Infected Wounds

by the WoundSource Editors Best practice in skin care focuses on the prevention of skin breakdown and the treatment of persons with altered skin integrity. When we ask what causes skin damage we should consider the conditions that can harm the skin, including excessive moisture and overhydration, altered pH of the skin, the presence of fecal enzymes and pathogens, and characteristics of incontinence such as the volume and frequency of the output and whether the output is urine, feces, or both. If left untreated or not treated appropriately, moisture-associated skin damage or MASD can lead to further complications such as Candida infections, bacterial overgrowth, pressure injuries, and medical adhesive-related skin injury (MARSI). These can occur individually or overlap, which can make them even more difficult to manage. Today our focus is to discuss each of these complications of MASD in more detail and address some of the most common issues leading to their development.

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.

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA As I was commuting in to work a few Saturdays ago, I listened to The People’s Pharmacy on NPR. The topic was non-pharmacological treatment of infection, so being a wound care professional, I immediately started thinking of the ways I treat wound infections. In addition to oral, topical or IV antibiotics, as a PT there are modalities available to me to treat wound infections. The advantage of using these modalities is that treatments are effective across a broad spectrum of bacteria without the risk of resistance. Really! These treatments include ultrasound, electrical stimulation and laser or light-emitting diode (LED) therapy.

By Lydia A. Meyers RN, MSN, CWCN Wound infections are discussed in the media and are a major reason for admission into the hospital. With the importance in health care today to decrease costs, I was encouraged to do research into where infections come from and the causes for hospitalization and death among wound patients. In the current data I found there is information showing how the government has increased surveillance related to reportable admission to hospital in relation to infections in wounds by home health and hospice organizations.

By Dr. Mark Hinkes, DPM Twenty first century technology is helping people with diabetes to heal foot ulcers. An Australian colleague, for example, is developing an application that reminds people with diabetes to control their blood sugars with prompts and instructions, and allows them to upload a picture of their wound for their podiatrist to evaluate.

The concept of wound hygiene has grown traction recently as clinicians increasingly adopt an antibiofilm-oriented approach to wound care. Despite the increase in recognition of wound hygiene as a four-step protocol, many definitions for wound care terminology evolve as clinical understanding grows and new wound care protocols continue to emerge.

By Emily Greenstein, APRN, CNP, CWON, FACCWS I recently presented this topic as a Journal Club presentation for the Association for the Advancement of Wound Care Members. I feel like this is a very important and interesting subject, so I wanted to share it with more people. Morgellons disease (MD) is a disorder that can be considered controversial. One view of it is that the disorder is purely a psychological condition, and the other view is that the disorder is actually a byproduct of another infectious process. My goal is to give you some facts from both sides and allow you to make your own decision.

Treatment of chronic and complex wounds complicated by biofilm formed by pathogens remains a tremendous challenge for the health care industry. Recent increases in infections mediated by drug-resistant bacterial and fungal pathogens highlight the need for new antimicrobial therapies. The application of topical agents with antimicrobial and antiseptic properties is gaining traction as an alternative to antibiotic prescriptions.

Wound healing is often accompanied by bacterial infection. Many clinicians use antibiotics to treat wound infections. However, the overreliance on antibiotics is becoming an increasing concern for many global health organizations because it contributes to widespread antibiotic resistance. Excessive use of synthetic antibiotics leads to drug resistance, which poses a substantial threat to human health.

By Mary Ellen Posthauer RDN, CD, LD, FAND Microbiota are living organisms that coat the lining of the stomach, small intestine and the colon, which has the highest concentration. They serve as the front line of defense by protecting against incoming microbes, modulating the immune system, exerting anti-inflammatory activity and maintaining intestinal cell activity. While many factors disturb the intestinal microbiota such as age, stress, and poor hygiene, the wide spread use of broad-spectrum antibiotics has led to the increase and severity of Clostridium difficile (C. diff). C. diff is a spore-forming bacterium that releases toxins in the intestine, causing mucosal inflammation, intestinal damage and diarrhea.