Wound Care Diagnostics

By Paula Erwin-Toth MSN, RN, CWOCN, CNS, FAAN January is the month for committing to new goals and resolutions for the year ahead. Several years ago I made a New Year's resolution to stop making New Year's resolutions. Like most New Year's resolutions I have not had much success in keeping it. Therefore I am sharing a few resolutions.

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.

by the WoundSource Editors Have you ever had plaque buildup on your teeth, seen a thin clear film on the top of your pet's water bowl, or stepped into a locker room shower where the floor felt slick and slimy? If so, then did you realize these were all forms of biofilm? Biofilm is a complex microbial community containing self- and surface-attached microorganisms that are embedded in an extracellular polymeric substance, or EPS.1,2 The EPS is the slimy substance in the previous examples and is primarily a polysaccharide protective matrix synthesized and secreted by the microorganisms that attaches the biofilm firmly to a living or non-living surface. This film protects the organisms from destruction first by being tenacious and keeping the microbial community strongly attached to a surface.

by Bruce E. Ruben MD Chronic venous insufficiency (CVI) refers to a long-term condition where the veins inside the legs have lost their ability to move blood back up to the heart from the legs. This occurs because the vein walls have weakened to the point where the venous pumps are no longer sufficient enough to send blood back up, against gravity, to the heart. CVI also affects the tiny valves inside the leg veins. When these valves do not close sufficiently, blood seeps back down past the valves and pools in the lower legs.

By Paula Erwin-Toth MSN, RN, CWOCN, CNS, FAAN What's the best approach to wound management: use of the latest advanced technology or "back to basics" treatment methods? How many times have you, the experienced wound clinician, been asked this question? It is only natural for people (especially patients and their families) to gravitate to a solution that seems to offer a quick fix for a very complex problem.

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC I see it all of the time. Wound care clinicians performing wound cultures incorrectly, or obtaining cultures just because there is an open wound. With this being said, there are certain health care settings where per protocol, swab cultures are taken on every wound, even without signs and symptoms of infection. But I want you to always ask yourself a few questions when determining if a culture is warranted: Are there signs and symptoms of infection? Is there an odor after the wound has been cleansed? Has wound healing stalled? Maybe there is a biofilm present?

By Michel H.E. Hermans, MD

By Thomas E. Serena MD, FACS, FACHM, FAPWCA The Emperor's New Clothes was one of my favorite childhood stories. In this Hans Christian Anderson tale, two weavers clothe the emperor in what today would be referred to as "virtual finery." All of his ministers, advisers, factotums and subjects praise the beauty of the unseen linens until a small boy states the obvious truth, "Look, the Emperor is naked."