Case Study

Becky Naughton's picture
Calciphylaxis

By Becky Naughton, RN, MSN, FNP-C, WCC

Picture this: you've been seeing a patient in your wound center for the last several months to treat a slowly healing post-operative abdominal wound. The wound has been gradually responding to an assortment of treatments, including initial wound vacuum therapy after the surgery, followed by alginate and now a collagen dressing. The wound is getting smaller and has new granulation tissue at the base. You're actually a bit surprised that it's healing so nicely because the patient has multiple serious chronic illnesses, including severe chronic kidney disease that requires hemodialysis sessions three times per week, type 2 diabetes, morbid obesity, cardiovascular disease, and peripheral vascular disease.

WoundSource Practice Accelerator's picture
 Evidence-Based Product for Diabetic Foot Ulcer Management

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.

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Becky Naughton's picture
platelet-rich plasma

Becky Naughton, RN, MSN, FNP-C, WCC

What if I told you that there is a substance that we can isolate from your own blood that can help to heal the most difficult wound? I envision a scene out of "Star Trek" where Bones does a quick scan of his patient, draws some blood, runs it through some machines, and then out pops a seemingly magical elixir. He studies this new yellow substance and then injects it back into his patient (with a quick and seemingly painless puff from his high-tech injector gun).

Lydia Corum's picture
Wound Care Costs

By Lydia Corum RN MSN CWCN

The times are changing in the world of wound care. There used to be a time when there were no problems with reimbursements, as long as the doctor wrote the order. Today, the Centers for Medicare & Medicaid Services (CMS) regulations confuse clinicians and make the world of healing wounds much more difficult. The changes are in the area of denials with not enough information given for choosing dressings, use of negative pressure therapy and hyperbaric oxygen therapy. Are all these changes needed? Why are these changes happening? What can hospitals and wound clinics do to make things better?

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Temple University School of Podiatric Medicine's picture
Mesenchymal stem cells to heal diabetic foot ulcers

By Temple University School of Podiatric Medicine Journal Review Club

Article Title: Mesenchymal Stem Cells Improve Healing of Diabetic Foot Ulcer
Authors: Cao Y, Gang X, Wang G
Journal: J Diabetes Res. 2017;2017:9328347.
Reviewed by: Sai Vemula, class of 2020, Temple University School of Podiatric Medicine

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Temple University School of Podiatric Medicine's picture
Temple University School of Podiatric Medicine

Temple University School of Podiatric Medicine Journal Review Club

Delayed healing in diabetic foot ulcers (DFUs) is the result of the polymicrobial structures of DFUs and the buildup of biofilms. Wound debridement is an essential part of wound bed preparation (WBP) that helps to remove bacteria and allow the body to continue the healing process. Although sharp debridement is the most common technique used for DFUs, it has many limitations, including contraindications in patients with poor vascular status, the need for an operating room, and the requirement for specific surgeon skills. There is also the potential for extensive damage to the wound bed with exposed bone because of obstruction of the view from biofilm formation. The use of an ultrasound-assisted wound (UAW) debridement device aims to disrupt the formation of biofilms and stimulate wound granulation, thus allowing for the wound to have a healthy environment in which to heal. This study evaluated the clinical and microbiological impact of using UAW debridement devices in individuals with neuroischemic DFUs.

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WoundSource Practice Accelerator's picture
Factors Contributing to Complex Wounds

By the WoundSource Editors

A vast percentage of wounds become chronically stalled because of mixed etiology and other underlying comorbid medical conditions. This means the wound is multifactorial, and using a singular approach won’t be enough. Lower extremity wounds, for example, can have diabetes, venous and arterial issues, and pressure all as factors playing into the same wound.

Temple University School of Podiatric Medicine's picture
Temple University School of Podiatric Medicine

Temple University School of Podiatric Medicine Journal Review Club
Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.

Article Title: Stability, Activity, and Application of Topical Doxycycline Formulations in a Diabetic Wound Case Study
Authors: Gabriele, S; Buchanan, B; Kundu, A; Dwyer, HC; Gabriele, JP; Mayer, P; Baranowski, DC
Journal: Wounds. 2019;31(2):49-54
Reviewed by: Garrett Biela, Class of 2020, Temple University School of Podiatric Medicine

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Christine Miller's picture
Patient Noncompliance

Christine Miller, DPM, DMM, PhD, FACCWS

One of the most difficult aspects of patient care is dealing with non-compliance. How do we help those who refuse to help themselves? This question is very convoluted indeed! The best treatment protocols in the world will be unsuccessful if the patient does not follow the recommendations. Patients with chronic wounds are usually those with multiple comorbidities such as uncontrolled diabetes, autoimmune disease, and uncontrolled hypertension. This complex medical picture is challenging enough for all of us trying to heal them, but add the patients' lack of concern for their own health and it is quite frankly maddening. I find myself often saying, "Help me help you" or "Healing is a team event," although mostly my genuine pleas for partnership fall on deaf ears.

Aletha Tippett MD's picture
Pressure Ulcer Prevention

by Aletha Tippett MD

How do you prevent pressure ulcers? This is an interesting question and one that eludes many. Currently, I am involved in reviewing research proposals to prevent pressure ulcers (injuries). The funny thing is that there is nothing new. Everyone is using the same known techniques, just trying different forms. However, there is a proven way to prevent pressure ulcers and it was done years ago in a Cincinnati nursing home I was working in without any fanfare. The results from this nursing home wound care program were even published.1

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