Practice Accelerator

by the WoundSource Editors

Venous leg ulcers can be painful, cause distress, and affect quality of life, from the weekly wound center visits, multilayer wraps, debridements, compression hose, elevation of legs above the heart, to the odor from heavy exudate.

by the WoundSource Editors

Chronic non-healing venous ulcer wounds are an economic burden to the health care system and are the most common type of leg ulcer, affecting around 1% of the population, with 3% of people aged over 80. With obesity and diabetes on the rise, the burden is likely to continue to increase. Lowered quality of life, amputation, and death are often the results of venous leg ulcer chronicity, and the rate of recurrence within three months after wound closure has been reported to be as high as 70%.

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.

by the WoundSource Editors

A venous leg ulcer (VLU) is caused by vein disease that primarily affects older adults. As a prevalent problem among older patients, providing care for individuals with VLUs is time-consuming and costly. The direct costs vary from country to country, with reporting numbers of €800 monthly in Germany. Statistics report $2,500 monthly in the United States per patient, and given the chronic nature of VLUs, the cumulative costs per patient increase rapidly.

by the WoundSource Editors

Calf muscle pump: Functional result of the calf muscle surrounding the deep venous system and compressing the veins during plantarflexion by contracting the muscle to assist with venous return to the heart.

by the WoundSource Editors

Advancements in molecular microbiology, microscopy technology, and techniques for study of bacteria have increased the ability to identify the existence of biofilms, but there still remains the unknown, such as differentiating between planktonic bacteria and biofilm.¹ Chronic non-healing wounds harbor bacteria across the wound etiology classification.^2–4 Malone et al. determined that the prevalence of biofilms in chronic wounds was 78.2% (confidence interval, 61.6–89, P < 0.002).² The development of biofilms moves through a common pattern: attachment, microcolony formation, maturation, and dispersion. The initial attachment is reversible, but the attachment becomes stronger as cells multiply and change their gene expressions. This cell communication process is referred to as quorum sensing, allowing cells to survive.

By the WoundSource Editors

Wound biofilms not only impede healing but also increase the risk of infection. It is essential that wound biofilms be addressed and treated in a prompt, consistent manner. Biofilms have been an ongoing challenge because of the majority of resistant bacteria. Research in antibiofilm technology continues to grow, and it is essential to keep up on the most recent evidenced-based practice literature for improving patients’ outcomes.

by the WoundSource Editors

Wound infection is a complex process that can be affected by a variety of factors, some of which inhibit the ability to heal. The first stage of healing, the inflammatory stage, is particularly susceptible to chronicity. Chronicity can be influenced by many factors, with a common contributor being the presence of infection. The wound infection continuum begins with contamination and, if left unchecked, will progress to systematic infection.

by the WoundSource Editors

The human skin microbiome is incredibly diverse and can contain up to one billion microorganisms on a single square centimeter, including bacteria, fungi, viruses, and arthropods. These dynamic environments often become more complicated when wounds are present, and the types of microorganisms present near the dead and damaged tissue reduce the ability to eliminate them through normal immune responses and with standard antimicrobials.

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.