Debridement

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.

By Michel H.E. Hermans, MD At the beginning of a new year, many look back at the previous one in an attempt to analyze what happened, whether it was good or bad or perhaps even special.

In a recent survey, we asked our WoundSource Editorial Advisory Board members what outdated wound care practices they continue to see in the field. Depending on what health care setting clinicians work in, there are specific guidelines, policies, and procedures that may impact standard of care. Our board members come from a variety of backgrounds, so their answers varied based on their areas of expertise, but there were a few practices that they could all agree should be left in the past. Do you still use any of these?

By the WoundSource Editors Wound healing is a highly complex chain of events that allows the skin to repair and regenerate to provide protective functions, such as temperature modulation, and moisture regulation, as well as sensation reception and transmission.

By Paula Erwin-Toth MSN, RN, CWOCN, CNS Now that summer is upon us we will soon be entering the orientation and entry of new residents, fellows and new nursing graduates in acute care. This is a terrific opportunity for you to reach out and engage the interest of these new clinicians in evidence-based wound care practice. Granted, they are overwhelmed with new information and new responsibilities, but prevention and management of wounds is knowledge they can apply to nearly all their patients and across all health care settings.

Advanced wound care technologies have come a long way in treating chronic wounds. However, diabetic foot ulcers (DFUs) can be challenging, and not every patient should have identical treatment. Utilizing a patient-centered approach is necessary for selecting appropriate treatments and achieving best possible outcomes. Understanding the specific patient’s needs and understanding the pathophysiology of diabetic wound chronicity are key elements in DFU management. The primary goal should be wound closure, while also preventing recurrence. To achieve both goals, clinicians must incorporate ongoing education and clinical support. Health care professionals should keep up on latest evidence-based research and practices to select the best advanced treatment for each patient.

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.

Chronic and non-healing wounds are those that do not progress through the healing process in a timely or predicted manner. They are a global problem and are becoming harder to treat. Medicare estimates that over 8 million Americans have chronic wounds that cost the national health care system between $18.1 and $96.8 billion dollars annually.

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC The big debate continues in regards to using wet-to-dry dressings. One thing that is for certain though is that this type of dressing is frowned upon in long-term care facilities per the National Pressure Ulcer Advisory Panel (NPUAP) Guidelines for pressure ulcers. However, long-term care facilities are put at risk for citations when using wet-to-dry dressings for any wound type.

By Ron Sherman MD, MSC, DTM&H I have been avoiding the topic of addressing the differences between contained (bagged) versus confined (non-bagged or "free-range") maggot therapy because I haven't wanted to take a position in affairs that affect specific companies' products. In addition, I have a conflict of interest in that I run a laboratory that produces one type of dressing and not the other. Nevertheless, I have been dragged involuntarily into this conversation by the hoards of people who ask me about the data and information surrounding the application of maggots in containment bags. Indeed, I may even have an obligation to share my thoughts, given my role in the maggot therapy movement, and given that I have experience in testing and using both techniques. So with that understanding, let's begin by exploring the maggot dressing options currently available. The terminology can be a bit confusing so we should begin there.