Pressure Ulcer

Holly M. Hovan MSN, APRN, GERO-BC, CWOCN-AP

In chronic wound management, clinicians often see and treat both partial- and full-thickness wounds. These wounds may present as pressure injuries or other wound types, including, although not limited to burns, trauma wounds (skin tears, abrasions, lacerations), vascular wounds, diabetic wounds, and surgical wounds. It is vital to differentiate partial- versus full-thickness wounds for a multitude of reasons, such as to understand how they heal, guide treatment, and ensure clear accurate documentation, to name a few.

By Dr. Lenz and Dr. Hussain

For the patient, the prevention of sores and injuries is better than treating them. Pressure-relieving mattresses may be essential for preventing pressure injuries (bed sores). These mattresses aid in relieving and redistributing pressure and can thereby cause a reduction of friction and shearing. Pressure-relieving mattresses provide support for the body and reduce the amount of force applied to a given area. Thus, for bedbound patients and patients who are unable to reposition themselves, these types of beds can be especially beneficial.

By Dr. Lenz and Dr. Hussain

Heel pressure injuries and various forms of ulcers are easy to identify, but are you overlooking sleeping position as a cause for wounds in other locations? Do you have a wound you are sure is venous but has normal venous insufficiency testing results and fails to respond to compression? Can pressure while sleeping slow or stop healing in your patients with venous and arterial wounds? Do you ask patients about their sleeping position in your history taking and physical examination? After reading this article, you will be able to ask patients about their sleeping habits and heal more wounds with that knowledge

By Margaret Heale, RN, MSc, CWOCN

Medical device–related pressure injuries (MDRPIs) are recognized as a significant problem, evidenced by the inclusion in the National Pressure Injury Advisory Panel pressure injury definitions and described by Pitman and Gillespie in 2020.¹ Prevention of medical device-related pressure injuries is a goal that may be achieved through meticulous patient care.

Join Dr. Caroline Fife at WoundCon Fall 2021 for her talk on the angisome concept and how it applies to pressure injury development.

By Charles P. Buscemi, PhD, APRN, CWCN and Arturo Gonzalez, DNP, APRN, ANP-BC, CWCN-AP

Urinary catheters serve several purposes, including monitoring urine output, relieving urinary retention, and facilitating diagnosis of disease in the lower urinary tract. These catheters can be inserted easily and are universally available, which usually results in their continued and indiscriminate usage. Urinary catheters can be indwelling or external-condom types. The indwelling catheter can be either a suprapubic or a urethral catheter. The external catheter provides a safe alternative to an indwelling catheter for patients having urinary incontinence (UI). It comprises a sheath surrounding the penis with a tube situated at the tip linked to a collection bag. Conversely, the condom catheter seems an attractive option for patients with UI. About 40% of condom catheter users have urinary tract infections. Moreover, 15% of condom catheter users have necrosis, ulceration, inflammation, and constriction of the penile skin. There is also an additional risk of urine leakage and condom detachment. Furthermore, the use of the external catheter requires significant nursing time. Overall, the condom catheter cannot be satisfactorily used for managing UI; nevertheless, it is useful for the non-invasive measurement of bladder pressure.

By Dianne Rudolph, APRN, GNP-BC, CWOCN, UTHSCSA

Pressure injuries (PIs) are defined by the National Pressure Injury Advisory Panel as “localized damage to the skin and/or underlying soft tissue usually over a bony prominence or related to a medical or other device.” Pressure injuries may present as intact skin or as an open ulcer. These wound may be painful. Pressure injuries occur after exposure to prolonged pressure or as a result of pressure in combination with shear. Other factors may affect soft tissue tolerance, such as nutrition, perfusion, microclimate, the presence of comorbidities, and the condition of the soft tissue.

By Cathy Wogamon, DNP, MSN, FNP-BC, CWON, CFCN

Many questions arise and confusion develops when wound care providers mention Kennedy terminal ulcers (KTUs). Because these wounds are not frequently seen, and because they develop rapidly and observation ends abruptly with the death of the patient, wound care providers may have never observed a KTU, even in a long career in wound care. Although the literature reveals that there is a lack of knowledge regarding the exact cause of a KTU, let’s look at the facts currently known from published resources.

By Ivy Razmus, RN, PhD, CWOCN

There remain many unanswered questions regarding pressure injury and prevention practices among neonatal patients. Guidelines for pressure injury prevention were initiated in 1992 by the U.S. Agency for Healthcare Research and Quality (AHRQ). Pressure injury prevention practices are based on these guidelines, which recently expanded to include pediatric patients.

By Holly Hovan, MSN, RN-BC, APRN-CNS, CWOCN-AP

What is mobility? Typically, when we hear the word mobility, we think about our ability to move, with or without assistance. In a long-term care setting, we often hear the words, "mobility aids," which are typically pieces of medical equipment that are used to enhance mobility—wheelchairs, walkers, canes, power wheelchairs, crutches, and even guide dogs for those who are sight impaired. There are many intrinsic and extrinsic factors that impact one's mobility, which will be discussed in this blog.