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Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

Ideally, most wound care professionals may want to prevent surgical wound dehiscence before it occurs. If clinicians prevent dehiscence, the healing process and, subsequently, the patient's ability to return to normal daily activities is typically quicker. Some methods to prevent surgical wound dehiscence include supporting the abdomen when coughing, sneezing, or moving around/sitting up in bed, avoiding strain or pressure to the wound area (heavy lifting, exercise, coughing, constipation/straining with bowel movements), and maintaining a good diet and good oral intake to prevent dehydration. It is essential to practice good hygiene, keep the wound clean, dry, and intact, and follow the provider's specific instructions on wound care and any prescribed medications.

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By Holly M. Hovan MSN, APRN, GERO-BC, CWOCN-AP

Chronic wounds impact more than 8 million Americans in a multitude of ways ranging from affecting quality of life along to creating a significant economic burden, with the estimated cost of care in the United States currently at 30 billion dollars. As technology and medicine continue to advance, our aging population continues to grow, and those impacted by chronic wounds are likely to increase. This blog will take it back to the basics—using our senses to guide wound assessment and management—while incorporating technology/telemedicine and wound photography to guide treatment and track progress.

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Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

Peristomal pyoderma gangrenosum (PPG) is a somewhat uncommon and challenging condition to diagnose and treat, as no evidence-based guidelines or standard treatments exist. PPG can occur after the surgical placement of an ostomy, impacting approximately 0.5 to 1.5 people per million annually, and accounts for 15% of pyoderma gangrenosum cases. Effective management of PPG requires local and often systemic immunosuppression and topical wound care, which is compatible with being applied beneath an ostomy pouch.

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Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

“Top-down skin injury” is an increasingly common term used to describe superficial cutaneous injury. These injuries result from damage beginning at the skin’s surface or soft tissue. In contrast, “bottom-up” injuries are often the result of ischemia. Top-down injuries are usually caused by mechanical forces, inflammation, or moisture. Medical adhesive-related skin injury (MARSI) is a frequently seen type of top-down skin injury that is almost always preventable. In this blog, I focus on preventing MARSI and describe the different techniques and adhesives (along with adhesive alternatives) available for use.1

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By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Moisture-associated skin damage (MASD) is becoming increasingly prevalent in today’s health care system. Often associated with discomfort and pain, MASD ultimately negatively impacts quality of life. MASD is usually broken down into 3 or 4 categories, most commonly incontinence-associated dermatitis (IAD), intertriginous dermatitis, periwound dermatitis, and peristomal dermatitis. In this blog, I focus on the prevention and treatment of IAD and subsequent pressure injuries in critical care through a nurse-led approach.

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By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Pressure injuries (PIs) typically are the result of unrelieved pressure, shear, or force. In an inpatient or hospital setting, interventions are put into place to prevent pressure injuries based on evidence and patient risk. However, PIs still develop in some patients despite interventions. Experts agree that most PIs are in fact avoidable; however, some patients may experience unavoidable skin breakdown at end of life (EoL).¹ Kennedy terminal ulcers (KTUs), skin changes at life’s end (SCALE), and Trombley-Brennan terminal tissue injuries (TB-TTIs) are some of the common terms used to describe unavoidable skin changes at EoL.¹

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by Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

The literature suggests that patients with a high degree of adiposity are more at risk for inflammatory conditions, and the numbers of these patients continue to rise. Increased adipose tissue may impact activities of daily living, continence, and overall quality of life (QoL), among other complications. Abdominal (central) obesity may be associated with incontinence, mechanical and neurogenic changes (chronic strain or weakening of nerves in the pelvic area), and skinfold inflammation or irritation.

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Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Standards of care and evidence-based guidelines should lead our wound care practice to ensure the best possible outcomes for our patients. There are often prewritten algorithms or first- and second-line therapies, along with outlined treatment plans and guidelines established based on evidence. These guidelines can be adjusted to meet each patient’s specific needs.

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Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

Pain has been a prevalent health care challenge in the United States for some time, with data from the Centers for Disease Control and Prevention showing that approximately 16% of men and 20% of women experience pain on most days or even every day.

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Holly Hovan MSN, GERO-BC, APRN, CWOCN-A

Predominant pain pattern, ulcer location, ulcer appearance, type and amount of wound exudate, and vascular and sensorimotor assessment are some key factors used to determine the primary etiology of lower extremity ulcers.

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