Wound Bed Preparation

Cheryl Carver's picture
Staphylococcus aureus biofilm

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC

One of my favorite topics to discuss in wound care is biofilms. When I conduct wound care in-services or trainings, I always ask the audience, "Who wants to tell me what a biofilm is?" There is silence. From that point, I proceed to tell my little story about biofilms. It sounds a little like this...You know when we go to bed at night, get up in the morning and feel that sticky film on our teeth? We brush our teeth with a minty-fresh toothpaste. Now our teeth feel clean. By the next morning, that sticky, fuzzy feeling returns, right? Or, when your pet's water dish develops that slimy swamp layer and then you change it? Well that, my folks, is a biofilm!

Michel Hermans's picture
scapel for debridement

By Michel H.E. Hermans, MD

There are a number of general rules in surgery. Among these: dead space has to be avoided. interestingly enough, there is virtually no real scientific documentation about this topic but everybody knows this to be true (in ulcers this, of course, applies to fistulae, crevices, etc.).

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Laurie Swezey's picture
wound care 101 - wound debridement

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

There are four main types of debridement: mechanical, autolytic, enzymatic, and surgical. Each has its own advantages and disadvantages. Let’s take a look at each method individually:

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Temple University School of Podiatric Medicine's picture
Vashe Wound Solution

By Keval Parikh and James McGuire DPM, PT, CPed, FAPWHc

An important aspect of the field of wound care is the proper preparation of the wound bed. Key points in wound bed preparation include minimizing exudate, assistance in the facilitation of the body’s healing process, and helping to produce a well-vascularized, stable wound that is free of microbes.

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Bruce Ruben's picture
Scab

By Bruce E. Ruben MD

In the beginning, long before Johnson met Johnson and Band-Aids were invented, primitive men and women suffered minor cuts and abrasions and probably left them uncovered to heal. After all, the bleeding had stopped, a scab eventually formed and experience had taught them that their skin would heal in a week or two. So there was no great rush to find a use for those puffy, cottony, soft, white plants growing in the fields just yet.

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Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Necrotic tissue that is present in a wound presents a physical impediment to healing. Simply put, wounds cannot heal when necrotic tissue is present. In this article, we'll define necrotic tissue and describe ways to effect its removal from the wound bed.

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Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWON

Finding the key to unlocking a non-healing chronic wound keeps us awake at night. Though we have, as bedside clinicians, learned much about the physiology and biochemistry of chronic wounds over the past decade, wound healing is not an exact science. Negative pressure wound therapy (NPWT) has become standard care for certain chronic wounds. Sometimes, however, wounds treated with this therapy do not progress as readily as we think that they should. This has led us to consider combining other wound care products with NPWT. This article will examine the rationale for using three products in combination with negative pressure.

Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWOCN

Negative pressure wound therapy (NPWT) has become a mainstay in wound management. During the advent years of its use, NPWT was only used to treat large, difficult wounds. Now it is a standard treatment for a wide range of wounds. As a clinician interested in wound management, you are likely using this therapy frequently. But how knowledgeable are you about important aspects of NPWT? The author’s hope is that, as you read these NPWT-focused articles, you will become interested in filling in any “knowledge gaps” that you identify.

Ron Sherman's picture

By Ron Sherman MD, MSC, DTM&H

As far back as 1930, clinicians and researchers had a pretty good understanding of what “the right kind of maggots” could do for a wound. Those maggots are now known generically as “medicinal maggots” or “medical grade maggots.” Largely as the result of careful observations by William Baer (Chief, Orthopedic Surgery, Johns Hopkins, Baltimore) and others, we now describe the beneficial effects of medicinal maggots as being: 1) debridement; 2) disinfection; and 3) growth promotion. What is the evidence for these effects, and why is it that the only brand of medicinal maggots cleared by U.S. Food and Drug Administration (FDA) for marketing in the US (Medical Maggots™ by Monarch Labs, Irvine, CA) lists only debridement among its indications?

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