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By: Marta Ostler, PT, CWS, CLT, DAPWCA, and Janet Wolfson, PT, CLWT, CWS, CLT-LANA

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By Samantha Kuplicki, MSN, APRN-CNS, AGCNS-BC, CWCN-AP, CWS, RNFA

Should pain management interventions be put in place before debriding a venous ulcer?

Without question, yes. Any comprehensive wound treatment plan must include a thorough pain assessment, accounting for cyclical and non-cyclical pain sources. This will best guide interventions based on patient’s unique history, which can potentially include complicating factors such as complex personal pain management secondary to chronic pain, inability to tolerate specific interventions because of existing comorbid conditions, limited financial or social resources, etc. Multimodal pain management is standard of care, using the least invasive options and beginning pharmacologic therapy with the lowest necessary dosage possible.

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By Miranda Henry, Editorial Director of WoundSource

Whether meeting with patients via telehealth at your home-based office or doing rounds at the clinic, WoundSource is still there to provide you with the most trusted and up-to-date wound care education and product information.

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By the WoundSource Editors

Studies have shown significant value in moist wound healing as opposed to treatment of wounds in a dry environment, and clinical evidence has supported this view for many years. Moist wound healing has been shown to promote re-epithelialization and can result in a reduction of scar formation because a moist environment keeps new skin cells alive and promotes cell regrowth. Treatment of wounds in a moist environment additionally shows promise for the creation of a microenvironment conducive to regenerative healing without scar formation. For these reasons, clinicians often select dressings that will create and manage a moist wound environment.

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Dehiscence

By the WoundSource Editors

Dehiscence occurs when a surgical incision that was closed opens, either partially or completely. Dehiscence is most likely to take place within the first two weeks after surgery, but it can occur as late as one month after surgery.

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Antifungal Cream

By the WoundSource Editors

Antifungal cream is a broad term used to describe a range of products containing antifungal agents that are topically applied to the skin to control and manage fungal infections. These products may be formulated with a moisture barrier to protect and condition the skin. Antifungal creams are used both as a palliative treatment for existing fungal infections and as a prophylactic measure in cases where there is a risk of fungal infection.

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Maceration

By the WoundSource Editors

Maceration occurs when skin has been exposed to moisture for too long. A telltale sign of maceration is skin that looks soggy, feels soft, or appears whiter than usual. There may be a white ring around the wound in wounds that are too moist or have exposure to too much drainage.

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Silver Nitrate Sticks

By the WoundSource Editors

Silver nitrate is a natural, inorganic chemical compound with antimicrobial properties that has been used in medical applications since the 13th century. It is used as a cauterizing agent and is available as a solution or an applicator stick. The applicator sticks, known as silver nitrate sticks or caustic pencils, contain silver nitrate and potassium nitrate. There are certain brands of silver nitrate sticks that can be bent or shaped to increase ease of access within a target area. The silver nitrate stick is activated by contact with moisture. When applied to wounds, silver nitrate sticks deliver free silver ions to the tissue that form an eschar as they bind to tissue and obstruct vessels.

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By the WoundSource Editors

Before the mid-1990s, venous disorders and disease were classified almost solely on clinical appearance, which failed to achieve diagnostic precision or reproducible treatment results. In response to this, the American Venous Forum developed a classification system in 1994, which was revised in 2004. This classification system has gained widespread acceptance across the clinical and medical research communities, and most published papers now use all or part of the CEAP system (defined in the next section). This system was once again updated in 2020.

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By the WoundSource Editors

Scrotum injuries can be caused by one or more mechanisms of injury such as trauma, pressure, friction, and moisture. Minor injuries frequently result in pain to the afflicted area, swelling, or ecchymosis.

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