Skin Flaps

Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP Payne and Martin brought skin tears to the attention of wound and skin specialists and to the wound care community when they reported an incidence rate of 2.23% in individuals aged 55 years and older, living in a long-term care facility. A skin tear is "a wound caused by shear, friction, and/or blunt force resulting in a separation of skin layers." Skin tears may be partial- or full-thickness wounds, develop into chronic wounds without proper treatment and follow-up, and, most importantly, are preventable.

By Aletha Tippett MD People from across the country call or email me asking about using leeches for a loved one. Usually, I tell them to try to find someone close to them to administer therapy. Often, the problem is not something a leech could help. I have written about leech therapy before, but maybe it’s time to review how leeches can be used in wound management.

By Aletha Tippett MD Sometimes when we think back on the things that have we have done for a patient it gives us a feeling of great satisfaction. Sometimes, however, these past reflections give us feelings of sadness and futility.

Editor's Note: What are the first steps to treating a skin tear? In this interview, Emily Greenstein, APRN, CNP, CWON-AP, FACCWS describes some best practices for skin tear management, such as marking a dressing for the direction of the skin flap.

By Aletha Tippett MD I have written about biotherapy in the past, primarily about maggot therapy, but today I would like to discuss leech therapy. In the U.S., leeches are used frequently by plastic surgeons to save a surgical flap that is in danger of dying. Leeches in the U.S. are provided by Leeches USA and they keep leeches ready at the New York airport to ship out in an emergency 24/7. The leeches used actually come from France and are FDA approved. Monarch Labs in the U.S. is working to develop a U.S. leech, but has a ways to go to get FDA approval.