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Ron Sherman's picture

By Ron Sherman MD, MSC, DTM&H

This week I was asked about using maggot therapy for treating a tumor that eroded through the skin, causing a foul-smelling, necrotic draining wound. This is not an uncommon question, and it touches upon several important elements of biotherapy, as well as palliative wound care in general. This is also a timely subject because of the upcoming (third) Annual Palliative Wound Care Conference.

Karen Zulkowski's picture

By Karen Zulkowski DNS, RN, CWS

Last month I talked about the issues that occurred during my husband’s knee surgery. This month I want to bring the focus back to lawsuits and how they arise. What are the implications for the patient and family, and how does palliative wound care fit in?

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Aletha Tippett MD's picture

By Aletha Tippett MD

Palliative wound care is a relatively new field targeting wound treatment for patients at the end of life, or patients with terminal disease or inability to tolerate standard care. The traditional goal of wound care is to heal or prepare for surgical closure, but techniques and procedures used to “heal” a wound can be painful or uncomfortable and very costly, plus patients who qualify for palliative care may not live long enough to heal a wound.

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

Food is a major part of our lives with strong emotional and symbolic implications that encompasses nurturing, cultural, religion, tradition and social values. Nutrition and hydration has an effective role in healing wounds, but cannot prevent an individual with co-morbid conditions at the end of life from suffering or imminent death. This concept is often difficult to explain to the individual and especially to the caregivers who view nutrition and hydration as essential for life.

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Sue Hull's picture

Part 1 in a series examining the reduction of facility costs and the continuation of quality care

By Sue Hull MSN, RN, CWOCN

Remember W. Edwards Deming? We all learned about him in business management, right? He taught and demonstrated that systematic approaches were necessary to improve quality and control costs. Maybe I’m the only one, but I couldn’t really grasp how that principle could be applied to wound care.

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Michael Miller's picture

By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 10

A house call to a delightful 78-year-old lady revealed a history of a hip prosthesis placed three years earlier that unfortunately had become infected. When the first surgeon could not be found (he had moved out of state just in time), his associate opened the hip, carefully lavaged out the “Root Beer Float” material (per the family, an interesting description if I ever heard one), and then closed the hip primarily.

Karen Zulkowski's picture

By Karen Zulkowski DNS, RN, CWS

The past few months I have written about legal cases and palliative care. My plan was to combine them for March. However, my husband had a partial knee replacement at the end of February and I wanted to write about that. My apologies for no March column.

Aletha Tippett MD's picture

By Aletha Tippett MD

With a theme this month of dressings, I think it is time to give gauze its rightful due. There are a number of wound care providers who would say that “gauze has no cause”. Of course, this is said because of the understanding that moist gauze dries out when on a wound, leading to “wet to dry”, which is a major no-no according to CMS. This wet-to-dry results in debridement of viable tissue. It is also because of the belief and practice that a gauze dressing needs to be changed daily, and with all the cost-consciousness, this makes it more expensive than a once-a-week higher end dressing. However, in real life, how often does a once-weekly dressing actually last the full week, especially on a sacral or buttock wound?

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Laurie Swezey's picture

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

There are more than 3,000 types of wound dressings available on the market today, and more are being launched every day. Although there are a number of protocols and algorithms available to help with the selection of wound dressings,1,2 and individual facilities are likely to have their own dressings of choice, the decision can still seem overwhelming. Even the most seasoned wound care practitioner can find it difficult to assess the advantages and disadvantages of each dressing available and to make the appropriate choice for a particular patient. Rather than consider each dressing in isolation, a useful technique can be to mentally place each type of dressing on a continuum of occlusion.3

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Kim Coy Decoste's picture

By Kim Coy DeCoste RN, MSN, CDE

It can be quite concerning when you ask your patients attending a DSME class “How many of you have had your feet checked for blood flow and nerve function by your health care provider?”, and far less than half of them raise their hands. Probing a little further, you find that a number of patients have never even had their feet visually inspected by their health care provider (HCP) for signs of diabetic foot ulcers. This isn’t unique to my practice site. Recently when I was teaching a professional education program with diabetes educators from across the US, most in the group concurred with my findings.

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