and a pedorthist.

Sue Hull's picture

Part 2 in a series examining the reduction of facility costs and the continuation of quality care

For Part 1, Click Here

By Sue Hull MSN, RN, CWOCN

After North Mississippi Medical Center (NMMC) identified advanced wound care as a costly service, observed that multiple wound care products were being used to perform the same clinical functions, and realized that evidence-based practice would be difficult to implement without standardization, they developed a strategy for change.

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer, RDN, CD, LD, FAND

Fat-soluble vitamins A, E, and K dissolve in fat and are transported in the body attached to lipids and require pancreatic enzymes and bile for absorption. They are stored in the liver and fatty tissue, which is why an excess concentration of fat-soluble vitamins can be toxic. When blood concentrations of fat-soluble vitamins decline, the body simply retrieves them from storage. Individuals with pancreatic insufficiency, cirrhosis or malabsorption syndrome may have low concentrations of fat-soluble vitamins. Consuming sources of fat-soluble vitamins daily is not necessary, but average intake of these vitamins consumed over time is beneficial. The impact of these fat-soluble vitamins in the management of wounds and other conditions will be discussed.

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Michael Miller's picture

By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 11

I have always had a penchant for the ironic. I love a great joke well told, an amusing anecdote well written or a cartoon well drawn. Charles Addams, creator of the Addams family in the New Yorker magazine introduced his “unusual” family by drawing them poised several stories above and looking down upon a group of happy, singing Christmas carolers as they prepared to pour boiling oil on them. I still chuckle when I think about it. I love unusual sayings such as “You have a firm grasp of the obvious”, “You may not be good, but at least you’re slow” or “I can’t see the forest because of the trees.”

Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

According to the National Pressure Ulcer Advisory Panel (NPUAP, 2007), a support surface is “a specialized device for pressure redistribution designed for management of tissue loads, micro-climate, and/or other therapeutic functions (i.e. any mattresses, integrated bed system, mattress replacement, overlay, or seat cushion, or seat cushion overlay).” Because there is no method available to provide weightlessness for our patients, the next best thing we can do to prevent skin breakdown is to reduce pressure on bony prominences as much as humanly possible.

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