Wound Assessment

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Tissue Debridement

By the WoundSource Editors

The concept of wound bed preparation has been utilized and accepted for over two decades. Wound bed preparation techniques can only be accurately employed after a thorough and complete assessment of the wound. Poor assessments result in a negative impact of needless costs and truancy of appropriate treatments and outcomes. The goal of wound bed preparation is to provide an optimal wound healing environment. Up-to-date research in molecular science has helped evolve new technology and advanced therapies that include growth factors, growing cells in vitro, and developing bioengineered tissue. Researchers now know that the healing process involves an array of elements that require monitoring and attentiveness.

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Wound Bed Preparation for Chronic Wounds

By the WoundSource Editors

Wound bed preparation is a well-established concept, and the TIME framework is the standard tool used to assist clinicians with the management of patients’ wounds throughout the care cycle. Recent clinical and technological breakthroughs are enhancing our understanding of this care cycle. An overview of the wound bed preparation care cycle and the TIME framework is provided here.

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Emily Greenstein's picture
Patient-Centered Wound Care

By Emily Greenstein, APRN, CNP, CWON, FACCWS

Recently I was able to attend the Spring Symposium on Advanced Wound Care (SAWC) in San Antonio, Texas. I attended many different lectures, presented, and sat on a few expert panels. The one recurring theme that kept echoing was the need to look at the whole picture. Often, as wound specialists, we get in the habit of looking just at the wound without taking into consideration the underlying comorbidities and potential causes of the wound in the first place. This got me thinking, how do I treat a new patient who comes into my wound center? I decided to put together the top five "tips" to remember to look at the whole patient, not just the hole in the patient (as originally stated by Dr. Carrie Sussman, DPT, PT).

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Wound Chronicity

by the WoundSource Editors

Chronic wounds affect over 6.5 million people annually in the United States, with a total cost of over $26.8 billion per year. Proper identification of chronic wounds is necessary to develop an effective treatment plan, although many elements—such as intrinsic and extrinsic factors, comorbidities, and mixed etiologies—may complicate this process.

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WoundSource Practice Accelerator's picture

by the WoundSource Editors

Periwound skin management is just as important as wound bed preparation in wound healing. The goal of periwound management is to maintain an optimal moist wound healing environment while preventing skin breakdown and infection. Skin is more vulnerable in patients with certain comorbidities and conditions. Periwound skin breakdown is just one of the culprits that delay wound healing and increase pain. It is important to identify conditions and risk factors early in your wound assessment to help prevent any risk of wound progress declination.

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by the WoundSource Editors

The skin is the largest organ of our body, covering 18 square feet and weighing approximately 12 pounds. Despite positive characteristics, the skin is always susceptible to and at risk of injury and breakdown. Maintaining skin integrity equals maintaining skin health, and this includes people of any age. Older adults are at a higher risk because of the skin aging process. As skin ages, the junction between the epidermis and dermis thins and flattens, reducing circulation. Moisturizing factors in older adults also reduce, thus causing dry, flaky skin and increased risk of skin breakdown.

Cheryl Carver's picture
Case Scenarios: Wound Documentation

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

Auditing documentation has always been part of my wound nurse role in some way or another. My first experience with auditing documentation with a fine-tooth comb was while working in the hospital wound center setting as a hyperbaric oxygen technician. Back then, hyperbaric oxygen therapy was more difficult to get reimbursed, and there were a lot of Medicare appeals. I would search through stacks of documentation to find validation for the diagnosis specific to the hyperbaric oxygen therapy indication. I quickly found out how ONE word determined reimbursement, and we are not talking pennies. The documentation is either there or it isn’t. Wound care documentation also requires the same impeccable documentation. Reimbursement is driven by Centers for Medicare & Medicaid Services (CMS) guidelines. We must follow the rules, or we do not get paid.

Emily Greenstein's picture
Wound Care

by Emily Greenstein, APRN, CNP, CWON, FACCWS

"When I grow up, I want to be a wound care specialist." That's not something you hear kids going around saying. Sure, kids want to be doctors or nurses. But wound care specialist?

When you think about it, being a wound specialist is not a glamorous position, unlike being a neurosurgeon. The best quote that I ever heard from a colleague of mine was, "No one wants to do wound care; wound care isn't sexy." This may be true, but what is wound care then? To me it is ever changing, it is learning new things (most of which are not found in text books), and it is about helping patients heal both emotionally and physically from a chronic condition.

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biofilm development stages

by the WoundSource Editors

Advancements in molecular microbiology, microscopy technology, and techniques for study of bacteria have increased the ability to identify the existence of biofilms, but there still remains the unknown, such as differentiating between planktonic bacteria and biofilm.1 Chronic non-healing wounds harbor bacteria across the wound etiology classification.2–4 Malone et al. determined that the prevalence of biofilms in chronic wounds was 78.2% (confidence interval, 61.6–89, P < 0.002).2 The development of biofilms moves through a common pattern: attachment, microcolony formation, maturation, and dispersion. The initial attachment is reversible, but the attachment becomes stronger as cells multiply and change their gene expressions. This cell communication process is referred to as quorum sensing, allowing cells to survive.

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wound infection

by the WoundSource Editors

Wound infection is a complex process that can be affected by a variety of factors, some of which inhibit the ability to heal. The first stage of healing, the inflammatory stage, is particularly susceptible to chronicity. Chronicity can be influenced by many factors, with a common contributor being the presence of infection. The wound infection continuum begins with contamination and, if left unchecked, will progress to systematic infection.