Practice Accelerator

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By the WoundSource Editors

The venous leg ulcer (VLU) is the most common type of chronic leg wound, and it can be challenging to manage. VLUs account for up to 90% of all chronic leg ulcers. Proper diagnosis and treatment planning are key to wound healing outcomes. This fact is particularly true for older adults, who have an annual VLU prevalence of 1.7%.

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By the WoundSource Editors

The most common type of chronic lower extremity wound is the venous ulcer, affecting 1% to 3% of the U.S. population. Chronic venous ulcers significantly impact quality of life and are a financial burden for both the patient and the health care system. In the United States, 10% to 35% of adults have chronic venous insufficiency, and 4% of adults 65 years old or older have venous ulcers. Identifying signs of venous disease early on while implementing surgical intervention, if warranted, can increase healing outcomes and decrease the recurrence of venous ulcers. Treatment of venous ulcers can include exercise, leg elevation, dressings, advanced wound care such as cellular and tissue-based products, compression therapy, medications, venous ablation, and surgical intervention.

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By the WoundSource Editors

Venous ulcers are known to be complex and costly. There is an array of evidence-based treatment options available to help formulate a comprehensive treatment plan toward wound closure. Health care professionals should utilize treatment options while encompassing a holistic approach to venous ulcer management. Involving the patient and/or caregiver in developing a treatment plan will increase the chances of successful wound healing outcomes. Wound closure is the primary goal of a treatment plan; however, preventing recurrence and infection should be considered just as important.

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By the WoundSource Editors

Venous ulcers pose a worldwide problem that comes with high recurrence rates, risk of infection, and substantial costs to treat. Health care professionals must be knowledgeable about underlying causes and pathological features. The comorbidities that are often associated with venous ulcers contribute to these lesions and prolong healing times, which in return can cause further complications. Venous disease and venous hypertension are lifelong conditions requiring lifelong management. The vicious cycle of venous reflux and obstruction associated with chronic venous disease leads to ulceration(s). Management of venous ulcers requires comprehensive wound care and compression therapy for life.

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By the WoundSource Editors

Antimicrobial dressings: Dressings that contain substances with antimicrobial properties, such as silver, chlorhexidine, honey, or iodine. These dressings can be effective in reducing bioburden and promoting healing.

Antimicrobial stewardship: Collective measures that are taken to slow the evolution of multidrug-resistant organisms.

Bacterial resistance: The capacity of bacteria to withstand the effects of antibiotics that are meant to kill them; this term is commonly used interchangeably with antibiotic resistance.

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by the WoundSource Editors

Antimicrobial: Describing the property pertaining to any of several categories of agents that are intended to be toxic to pathogenic organisms, including antibacterials, antiprotozoals, antifungals, and antiparasitics.

Chronic wound: A wound that has failed to re-epithelialize after three months, usually because of failure to progress past the inflammatory phase of wound healing.

Intraoperative phase: The time period beginning when the patient is brought to the operating suite and ending when the patient’s procedure is complete, typically when skin is closed and dressed and the patient is transferred to the post-anesthesia or recovery unit.

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Management of Surgical Wounds

By the WoundSource Editors

Wounds resulting from surgical procedures have many commonalities with wounds of other etiologies. However, there are a few notable differences in their classification, as well as in the recommended care practices that promote the healing of these wounds. In understanding these differences, it is important to understand the classification of surgical wounds.

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Surgical Wound Healing

By the WoundSource Editors

The number of surgical procedures performed in the United States has been increasing annually by as much as 300% over a 10-year period. Although technological advances in surgical procedures have allowed some procedures to be performed using minimally invasive techniques, many operations still require incisions, which require special care to prevent dehiscence and surgical site infections (SSIs). SSIs occur in 2% to 4% of all patients undergoing surgical procedures, and they are among the most expensive inpatient harms, adding approximately $30,000 to the total hospital cost per infection.

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Preventing Surgical Site Infections

By the WoundSource Editors

The Centers for Disease Control and Prevention (CDC) define a surgical site infection (SSI) as "an infection that occurs after surgery in the part of the body where the surgery took place." The CDC go on to say the infection can be superficial involving just the skin or more serious infections can occur that involve deeper structures, such as tissue under the skin, organs, or implanted devices or materials. The CDC offer tools and guidelines to prevent SSIs and provide education to the public. Public education includes tips and advice on how to prevent patient surgical sites from becoming infected. Although such steps may not always prevent a surgical wound from becoming infected, it is always important to involve the patient in postoperative care.

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Surgical Wound Infection Assessment

By the WoundSource Editors

With an associated cost of $3.5 billion to $10 billion spent annually on surgical site infections (SSIs) and complications in the United States, it is important to know how to assess for surgical wound complications. There is a difference between the normal cascade response and a brewing infection. Symptoms of infection are often the first clue that there is more occurring in the wound than meets the eye.