Practice Accelerator

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.

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.

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.

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.

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.

by the WoundSource Editors

Cellular and/or tissue-based products: Formally referred to as skin substitutes, these are engineered products, both cellular and acellular, intended to facilitate biological repair or regeneration of wound tissue by providing signaling, structural, or cellular elements.

By the WoundSource Editors

The definition of a diabetic wound of the lower extremity in its simplest form could be described as an open area on the lower extremity limb of anyone with diabetes. Some wound specialists would also state that pre-diabetes is still diabetes in a wound care world, so if someone with pre-diabetes develops a wound you should still treat it as if the patient had diabetes.

By the WoundSource Editors

Diabetes is one of the most common and costly conditions encountered in the U.S. health care system. The condition impacts over 23 million people annually, for a total cost of $245 billion per year. Although surgical infections remain the leading cause of non-healing wounds, diabetic infections follow closely behind, and they impose a substantial financial burden on the U.S. health care system. Treatment of diabetic ulcers in the United States contributes an additional $9 to $13 billion to the direct annual costs associated with diabetes.

By the WoundSource Editors

In patients with diabetes, the lifetime risk of diabetic foot ulcers (DFUs) is approximately 25%, and these wounds are frequently a source of pain and discomfort. Severe cases can even result in amputation of a portion of or the entire affected extremity. Proper classification of DFUs is essential for selecting the appropriate treatment course and coordinating care for the patient. Several systems are frequently used in classifying DFUs, although there is no universally agreed-on standard.

By the WoundSource Editors

For people with diabetes who develop a wound, the statistics are high. The data are as overwhelming as the cost of care, and the outcome if these wounds do not heal is often deadly. The faster we can intervene and get closure in these limbs, the better the patient outcomes and chance for a longer, fulfilled life. How do we go from ulceration to closure, and what tools do we need in our arsenal?