Moist Wound Healing

Emily Greenstein's picture

By: Emily Greenstein, APRN, CNP, CWON, FACCWS

Being a wound care professional is often a lot like being a detective. You have to decide what caused the wound, what is contributing to its not healing and how you are going to get it to heal. I have decided to start a series of “cases” that are commonly overlooked or seen in the chronic wound care setting. The cases will focus on real-life scenarios—moisture-associated skin damage versus pressure injury, red leg syndrome versus venous stasis ulcer, how to identify pyoderma, and the importance of a moist wound healing environment. This series will also provide practical strategies for overcoming healing obstacles for slow, non-healing, and challenging wounds.

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By the WoundSource Editors

Studies have shown significant value in moist wound healing as opposed to treatment of wounds in a dry environment, and clinical evidence has supported this view for many years. Moist wound healing has been shown to promote re-epithelialization and can result in a reduction of scar formation because a moist environment keeps new skin cells alive and promotes cell regrowth. Treatment of wounds in a moist environment additionally shows promise for the creation of a microenvironment conducive to regenerative healing without scar formation. For these reasons, clinicians often select dressings that will create and manage a moist wound environment.

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Maceration

By the WoundSource Editors

Maceration occurs when skin has been exposed to moisture for too long. A telltale sign of maceration is skin that looks soggy, feels soft, or appears whiter than usual. There may be a white ring around the wound in wounds that are too moist or have exposure to too much drainage.

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Wound Infection

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.

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

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

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Entropic Wound Cycle

Temple University School of Podiatric Medicine Journal Review Club

Article Title: Using the Entropic Wound Cycle as the Basic for Making Effective Treatment Choices
Authors: Mcguire, J, Sebag JA, Solnik, J
Journal: WoundSource
Reviewed by: Cindy H. Duong, class of 2021, Temple University School of Podiatric Medicine

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Wound Bed Assessment

By the WoundSource Editors

Wound treatment plans are frequently ineffective because of a widespread failure to identify wound etiology accurately. One study found that up to 30% of all wounds lack a differential diagnosis, and this poses a real barrier to administering effective treatments. Furthermore, recent advances in the understanding of wounds, including the use of growth factors and bioengineered tissue and the ability to grow cells in vitro, present new opportunities to provide more effective treatment. Wound bed preparation that incorporates the TIME framework (tissue management, Infection or inflammation, moisture imbalance, and edge of wound) into the A, B, C, D, E wound bed preparation care cycle can significantly increase the ability to perform the following accurately.

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Tissue Debridement

By the WoundSource Editors

The concept of wound bed preparation has been utilized and accepted for over two decades. Wound bed preparation techniques can only be accurately employed after a thorough and complete assessment of the wound. Poor assessments result in a negative impact of needless costs and truancy of appropriate treatments and outcomes. The goal of wound bed preparation is to provide an optimal wound healing environment. Up-to-date research in molecular science has helped evolve new technology and advanced therapies that include growth factors, growing cells in vitro, and developing bioengineered tissue. Researchers now know that the healing process involves an array of elements that require monitoring and attentiveness.

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Wound Bed Preparation for Chronic Wounds

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.

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Holly Hovan's picture
Skin Tear Protocol

Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP

Payne and Martin brought skin tears to the attention of wound and skin specialists and to the wound care community when they reported an incidence rate of 2.23% in individuals aged 55 years and older, living in a long-term care facility. A skin tear is "a wound caused by shear, friction, and/or blunt force resulting in a separation of skin layers." Skin tears may be partial- or full-thickness wounds, develop into chronic wounds without proper treatment and follow-up, and, most importantly, are preventable.