Chronic Wounds

By the WoundSource Editors

The venous leg ulcer (VLU) is the most common type of chronic leg wound, and it can be challenging to manage. VLUs account for up to 90% of all chronic leg ulcers. Proper diagnosis and treatment planning are key to wound healing outcomes. This fact is particularly true for older adults, who have an annual VLU prevalence of 1.7%.

By the WoundSource Editors

The most common type of chronic lower extremity wound is the venous ulcer, affecting 1% to 3% of the U.S. population. Chronic venous ulcers significantly impact quality of life and are a financial burden for both the patient and the health care system. In the United States, 10% to 35% of adults have chronic venous insufficiency, and 4% of adults 65 years old or older have venous ulcers. Identifying signs of venous disease early on while implementing surgical intervention, if warranted, can increase healing outcomes and decrease the recurrence of venous ulcers. Treatment of venous ulcers can include exercise, leg elevation, dressings, advanced wound care such as cellular and tissue-based products, compression therapy, medications, venous ablation, and surgical intervention.

By the WoundSource Editors

With multiple risk factors impeding wound healing and wounds often diagnosed with mixed etiology, wound healing can be complicated. Understanding the pathophysiology of wound healing can help clinicians to better comprehend the needs of a wound to help it progress through the stages of wound healing.

By Industry News

September, 2019 – Three wound care quality measures developed by the Alliance of Wound Care Stakeholders and the US Wound Registry (USWR) are now included on Centers for Medicare and Medicaid Services' (CMS) Physician Compare website following a summertime content update that expanded quality performance data on the site.

Temple University School of Podiatric Medicine Journal Review Club

Article Title: Efficacy of Cadexomer Iodine in the Treatment of Chronic Ulcers: A Randomized, Multicenter, Controlled Trial
Authors: Radhakkrishnan R, Kethavath SN, Sangavarapu SM, Kanjarla P, Dexadine Study Group
Journal: Wounds. 2019;31(3):85-90
Reviewed by: Elizabeth Connolly, class of 2021, Temple University School of Podiatric Medicine

By the WoundSource Editors

Caseous necrosis: Caseous necrosis is found in tuberculosis, syphilis, and some fungal diseases. It forms in response to intracellular pathogens, such as mycobacteria, and can also be found in association with granulomas. With this type of cell death, the tissue assumes a cheese-like appearance.

Clostridium difficile: Also referred to C. diff, this bacterium can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. On a lesion, semihard nodules may be found, in which case lymph node tuberculosis may be present.

Complex wounds: Wounds that have one or more complicating factor, such as exudate, infection, comorbidity, or polypharmacy. They can be acute or chronic wounds that defy cure with conventional therapies. Treating complex wounds generally requires a multidisciplinary approach.

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.

By the WoundSource Editors

Wound bed preparation is a well-established concept, and the TIME framework is the standard tool used to assist clinicians with the management of patients’ wounds throughout the care cycle. Recent clinical and technological breakthroughs are enhancing our understanding of this care cycle. An overview of the wound bed preparation care cycle and the TIME framework is provided here.

By James McGuire, DPM, PT, LPed, FAPWHc

In my recent WoundSource webinar, I discussed the topic of debridement strategies and chronic wounds. The webinar is still available for viewing on WoundSource.com. Wound debridement is the foundation for healing in chronic wounds. Excessive debridement is a detriment to healing, whereas proper removal of accumulated non-viable tissue or foreign material from the wound bed maintains a healthy progressive healing trajectory and avoids wound chronicity.

By Heidi Cross, MSN, RN, FNP-BC, CWON

In my recent WoundSource webinar, I discussed the topic of chronic wound etiology and management. The webinar is still available for viewing on WoundSource.com. Chronic wounds are vexing and frustrating to manage; they can be expensive and are a huge source of morbidity and mortality. Infection prevention is a key part of chronic wound management, with recognition of the role that biofilms play.