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Karen Zulkowski's picture

Part 1 in a series discussing the process of litigation in patient care lawsuits

By Karen Zulkowski DNS, RN, CWS

Hopefully none of you will be involved in a lawsuit over patient care. However, pressure ulcers are the second most common lawsuit (wrongful death is #1) and 50% of patients with a pressure ulcer in the hospital go to a nursing home. That is 3 times the rate of any other reason for nursing home placement. To complicate matters, patients with pressure ulcers frequently go back and forth between the hospital and nursing home as additional medical complications arise and the patient’s condition deteriorates.

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Thomas Serena's picture

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

From the third floor patio of the Foreign Correspondent’s Club (FCC), the evening breeze is a welcome respite from the sweltering heat of Phnom Penh’s hospital wards. An assortment of barges and boats strung with neon lights drifts along the Mekong Delta. This location, made famous by the movie the Killing Fields, has become the meeting place for NGOs (non-governmental organizations) and volunteers of all sorts. Nightly, we would share our tales of life and death in Cambodia’s capital city. A recurring theme was the lack of active ingredients in medicines purchased at local pharmacies. A trio of Brits complained that it was far worse in other resource poor nations. I was appalled that someone would reduce the dose of a medicine for economic gain.

Laurie Swezey's picture

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

Diabetic foot ulcers are one of the most dreaded complications of diabetes, and represent a significant cause of morbidity and mortality. It is estimated that a lower limb is sacrificed every 30 seconds somewhere in the world due to diabetes, and that diabetes is the reason for almost 50% of non-traumatic amputations of the lower leg throughout the world. Considering these facts, proper management of diabetic foot ulcers is of paramount importance.

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

The role of protein in wound healing has been documented in many studies with the focus on offering high calorie, high protein supplements in addition to diet. Protein is responsible for cell multiplication, repair, and synthesis of enzymes involved in wound healing. Protein supplies the binding material of skin, cartilage, and muscle. In wound cases, research supports offering protein above the traditional 0.8 grams/kilogram of body weight recommended for the healthy adult.

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Glenda Motta's picture

By Glenda Motta RN, MPH

Medicare is now beginning round two of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. Congress mandated this through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). This applies to a number of items used by beneficiaries on an outpatient basis. The intent is to reduce beneficiary out-of-pocket expenses and save the Medicare program money, but still ensure beneficiary access to quality items and services.

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Michael Miller's picture

By Michael Miller DO, FACOS, FAPWCA


I just had the most amazing thing happen: I received a letter from my hospital informing me that they were considering creating an Open-Heart Surgery Center. Other than myself, there will be Radiologists, Family Practitioners, and Pathologists all participating in the program. In an effort to share the proceeds from participating in this venture, all participants will be offered four hour time periods throughout the week in which to practice this new specialty. Recognizing that we are not experts in this area of medicine, each of us will be required to take a one-week course in open-heart surgery before being able to hang our shingles outside the clinic.

Ron Sherman's picture

By Ron Sherman MD, MSC, DTM&H

Although maggot therapy has been with us for nearly 100 years, many wound care specialists are still unfamiliar with it. Therefore, we should step back and briefly review the history and general concepts underlying maggot therapy, before delving into the recent scientific literature on this method of biotherapy.

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Aletha Tippett MD's picture

By Aletha Tippett MD

In my work with wounds, I frequently find the absence of a diagnosis of ischemia, or worse, I find a misdiagnosis. Ischemia is caused by severe obstruction of the arteries, which seriously decreases blood flow. If the arteries are in the heart, you will find a heart attack. If the arteries are in the brain, you will find a stroke. In the skin, you will find a wound.

Thomas Serena's picture

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

One of the greatest honors of my life was being inducted into the Athletic Hall of Fame at The College of William and Mary. I was a gymnast there during my college days, a sport I chose early in life. My first loves were basketball and football, but I was always either too small or too light to play these sports competitively for my school teams. Even on the playground I was frequently chosen last in basketball pick-up games. To this day I remain sensitive to team picking. I recently received a call from a physical therapist looking to join my wound care team. Her hospital had enlisted the services of a management company that had marginalized the role of physical therapy in the outpatient wound care center.

Kathi Thimsen's picture

By Kathi Thimsen RN, MSN, WOCN

Hydrogel dressings were one of the first wound care products to change the practice of drying out wounds using caustic agents. Hydrogels drove home the advanced theory of Dr. George D. Winter, referred to as “moist wound healing.” Winter was the scientist that identified and validated the theory that by providing a moist wound environment, the outcomes for patients were those of faster healing and stronger regenerated wounds tissue, with less scarring and pain.

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