Wound Care

3M Health Care's picture
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Chronic wound care is challenging for the entire healthcare ecosystem, from clinicians to patients, and COVID-19 has only exacerbated those challenges. Patients are delaying primary care provider and wound clinician visits for ongoing guidance and therapy to reduce possible exposure to the virus. This is understandable, as many chronic wound patients are in the high-risk category if they become ill with COVID-19.1 They are also putting off elective surgeries, annual physicals, and basic preventive care, which can negatively affect long-term outcomes.

Holly Hovan's picture

Holly Hovan MSN, GERO-BC, APRN, CWOCN-A

Determining Wound Etiology:

Predominant pain pattern, ulcer location, ulcer appearance, type and amount of wound exudate, and vascular and sensorimotor assessment are some key factors used to determine the primary etiology of lower extremity ulcers.1

Jeffrey M. Levine's picture

Jeffrey M. Levine MD, AGSF, CMD, CWSP

My colleagues, Barbara Delmore PhD, RN, CWCN, MAPWCA and Jill Cox PhD, RN, APN-c, CWOCN, and I have written a paper,1 available electronically ahead of print, that reviews the skin failure concept, defines related controversies, and proposes a model for its pathogenesis. Like all other organs, skin can fail; however, experts continue to grapple with definitions, causative factors, and manifestations.

Emily Greenstein's picture
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Emily Greenstein, APRN, CNP, CWON, FACCWS

Wound care has evolved from treatments based on superstition to systematic, evidence-based care. The history of wound healing dates back to 2000 BCE. Various civilizations over the centuries had differing approaches to wound care.

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

Wound care and healing require an evidenced-based, interprofessional approach, following standards of care, and treating the whole patient, not just the hole in the patient. Often, wound care clinicians are consulted for recommendations on the treatment of chronic or non-healing wounds, as well as other wound, ostomy, and continence issues. Treating a wound and successfully healing a wound require a holistic approach for the best outcomes.

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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.

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By: Emily Greenstein, APRN, CNP, CWON, FACCWS

Being a wound care professional is often a lot like being a detective. You have to decide what caused the wound, what is contributing to its not healing and how you are going to get it to heal. I have decided to start a series of “cases” that are commonly overlooked or seen in the chronic wound care setting. The cases will focus on real-life scenarios—moisture-associated skin damage versus pressure injury, red leg syndrome versus venous stasis ulcer, how to identify pyoderma, and the importance of a moist wound healing environment. This series will also provide practical strategies for overcoming healing obstacles for slow, non-healing, and challenging wounds.

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By Temple University School of Podiatric Medicine Journal Review Club

An appropriate timeline to initiate biofilm-based wound care (BBWC) has been a topic of question since the incorporation of biofilm therapy was introduced. In hard-to-heal delayed wounds, it is largely agreed upon that biofilms are a significant barrier to healing, and that removal is essential. By definition, hard-to-heal wounds are wounds that have failed to respond to evidence-based standard of care and contain biofilm. Biofilms are polymicrobial communities residing in an extracellular matrix produced by bacteria, which is well-hydrated and resistant against antimicrobial agents and host defenses. Biofilm can form within hours, can reach maturity within 48-72 hours, and has the ability to regrow within 24-48 hours. A first critical step to BBWC is debridement, though it requires additional suppression methods, as well as considerations of a patient’s risk factors. Risk factors include peripheral vascular disease, infection, diabetes, and pressure off-loading, which encourage biofilm development by delaying wound healing. Risks and costs with early BBWC are most likely less than those associated with biofilm-related wound complications. Thus, in March 2019, a panel of nine experts met in London for an Advisory Board Meeting, where they developed solutions to barriers preventing early BBWC and methods of appropriate “wound hygiene” for all health professionals. They reconvened in the summer of 2019 to create a clinical consensus document published in the Journal of Wound Care supported by ConvaTec Limited.

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By Miranda Henry, Editorial Director of WoundSource

Whether meeting with patients via telehealth at your home-based office or doing rounds at the clinic, WoundSource is still there to provide you with the most trusted and up-to-date wound care education and product information.

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Heidi Cross's picture

By Heidi Cross, MSN, RN, FNP-BC, CWON

Pressure injury risk and development are multifactorial, individualized processes. Each patient presents with a unique set of circumstances and needs. In looking at charts for attorneys to determine whether standards of care related to pressure injuries have been met, key elements include turning and positioning measures, support surfaces, mobility, proper and timely assessment of risk factors and wounds, physician communication and notifications, communication with family, proper wound treatments, and nutrition assessment and measures.

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