Wound Exudate

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS Wound exudate and how to properly assess and manage it has been a long standing clinical challenge in wound care. Assessing the exudate color, odor, volume, viscosity, and if it is causing maceration of the periwound skin are all important to note when creating a care plan for the patient. If there is not proper management of the exudate, then the high protease levels and low growth factor levels will negatively impact wound healing time.

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 Emily Greenstein, APRN, CNP, CWON, FACCWS Last month I introduced you to the concept of how being a wound care professional is often a lot like being a detective. This blog post is going to start our “cases.” I decided, in keeping with the theme, to write it up similar to what you would see in a court document.

By Holly M. Hovan, MSN, GERO-BC, APRN, CWOCN-AP Wound assessment is one of the initial steps in determining the plan of care, changes in treatment, and the choice of key players in wound management. However, wound assessment needs to be accurately understood and documented by frontline staff to paint a true picture of what is happening with the wound.

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.

By Holly Hovan MSN, APRN, CWOCN-AP As wound care clinicians, we are aware that part of the process of consulting requires a comprehensive wound assessment, looking at wound characteristics, causative factors, and drainage. As I've previously mentioned, we've all heard the term, "a dry cell is a dead cell." However, not all wounds are dry.

Effective wound management often requires attending to multiple aspects of the wound itself, including properly preparing the wound bed and managing moisture and exudate, among other facets of wound care. Tissue viability is another crucial aspect of wound management. Unfortunately, many types of wounds, including acute and chronic wounds, contain devitalized tissue. Devitalized tissue inhibits healing in multiple ways. It can serve as a source of nutrients for bacteria, especially if the tissue is necrotic. Devitalized tissue also acts as a physical barrier for re-epithelialization, thereby preventing topical compounds from penetrating the wound bed when required. Further, this tissue can prevent angiogenesis, granulation tissue formation, epidermal resurfacing, and standard extracellular matrix (ECM) formation. It can also cover the wound and render it difficult for clinicians to assess the extent and severity of the wound adequately.