Wound Assessment

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS Wound exudate and how to properly assess and manage it has been a long standing clinical challenge in wound care. Assessing the exudate color, odor, volume, viscosity, and if it is causing maceration of the periwound skin are all important to note when creating a care plan for the patient. If there is not proper management of the exudate, then the high protease levels and low growth factor levels will negatively impact wound healing time.

By the WoundSource Editors Writing up a case report is an important professional activity in not only wound care, but in any other field as well. A case report records the details of the presentation of signs and symptoms, assessment, diagnosis, treatment and outcomes of a patient case or series of cases. Case reports typically describe an unusual presentation or complication relating to the patient's condition, or a new clinical approach to a common problem. The publication of a case report in a peer-reviewed journal, if that is your intent, is a great addition to your CV, especially if you are new to the profession.

By Bruce E. Ruben MD In order to heal a wound, the body needs oxygen, nutrients, energy and a fully functioning vascular system that brings those resources to the wound and takes waste products away from the wound.

By the WoundSource Editors A myriad of factors need to be addressed when evaluating a patient with a wound. A thorough patient history, including previous wounds, surgeries, hospitalizations, and past and existing conditions will help guide your clinical assessment, in addition to a number of questions specific to the wound(s) being assessed. Following is a list of general questions to ask when evaluating a wound care patient. (Please note that this list is not comprehensive and is intended only to serve as a guide):

By Lydia A. Meyers RN, MSN, CWCN Wound infections are discussed in the media and are a major reason for admission into the hospital. With the importance in health care today to decrease costs, I was encouraged to do research into where infections come from and the causes for hospitalization and death among wound patients. In the current data I found there is information showing how the government has increased surveillance related to reportable admission to hospital in relation to infections in wounds by home health and hospice organizations.

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS The measurement of a wound, and the plotting of its size over time, is the only estimate that can be used to accurately predict wound healing. This includes such variables as wound exudate, the presence of necrotic tissue, slough and granulation tissue, as well as undermining and tunneling.

By Dr. Mark Hinkes, DPM Twenty first century technology is helping people with diabetes to heal foot ulcers. An Australian colleague, for example, is developing an application that reminds people with diabetes to control their blood sugars with prompts and instructions, and allows them to upload a picture of their wound for their podiatrist to evaluate.

By Lydia A Meyers RN, MSN, CWCN Hyperbaric Oxygen Therapy (HBOT) is a type of therapy that is oxygen done under greater than atmospheric pressure. Treatments are done according to approval by Medicare/Medicaid rules and regulations. At this time HBOT has been approved for the following:

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA My current job as wound coordinator has pulled me into the world of incontinence and the many disciplines that care for people challenged by this disorder. I was previously acquainted with the therapy side as I worked with therapists certified in pelvic floor therapy. My work with venous edema acquainted me with medications that caused continence-challenged people to resort to absorbent adult briefs. As I work more closely with physicians, I am more familiar with medications to support weakened or sensitive pelvic muscles and nerves. On the nursing side, I have researched support surfaces, incontinence pads, and barrier creams. I see patients and occupational therapists working together to regain continence independence through problem-solving mobility issues.

By Margaret Heale, RN, MSc, CWOCN Most of the residents here are elderly, though some of the more acute rehab patients are quite a bit younger than me. We actually have five women over a 100 out of 116 people, quite impressive with the eldest being 105 years old. As for me, I am a retired British matron just doing a little volunteer work near where my granddaughter works.