Necrotic Wounds

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
Necrotic Foot

by the Wound Source Editors

Chronic non-healing wounds affect millions of patients each year and contribute significantly to their morbidity and mortality. These wounds have a substantial impact because of their economic burden and the significant effect on the reduction in quality of life, as well as the increased risk of death for those patients affected by them.1 A 2014 study of Medicare data showed that chronic non-healing wounds and associated complications affect nearly 15% or 8.2 million Medicare beneficiaries. The study also estimated the cost to treat these wounds at between $28.1 billion and $31.7 billion annually.2 The highest costs were associated with infected or reopened surgical wounds, and outpatient care had the highest site-of-service costs. In addition to being older, most of these patients have obesity and diabetes. Underlying causes often include diabetic foot ulcers, venous leg ulcers, arterial insufficiency, and pressure ulcers. The list of complications contributing not only to chronicity but also to further deterioration is quite lengthy.

Laurie Swezey's picture
aerobic proteus bacteria in a wound

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Activated charcoal has been used in various types of wound care dressings. Although activated charcoal in itself does not enhance wound healing, it can help to minimize the odors associated with wounds. This is important, as wound odor can be very distressing for the patient, and the patient's family and caregivers. Wound odor can impact the quality of life of individuals with strong, persistent wound odor to have feelings of embarrassment, depression and isolation.1

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Laurie Swezey's picture
wound care 101 - wound debridement

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

There are four main types of debridement: mechanical, autolytic, enzymatic, and surgical. Each has its own advantages and disadvantages. Let’s take a look at each method individually:

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Lindsay Andronaco's picture
Necrobiosis lipoidica

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

I had an interesting case come into the clinic and I wanted to share it with all of you. This is the first time in my clinical experience with a patient who has full-thickness ulcerations due to necrobiosis lipoidica. Necrobiosis lipoidica is a disorder of collagen degeneration with a granulomatous response, thickening of blood vessel walls, and fat deposition. The main complication of the disease is ulceration, usually occurring after trauma to a particular area. Although infections are rare, full-thickness ulcerations appear to be rarer from my literature search. This particular patient had full-thickness ulcerations with an active infection on presentation.

Lydia Corum's picture
black widow spider

By Lydia A. Meyers RN, MSN, CWCN

In the times that I have worked with amazing hospitals and doctors, I have learned and gathered information on the differences between two types of necrotizing infections that happen in the world of wound care. Necrotizing fasciitis (NF) and spider bites can present as similar in nature and need immediate intervention.

Temple University School of Podiatric Medicine's picture

By Elliot Fialkoff and James McGuire DPM, PT, CPed, FAPWHc

There are numerous causes for ulcerations including pressure, venous insufficiency, arterial insufficiency, and neuropathic wounds. All have very different characteristics and require very different interventions. One thing that all chronic wounds have in common is the accumulation of necrotic material, biofilm or non-viable materials secondary to a prolonged inflammatory stimulus to the wound. In order for an ulcer to heal properly this "slough" must be regularly removed from the wound base so that healthy granular tissue can develop.

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Bruce Ruben's picture

By Bruce E. Ruben MD

Before you can delve into the vicious and deadly world of necrotizing fasciitis, the ghastly "flesh-eating disease" that's been widely reported by the media, you have to understand something about the bacteria that causes it and who is most susceptible to this rare condition.

Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Necrotic tissue that is present in a wound presents a physical impediment to healing. Simply put, wounds cannot heal when necrotic tissue is present. In this article, we'll define necrotic tissue and describe ways to effect its removal from the wound bed.

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Lydia Corum's picture

By Lydia A Meyers RN, MSN, CWCN

Radiation necrosis can be defined as cell death as a result of high doses of radiation as used with aggressive tumors. The dead cells caused by the loss of blood flow can be located anywhere in line with the radiation treatments. This damage can cause wounds that will not heal, pain and skin that can be easily damaged. Radiation necrosis can be divided into the following classifications: acute, sub-acute and delayed complications. Acute damage is direct in-line damage as well as that in the surrounding area. The cells receive damage in the DNA structure enough to prevent mitosis. This damage does not last and can be treated by controlling the symptoms. Sub-acute damage is related to the treatment of lung cancer and mimics bronchitis. Another injury that can happen is related to temporary demylinization of the spinal cord and causes Lhermitte’s syndrome. With Lhermitte’s syndrome the patient suffers electric-like shocks in the legs when stretching the spine. Delayed injuries can happen from all types of treatments and from six months to many years after the initial treatment. This could also include acute injuries that were never resolved and became chronic injuries.