Skin Care

Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWON

How did you acquire your knowledge and skills around the application of NPWT dressings? Most of us learned by observing another clinician doing dressing applications, or from a manufacturer's representative. We likely just imitated what they did, largely winging it. In my work over the past few years, I have been surprised to learn that many excellent clinicians have gaps in technical ability. This article is intended to review principles of NPWT dressing application to increase the accuracy of your techniques. These tips are distilled from principles that are typical of manufacturer guidelines. It is always recommended that you read and follow the manufacturer’s guidelines for the product that you are using.

Paula Erwin-Toth's picture

By Paula Erwin-Toth MSN, RN, CWOCN, CNS

Winter weather is upon us and that brings a whole host of challenges. Our skin is more liable to experience dryness, cracking and breakdown. Everyone, especially older adults, are more vulnerable to falls due to slippery steps and walkways. Shoveling heavy, wet snow has been associated with increased risk of heart attacks. Just heading to the mailbox, grocery store or the doctor's office can spell disaster. All of these situations can combine for a 'perfect storm' for risk of skin breakdown at home and all healthcare settings.

David Hite's picture

By David Hite PhD

Diabetes, the leading cause of amputation of the lower limbs, places an enormous burden on both the individual and the health care system. It’s estimated that the annual cost for treating diabetic foot problems is over one billion dollars. During their lifetime, 15 percent of people with diabetes will experience a foot ulcer and about 20 percent of those will require amputation.

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Paula Erwin-Toth's picture

By Paula Erwin-Toth MSN, RN, CWOCN, CNS

The 4th Congress of the World Union of Wound Healing Societies (WUWHS) was held September 2-6, 2012 in Yokohama, Japan. It was an amazing experience. Multidisciplinary wound care professionals from around the globe shared their research and clinical findings.

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

Since we are fast approaching the deadline for the national elections, I decided to join the fray and campaign for accurate completion of the Braden Scale nutrition sub-score. The Centers for Medicare and Medicaid Services (CMS), Minimum Data Set (MDS) 3.0 Section M, Skin Conditions requires pressure ulcer risk assessment. Nursing facilities may use a formal assessment instrument such as the Braden or Norton tool to determine pressure ulcer risk. The most commonly used pressure ulcer assessment tool is the Braden Scale and one of the sub-scales is nutrition. Studies completed by Bergstrom and Braden in skilled nursing facilities found that 80% of pressure ulcers developed in two weeks after admission and 90% within three weeks of admission.

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Sue Hull's picture

By Sue Hull MSN, RN, CWOCN

Here is an idea you will love!

What do you do with a blister? You know the problem. You discover a blister. If you don’t do anything, it will probably unroof and be open and vulnerable by the next time you see it.

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Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWON

I am frequently asked for solutions relating to maceration to periwound skin in wounds being treated with negative pressure wound therapy (NPWT). As a clinician practicing in the outpatient and home care settings, it was not unusual for patients to have to take a "holiday" from negative pressure. Treatment was often put on hold for several days to allow skin to recover. Putting negative pressure on hold not only caused a potential delay in forward progress in the wound, but it also created the need for increased dressing change visits for the home care patient. While maceration is reported in wounds located anywhere on the body, it seems to be most prevalent on skin of the lower extremity.

Aletha Tippett MD's picture

By Aletha Tippett MD

Because of neuropathy, peripheral vascular disease, or age, most if not all of the patients seen for wound care have dry skin. This dry skin increases the risk of infection, skin tears, bruises and ulcers.

Kathi Thimsen's picture

By Kathi Thimsen RN, MSN, WOCN

Practicing skin and wound care requires the clinician to have many tools to address the myriad of issues related to patient management. Maintaining the integrity of a bandage, device, or skin edge all require operational understanding of the sticky aspect of wound care: adhesives.