Wound Diagnostics

By Martin D. Vera, LVN, CWS

Wound clinicians across the nation (and the world) are commonly faced with the difficult task of managing lower extremity wounds. Lower extremity wounds come in many different forms. We are not faced with a generic type, but several—in fact, we never know what we'll be presented with day-to-day.

By Catherine T. Milne, APRN, MSN, BC-ANP, CWOCN-AP

From Nike's "Just Do It" ad campaign to Google's corporate "Don't be evil" code, I've always been struck by the many marketing campaigns that remind us to pay attention to our conscience. A similar focus should apply to health care. In 2000, the Institute of Medicine (IOM) published a scathing report showing that the number of people who died from medical errors surpassed the combined total of those who died from breast cancer and car accidents.¹ To make matters worse, this was likely a low estimate. In 2013, the Journal of Patient Safety reported that adverse events from preventable harm may affect between 210,000 and 440,000 hospital patients each year.² As clinicians, we've all taken an oath, a pledge or a vow to "do no harm." Why is the reality so far from the ideal?

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

The American Professional Wound Care Association's (APWCA) annual meeting concluded in Philadelphia the last weekend in March. The meeting featured several novel ideas in wound care education. A hands-on competency session permitted attendees to place total contact casts, practice with two bedside grafting devices, assess vascular status, and become proficient in negative pressure wound therapy.

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

Deciding on a blog topic for this month was simple. August 12th marked 18 years since my 47-year-old mother passed away due to pressure ulcer complications. A flood of memories came rushing through, realizing just how much wound care has evolved throughout the years. A feeling of "if I only knew then, what I know now" type emotions. I cannot help but have a great deal of heartfelt empathy for caregivers and their loved ones with chronic wounds. My personal experiences have led me to my sense of gratification in what I do every day.

By Karen Zulkowski DNS, RN, CWS

Documenting wounds is always problematic for staff. It is important that wounds be assessed consistently both for measurement and characteristics. The use of pictures is also controversial. Pictures can help or hurt you if you are sued. However, consistent documentation of the wound, treatment and care planning that accompanies a picture would be useful.

By Michael Miller DO, FACOS, FAPWCA, WCC

For those of you who cannot remember the now deceased comedian Chris Farley, did not find his humor funny or simply cannot remember any of his memorable performances; I suggest you move on to another, less controversial, "here's how to use scissors" type of blog.

By Michael Miller DO, FACOS, FAPWCA, WCC

As we enter this New Year, I have several resolutions which I hope will act as a sextant for my upcoming wound care voyages. I promise to be less critical of my colleagues who do horrendous, insipid, unprofessional, unethical, unintelligent, profit-motivated things to patients in the name of good care…OK, maybe not. I have promised to continue my Sinbad-like voyage to find my much sought after ball-laden juggler for whom to send my much needed debridements and IV port placements. I understand that surgeons prefer to evaluate patients before elective procedures to assure that they have no potential problems and that they are low risk candidates for the requested procedure. But asking a 300 lb. paraplegic to come in to a poorly accessible office to vet them and then schedule them days later rarely identifies a reason to defer on the procedure but moreover, places the patient, their family and others at high risk and considerable inconvenience. Can you not arrange to see them early and help them later the same day?

By Aletha Tippett MD

What steps should be taken the first time you encounter a patient with a wound? Here is my list of priorities when I assess a wound:

By Aletha Tippett MD

In my work with wounds, I frequently find the absence of a diagnosis of ischemia, or worse, I find a misdiagnosis. Ischemia is caused by severe obstruction of the arteries, which seriously decreases blood flow. If the arteries are in the heart, you will find a heart attack. If the arteries are in the brain, you will find a stroke. In the skin, you will find a wound.