Wound Bed Preparation

By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

We have all heard the saying: a dry cell is a dead cell… we know that a moist wound bed is most conducive to healing. If a wound is too dry, we add moisture… and if a wound is too wet, we try to absorb the drainage. There must be a balance of moist and dry to promote an optimal healing environment. Much like a dry cell is a dead cell, a wound that is too moist often has delayed wound healing.

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

As a wound care nurse practitioner, when I see granulation tissue start to form on a wound, I do a little happy dance. Granulation tissue is a sign that the wound is on its way past an often-stubborn inflammatory phase of healing and progressing into the building phase of proliferation. But what exactly is granulation tissue? And why does its presence indicate that the wound is healing? Let’s explore this a bit more.

By Ronald A. Sherman, MD

Challenges are nothing new for those of us who work in health care. Every day, we triumph over difficult situations. Yet, the current coronavirus outbreak has complicated even the simplest of procedures and has brought us additional challenges.

By the WoundSource Editors

Silver nitrate is a natural, inorganic chemical compound with antimicrobial properties that has been used in medical applications since the 13th century. It is used as a cauterizing agent and is available as a solution or an applicator stick. The applicator sticks, known as silver nitrate sticks or caustic pencils, contain silver nitrate and potassium nitrate. There are certain brands of silver nitrate sticks that can be bent or shaped to increase ease of access within a target area. The silver nitrate stick is activated by contact with moisture. When applied to wounds, silver nitrate sticks deliver free silver ions to the tissue that form an eschar as they bind to tissue and obstruct vessels.

By the WoundSource Editors

Advanced wound care technologies have come a long way in treating chronic wounds. However, diabetic foot ulcers (DFUs) can be challenging, and not every patient should have identical treatment. Utilizing a patient-centered approach is necessary for selecting appropriate treatments and achieving best possible outcomes. Understanding the specific patient’s needs and understanding the pathophysiology of diabetic wound chronicity are key elements in DFU management. The primary goal should be wound closure, while also preventing recurrence. To achieve both goals, clinicians must incorporate ongoing education and clinical support. Health care professionals should keep up on latest evidence-based research and practices to select the best advanced treatment for each patient.

By Margaret Heale, RN, MSc, CWOCN

As patient-driven groupings model hits home care, patients or their caregivers will be expected to do more of the care. Subsequently, nursing staff are expected to provide more education, making "how to" information more crucial than ever.

By the WoundSource Editors

Wound treatment plans are frequently ineffective because of a widespread failure to identify wound etiology accurately. One study found that up to 30% of all wounds lack a differential diagnosis, and this poses a real barrier to administering effective treatments. Furthermore, recent advances in the understanding of wounds, including the use of growth factors and bioengineered tissue and the ability to grow cells in vitro, present new opportunities to provide more effective treatment. Wound bed preparation that incorporates the TIME framework (tissue management, Infection or inflammation, moisture imbalance, and edge of wound) into the A, B, C, D, E wound bed preparation care cycle can significantly increase the ability to perform the following accurately.

By the WoundSource Editors

The prevalence of non-healing wounds is a challenge and concern for all levels of health care professionals. Clinical evidence has proven that using a multidisciplinary team approach to wound care is key in providing quality of care across the continuum. Clinicians should keep the mindset of always viewing the patient as a whole. A multidisciplinary team consists of members from many different disciplines using their areas of expertise to focus on the wound care patient. Bringing the knowledge and skills together of the wound team will provide guidance to better clinical, health, and financial outcomes.

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.

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.