Risk Factors

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

A pilonidal cyst is a pocket located at the top of the cleft of the buttocks that usually results from an embedded or stiff hair. This area may remain dormant for years and cause no major issues; however, often the embedded or stiff hair may cause the cyst to become inflamed and infected, resulting in an abscess that requires an incision to drain the infected material. These abscesses can recur, causing the patient to require surgical intervention to remove the cyst. After surgery, some patients tend not to heal well, and the result is a chronic, tracking wound in an area that is difficult to heal.

By Diane L. Krasner, PhD, RN, FAAN

Scope of Practice and Standards of Practice guide nurses and other members of the interprofessional wound care team in caring for patients with wounds. Documentation in the medical record is a key aspect of the standard of practice and serves to record the care delivered to the patient or resident. Your documentation should follow your facility guideline for documentation. Accurate documentation helps to improve patient safety, outcomes, and quality of care.

This WoundSource Trending Topic blog considers general wound documentation dos and don'ts and presents 10 tips for success. Good, better, and best documentation examples are included for each tip.

By Lauren Lazarevski RN, BSN, CWOCN

Calling the COVID-19 pandemic an "unprecedented time" is an understatement. In this time of uncertainty, predicting what to expect can provide some comfort via preparation for the future. We can presume several implications for wound care professionals, based on the clinical course and community response to our evolving situation. Wound care health professionals should be prepared for some unique circumstances on the other side of the curve.

By Becky Naughton, RN, MSN, FNP-C, WCC

Picture this: you've been seeing a patient in your wound center for the last several months to treat a slowly healing post-operative abdominal wound. The wound has been gradually responding to an assortment of treatments, including initial wound vacuum therapy after the surgery, followed by alginate and now a collagen dressing. The wound is getting smaller and has new granulation tissue at the base. You're actually a bit surprised that it's healing so nicely because the patient has multiple serious chronic illnesses, including severe chronic kidney disease that requires hemodialysis sessions three times per week, type 2 diabetes, morbid obesity, cardiovascular disease, and peripheral vascular disease.

Burns occur when the skin comes into contact with a heat source or caustic substance, commonly fire or flames, boiling liquid, hot objects, electrical current, or chemical agents. Different mechanisms of injury that can cause a burn include scalding, fire, chemical exposure, electrical exposure, and radiation. The extent of injuries that can occur from a burn is highly variable, and morbidity and mortality tend to increase as the surface area of the burn increases. Proper classification of burns is essential in guiding the initial management of the burn wound and achieving optimal outcomes.

By Kara S. Couch, MS, CRNP, CWCN-AP

Hospital-acquired pressure ulcers (HAPUs) pose a challenge for acute and post-acute care environments and are listed as hospital-acquired conditions (HACs) by the Centers for Medicare & Medicaid Services (CMS). Other HACs include central line–associated blood stream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs). Although CLABSIs and CAUTIs have seen a decrease in prevalence over the past decade, the HAPU is the only HAC that has not. In my recent WoundSource webinar, I discussed the topic of building a pressure ulcer prevention program within hospitals. The webinar is still available for viewing on WoundSource.com.

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.

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.

By Margaret Heale, RN, MSc, CWOCN

Oral health is more than just important. As a child in a family supported by the state, we could afford hot water for a bath only once a week, but I cleaned my teeth twice a day and had regular dental visits. At school, we were taught to brush our teeth, and the twice a day routine was reinforced. I remember as a 16 year old showing my junior charges the scuzzy stuff at the gum margin and telling them it was called plaque. At nursing school, I once again was taught how to brush teeth, and we practiced on each other. Oral hygiene may seem irrelevant to wound care, but there is no doubt that the mouth can release bacteria into the bloodstream and be the root cause of deep bone infections after orthopedic surgery, pneumonia in intensive care unit (ICU), and subacute bacterial endocarditis.

By the WoundSource Editors

Fistulas are abnormal connections or passageways between two organs or vessels that do not usually connect. Although they typically develop as a result of an injury or surgery, they can also be caused by infection or inflammation. The World Health Organization estimates that there are between 50,000 and 100,000 new cases of obstetric fistula annually, and the number of all types of fistulas is substantially higher.