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By the WoundSource Editors

The World Health Organization declared COVID-19 a pandemic on March 11, 2020. Whether you are a provider or a frontline health care professional, we are experiencing a worldwide increase in “unavoidable” medical device–related pressure injuries (MDRPIs) during the current COVID-19 pandemic. Health care workers are challenged with a higher risk of pressure injury development secondary to prolonged wear time of the N95 mask, face shield, and goggle personal protective equipment (PPE). The intensity of one or more factors of pressure, moisture, shear, and friction influence pressure injury risk.

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By the WoundSource Editors

The current COVID-19 pandemic has changed various aspects of care across the health care continuum. Health care professionals have been forced to develop different strategies for engagement for those patients at higher risk for infection, those who are quarantined, and those who have tested positive for COVID-19. We know that telemedicine cannot replace an in-person visit to a provider, but during this time of crisis it serves as an advanced approach in wound care.

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By the WoundSource Editors

Wound care professionals are feeling the challenges of caring for patients with wounds during the COVID-19 pandemic. Coming together during this time is paramount for developing the best strategy for delivering quality of care across the continuum. Providers should implement wound management protocols for their specific health care setting to be most efficient.

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By the WoundSource Editors

Health care providers are currently faced with an all-time high of challenges and strain related to the crisis of COVID-19. They are confronted with short staffing, limited personal protective equipment supplies, delegated duties outside their role, and the worry of being infected with the virus. There are health care workers who are not living at home because of the high risk of infecting their family members and others who are quarantining themselves within their homes away from their families. As health care workers focus on working hard on the frontlines for their patients, they must also remember to take care of themselves. Learning and applying self-care practices are just as important to ensure that health care workers remain safe and healthy to optimize delivery of care for their patients.

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By the WoundSource Editors

COVID-19: The name of the disease caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The abbreviation COVID-19 is short for coronavirus disease 2019.

Fit test: A 15- to 20-minute testing of the seal between the respirator's facepiece and your face. After passing a fit test with a respirator, you must use the exact same make, model, style, and size respirator on the job.

Liquid sealant: Liquid skin sealants are designed to protect vulnerable areas from the effects of skin injury. They form a transparent protective coating on the skin. Indicated for use on stage 1 pressure injuries and low-exudating stage 2 pressure ulcers, pressure points and bony prominences, and under adhesive products to protect the skin.

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Achieving Closure

By the WoundSource Editors

Wound healing is a highly complex chain of events that allows the skin to repair and regenerate to provide protective functions, such as temperature modulation, and moisture regulation, as well as sensation reception and transmission.

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Patient Considerations

By the WoundSource Editors

Wound debridement is often necessary to address the underlying causes of chronic wounds, remove non-viable tissue, manage biofilm, and ultimately promote and expedite the healing process. There are multiple methods of debridement, including surgical/sharp, autolytic, mechanical, biological, enzymatic, ultrasonic, hydrosurgical, or synergistic (combination of debridement methods). Selecting the most appropriate methods of debridement is crucial in treating chronic and acute wounds successfully and optimizing the healing environment.

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Debridement

By the WoundSource Editors

Wound debridement is a crucial strategy for addressing some of the underlying causes of wound chronicity. The wound healing process can be impacted by chronic disease, vascular insufficiency, diabetes, neurological defects, nutritional deficiency, advanced age, and local factors such as pressure, infection, and edema. Debridement can expedite healing when used to remove necrotic tissue, other non-viable tissue, and foreign material. It can also be a tool to manage biofilm. Debridement exposes the viable underlying tissue, which promotes healing. There are several methods of debridement; determining the best option depends on the health care setting as well as the characteristics of the wound being treated.

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TIMERS

By the WoundSource Editors

Wound bed preparation is a well-established concept, and for many years the TIME framework – consisting of addressing Tissue Management, Inflammation and Infection, Moisture Balance, and Edge or Epithelial Advancement – was the standard tool used by clinicians to manage patients’ wounds throughout the wound care cycle.

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By the WoundSource Editors

Conservative sharp debridement: Conservative sharp debridement is done outside the operating room, and although it removes necrotic tissue and debris, it is not as aggressive a procedure as surgical sharp debridement.

Eschar: Eschar is dead tissue and is found only in full- thickness wounds. It may be tan, brown, or black.

Fibroblasts: Fibroblasts have several roles in wound healing, including breaking down fibrin clots, creating new extracellular matrix and collagen structures, and contracting the wound.

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