Acute Wounds

By Kathy Gallagher, DNP, APRN-FNP, CMC, UMC, BC, WCC, CWS, FACCWS Welcome to the first in a series of blogs focusing on acute surgical wound management. Future segments will discuss steps toward developing an acute surgical wound service (ASWS) and tips reflective of successful healing strategies.

By Kathy Gallagher, DNP, APRN-FNP, CMC, UMC, BC, WCC, CWS, FACCWS In 2010, Christiana Care Health System, a 1,000 bed Level I trauma center in Wilmington, Delaware, introduced an acute surgical wound service (ASWS) integration plan in with a single dedicated nurse practitioner, trauma surgeon, and administrative leader. Subsequently, trauma patients with complex wounds experienced decreased morbidity and length of stay. Closely aligned with these numbers, their patient days of negative pressure wound therapy fell from 11+ days in 2010 to 8.2 days in 2018, representing one of the lowest in the nation.

As a veteran of the U.S. Army, and having a grandfather who was a U.S. Army combat medic, I have always had an interest in combat wound care. Wound care has evolved immensely throughout the years in the military arena. The treatments used as far back as the fifth century B.C. were inconceivable. Examples are keeping wounds dry, wound irrigation with water and wine, burning oil into infected wounds, and topicals such as egg yolks, rose oil, and turpentine applied to the wound bed. Odor was controlled with bags of lavender at the soldier’s bedside.

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.

By Roshni Patel, BSc (Hons), MCOptom The cornea, as we know it, is a complex and fast-healing tissue that provides protection from infectious and non-infectious defects. However, it can still be injured through environmental impacts or surgical procedures, such as cataract operations or laser-assisted in situ keratomileusis (LASIK), as well as traumatic injuries. Although most corneal wounds repair themselves without further drawbacks, possible complications may occur and delay the healing process. This blog outlines the natural healing process of corneal wounds and post-surgical wound healing, as well as the obstacles to healing that may occur in diabetic patients.

By the WoundSource Editors Edema is the abnormalaccumulation of excess fluid within tissue. The swelling associated with edema can be localized to a small area following an acute injury, it can affect an entire limb or a specific organ, or it can be generalized throughout the entire body. Edema is not a disease, but rather a symptom that can indicate general health status, side effects of medications, or serious underlying medical conditions.

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.

By Emily Greenstein, APRN, CNP, CWON, FACCWS It’s that time of year again. For the leaves to change, all the ghouls and goblins to come alive, and for a sudden influx of sugar! After the success of last year's blog post "How Being a Wound Specialist Can Help You Survive a Zombie Apocalypse," I knew I had to do another Halloween-themed post. In my practice I have seen an influx of animals bites this summer, which got me to thinking, what if you were bitten by a werewolf or vampire?

by Kelly Byrd-Jenkins, CWS It may come as no surprise to some, but pressure ulcers are among the only hospital-acquired conditions that have been on the rise in recent years. Other hospital-acquired conditions—such as adverse drug events, falls, and catheter-associated urinary tract infections—have decreased, according to a statement by the Agency for Healthcare Research and Quality in January of this year.

Burn management is typically based on the severity of the wound, and the goals are to prevent shock, relieve pain and discomfort, and reduce the risk of infection. Pathogens are present everywhere, and any breach in the skin, especially burns, can lead to infection. When burns cover up to 35% in adults and 30% in children, they are considered major burns, and anything above those levels is considered critical or life-threatening. A thorough assessment of the patient and burn site is necessary to determine the most appropriate treatment interventions given the type and severity of the burn injury.