WoundSource Practice Accelerator's blog

Wound bed preparation is the systematic approach clinicians use to identify and remove barriers to the healing process of the wound. The approach aims to create an optimal wound healing environment by focusing on all critical components, including debridement, bacterial balance, and exudate management, as well as taking into account the patient's overall health status and how this may impinge on the wound healing process.

Wound bed preparation is the concept that provides clinicians with a framework for treating hard-to-heal wounds by assessing the patient as a whole and not focusing only on the characteristics of the wound. Moisture management is essential for a wound to heal correctly, so clinicians must regularly assess the wound because excess moisture or exudate can be an indicator of ongoing inflammation or other complicating factors.

Wound bed preparation is a vital element of wound care. It ensures that the wound has the best environment for closure by addressing the needs of the wound and removing barriers. Wound bed preparation is usually achieved by following a systematic approach such as the TIMERS mnemonic, which consists of tissue, infection/inflammation, moisture management, edge of wound/epibole, repair/regeneration, and social factors. These steps do not necessarily need to occur in order, and some or all of them may need to be repeated as the wound changes and progresses toward closure.

Biofilm: A complex microbial community containing bacteria and fungi. The microorganisms synthesize and secrete a protective matrix that attaches the biofilm firmly to a living or non-living surface. The biofilm contributes to underlying wound infection, chronic inflammation, and delay in healing, and it is present in 80% to 90% of chronic wounds and 6% of acute wounds.

Epibole: Rolled or curled-under closed wound edges. These rolled edges are thickened epidermis that may be callused, dry, scaly, and/or hyperkeratotic. When epibole is present in a wound, it signals to the body that the wound has healed, even though the wound remains open. Epibole must be resolved to allow the wound to close.

Exudate: Fluid drainage originating from tissue in the wound bed in response to injury or inflammation. Exudate types are serous or clear, sanguineous or bloody, purulent, or seropurulent. Exudate quantity is none, scant, small or minimal, moderate, large, or copious.

Chronic and nonhealing wounds are a worldwide issue and are becoming more difficult to treat. In the United States alone, according to Medicare, over 8 million Americans have chronic wounds that cost the national health care system between $18.1 and $96.8 billion per year. If standard treatment does not adequately heal a wound, additional methods of wound care treatment may be required, and the underlying disorder must be examined to determine the need for advanced wound care modalities. Advanced wound care therapies are interventions that are used after standard wound care has failed.

Patients with wounds are cared for according to the scope and standards of practice, which are used to guide nurses and other members of the interprofessional wound care team. An intricate network of physicians, medical researchers, government regulators, and medical journal contributors helps develop the standard of care. Standards are not enacted like laws; rather, they arise naturally as a result of research investigations, existing physician practices, and technological advancements. Standard of care in the health care profession is sensitive to time, place, and person. The wound care standard must be carried out in accordance with accepted wound treatment standards that are evidence based.

Wound care is complex. Even professionals who have worked as wound care specialists for decades are still learning as researchers discover more about the healing process and barriers that impede healing. Additionally, the medical professionals who may work with a patient with a complex or chronic wound can include clinicians with varying expertise, such as nurses, physical therapists, surgeons, dietitians, and so on. Fortunately, several national organizations are committed to enhancing the quality of wound care for both wound care professionals and patients alike.

Wound documentation is critical for the delivery of effective wound care, the facilitation of care continuity, and proper health data coding. Inaccurate wound documentation can impact the ability to determine the best wound treatment options and the overall wound healing process. Unfortunately, almost half of all medical record notes on wounds lack key details on assessment and intervention in some settings.

Accreditation: Accreditation is the process by which an accrediting agency certifies that an institution adheres to a set of educational criteria. The United States Department of Education maintains a listing of recognized accrediting agencies. Digital education materials such as conferences and webinars often go through accreditation.

CEU and CME: CME stands for continuing medical education credits for physicians and others with a medical license, whereas CE and CEU (continuing education unit) are terms used for other health professions.

Digital education: Digital education refers to the innovative implementation of digital tools and technologies during teaching and learning activities, including eLearning, microlearning, and mobile applications. Digital education can also be available in the form of virtual conferences and webinars.

For the wound healing process to be successful, it must pass through four stages: hemostasis, inflammation, proliferation, and remodeling or maturing. Wound healing requires inflammation, but it can be detrimental if it is persistent or encouraged by other factors, such as infection. It is during this phase that wound healing is most likely to stall.