Necrotic Wounds

Temple University School of Podiatric Medicine's picture

By Temple University School of Podiatric Medicine Journal Review Club

Chronic wounds require an increased amount of oxygen to help with cellular function and growth. They often manifest with biofilm, slough, and necrotic tissue, all of which deprive cells of the oxygen they need to perform vital functions. Various forms of debridement are commonly employed to rid wounds of pathological tissues that negatively affect cellular communication and growth. Sharp surgical debridement is most frequently performed by physicians. Continuous diffusion of oxygen (CDO) involves the use of humidified, purified air at 3mL/hour in conjunction with moist wound therapy (MWT) dressing. A previous paper by Niederauer et al. published in 2018 in the Journal of Wound Care, described using CDO for healing DFUs. This study showed that CDO improved the healing rate of DFUs in terms of time, chronicity, and weight-bearing ability when compared to a placebo. Additionally, the previous paper described wound size, chronicity, and adverse events.

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Temple University School of Podiatric Medicine's picture

By Temple University School of Podiatric Medicine Journal Review Club

Venous leg ulcerations (VLUs) are a common and often chronic pathology, and these wounds diminish the quality of life and increase the financial burden for affected patients. A recent article estimates that up to 3% of the U.S. population suffer from VLUs. A venous leg ulcer can be severely painful and may decrease a patient’s quality of life by affecting sleep, mobility, activities of daily living, and even result in social isolation. A 1994 paper proposed that approximately 65% of patients felt financially affected by a VLU, and this number is likely to have increased as a result of rising healthcare costs. The prevalence and chronic nature of the venous leg ulceration has motivated physicians to research novel techniques to heal ulcers successfully and in a timely manner.
Acellular dermal matrices have been utilized to treat diabetic foot ulcers with favorable outcomes.4 This study investigated the efficacy of a specific acellular dermal matrix for VLUs.

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WoundSource Practice Accelerator's picture
TIMERS

By the WoundSource Editors

Wound bed preparation is a well-established concept, and for many years the TIME framework – consisting of addressing Tissue Management, Inflammation and Infection, Moisture Balance, and Edge or Epithelial Advancement – was the standard tool used by clinicians to manage patients’ wounds throughout the wound care cycle.

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Necrotic Wounds

By the WoundSource Editors

Necrotic wounds are characterized by devitalized, or dead, tissue. Necrosis may be caused by malignancy, infection, trauma, ischemia, inflammation, or exposure to toxins. It may also be caused by improper care of an existing wound site. Devitalized tissue has no blood supply, and its presence prevents wound healing. It is necessary for necrotic tissue to be removed to allow wound healing to occur.

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Complex Wounds

By the WoundSource Editors

Complex wounds pose a significant challenge for many health care providers. These wounds are often multifaceted, making treatment tremendously difficult. They represent a substantial burden on the health care industry, with annual costs in North America alone estimated at $10 billion annually. They often also result in patient discomfort and pain, caregiver frustration, individual economic losses, and diminished quality of life.

Cheryl Carver's picture
Skin and Wound Management with Substance Abuse

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

The challenges for all clinicians associated with substance abuse and addiction are at an all-time high. We are seeing more and more overdoses and skin and wound issues. There needs to be less judgment and more education. Not every person with substance abuse issues is addicted due to a poor choice. Reasons for abuse can be related to unmanaged mental illness, self-medication and family genetics, to name a few. Compassion is lacking for this group of folks. I have seen it firsthand. This topic hits close to home as I have a son in recovery. This problem is an epidemic and needs to be talked about more. I live in Ohio, and we are one of the top five states for heroin and methamphetamine (meth) abuse.

WoundSource Practice Accelerator's picture

by the WoundSource Editors

Epidermis: the outer layer of the skin, which is the protective layer against the outside elements.

Epithelialization: the growth of the epidermis over a wound during the remodeling stage.

Granulation: condition occurring in a full-thickness wound where the growth of small vessels and connective tissue forms “scaffolding” as the wound rebuilds.

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Venous Leg Ulcer Complications

by the WoundSource Editors

Venous leg ulcers (VLUs) are difficult to treat, and when they are present a variety of complications may arise. These complications can be challenging to treat and may often contribute to the prolonged healing times resulting from chronicity found with many VLUs. Further, if the condition of the ulcer deteriorates, it may worsen any complication already present or serve as the catalyst for the development of complications.

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Margaret Heale's picture
Home Health Nurse

By Margaret Heale, RN, MSc, CWOCN

"Must Love Dogs (Cats, Lizards, Snakes, Birds, AND Arachnids)." This is a line that needs to be next to all job advertisements for home health care staff. You see, I am a dog lover, not because I love dogs but because I have a way of being able to adapt in order to survive. I work in home care as a clinical nurse specialist and have slowly learned to love dogs ever since I was reported to my manager for mentioning I didn't like them much. Shortly after this I was told not to visit a patient whose cat I had shooed away from my wound dressing field. While discussing this with a colleague, she told me of the bird that had landed on her head that morning just as she was probing the patient's foot wound with a Q-tip. Maybe everybody has had experiences like mine, but maybe not, so I would like to put mine to paper to entertain you in this season of good cheer.

WoundSource Practice Accelerator's picture

by the WoundSource Editors

Aerobic microorganisms: Organisms thriving in an oxygen-rich environment.

Anaerobic microorganisms: Organisms thriving in an oxygen-depleted environment.

Autolytic debridement: A selective process by which endogenous phagocytic cells and proteolytic enzymes break down necrotic tissue, occurring in varying degrees in the presence of a moist wound healing environment and dependent on the patient's having a functioning immune system.