Adjunctive Therapies

Elizabeth Day Dechant, BSN, RN, CWOCN, CFCN

The benefit of Negative Pressure Wound Therapy (NPWT) as an “active,” adjunctive treatment is well-established. Evidence has shown that wounds treated with negative pressure granulate faster than wounds managed with traditional dressings. There is ever-increasing literature to support the use of NPWT to treat wounds effectively and safely in even the youngest patients.¹ Some specific benefits of NPWT for pediatric and adolescent patients include decreased frequency of dressing changes, as well as a dressing that is occlusive and unlikely to be removed by the patient.

In this interview, Dr. Windy Cole discusses the use of topical oxygen therapies and what processes oxygen help facilitate in wound healing. She indicates the etiologies this therapy can treat as well as care settings that may find the therapy effective.

By Dr. Lenz and Dr. Hussain

Negative pressure wound therapy (NPWT) is a known adjunctive modality for healing wounds. The use of NPWT is well documented for the treatment of both acute and chronic wounds. NPWT is designed to remove fluid, decreasing the afterload to blood flow and resulting in increased localized tissue perfusion. Use of negative pressure may also enhance the formation of granulation tissue by secondary intention.

By Emily Greenstein, APRN, CNP, CWON, FACCWS

After attending the Spring Symposium for Advanced Wound Care and hearing many great lectures, I got to thinking, “What are the pillars of chronic wound care?” We have all heard of the concept “look at the whole patient and not the hole in the patient.” Heck, I have even written about it. But we also need to have a good foundation for how to implement this phrase or where to even start. I did a quick Internet search and came up with some interesting articles that talked about the basics of wound care and management. I found discussions on everything from maintaining a moist wound environment to being financially responsible. All of this information leads me to the concept of developing easy-to-understand pillars or categories to consider when caring for a patient with a chronic wound.

Arteriography: Also called angiography, this technique is the medical imaging of blood vessels to look for aneurysm and stenosis.

Hemosiderin staining: Hemosiderin staining results in a red, ruddy appearance on the lower leg and ankle. This appearance is caused when red blood cells are broken down and not removed adequately as a result of venous insufficiency or another medical condition.

Phlebectomy: A minimally invasive procedure (usually outpatient) to remove varicose veins located near the surface of the skin.

By the WoundSource Editors

When determining the course of action for treating a given wound, it is important that wound care clinicians evaluate how advanced wound care therapies have been deemed evidence based and how the specific product technology works. Evidence-based advanced wound care products are required to be safe and effective based on epidemiology, etiology, and pathophysiology. However, safety and efficiency are not a 100% guarantee of effectiveness in clinical practice.

By the WoundSource Editors

Diabetic foot ulcers (DFUs) continue to be a major problem, causing patient suffering, burden, infections, and high mortality. The cost of DFU treatment was estimated at $1.3 trillion globally in 2015. Despite evolving advanced wound care technologies through the years, DFUs continue to be among the most challenging chronic wound types.

By the WoundSource Editors

Wound reepithelialization is key in the goal of wound closure. Reepithelialization is a coordinated multifactorial systemic process that involves formation of new epithelium and skin appendages. The epithelialization process can be stalled by a number of factors, all of which must be resolved before wound healing can move forward.

By the WoundSource Editors

Wound chronicity is defined as any wound that is physiologically impaired due to a disruption in the wound healing cascade: 1) hemostasis, 2) inflammation, 3) proliferation, and 4) maturation/remodeling. To effectively manage chronic wounds, we must understand the normal healing process and wound bed preparation (WBP). Wound chronicity can occur due to impaired angiogenesis, innervation, or cellular migration. The presence of biofilm and infection are the most common causes of delayed healing.

By the WoundSource Editors

Wound chronicity is an ongoing challenge for patients and health care professionals around the globe. An astonishing 4.5 million people in the United States experience lower extremity wound chronicity, while an estimated 1% are affected in the Western population with all types of chronic wounds. The cascade of wound healing does not always follow suit in an orderly fashion of hemostasis, inflammation, proliferation, and remodeling.