Wound Healing

By Holly M. Hovan MSN, APRN-ACNS-BC, CWOCN-AP

After determining our goals of wound treatment (healing, maintaining, or comfort/palliative), we need to choose a treatment that meets the needs of the wound and the patient.

by The WoundSource Editors

There are five types of non-selective and selective debridement methods, but many factors determine what method will be most effective for your patient.¹ Determining the debridement method is based not only on the wound presentation and evaluation, but also on the patient's history and physical examination. Looking at the "whole patient, not only the hole in the patient," is a valuable quote to live by as a wound care clinician. Ask yourself or your patient these few questions: Has the patient had a previous chronic wound history? Is your patient compliant with the plan of care? Who will be performing the dressing changes? Are there economic factors that affect the treatment plan? Take the answers to these questions into consideration when deciding on debridement methods.

by The WoundSource Editors

There are four stages of wound healing. This systematic process moves in a linear direction. The four stages of wound healing are: hemostasis, inflammation, proliferation, and maturation. It is imperative to remember that wound healing is not linear. It is possible for a patient to move forward or backward through the wound healing phases due to intrinsic and extrinsic forces.

by Aletha Tippett MD

Well known for its pain-relieving properties, lidocaine can help us with wound care in many other ways. It has been my go-to product for wound care for over 20 years. I always use viscous lidocaine squirted on any dressing. The viscous lidocaine is what is prescribed for people to gargle for sore throats, so I always knew it was safe to put on a wound. It is wonderful for pain relief. A patient might need systemic pain relief also, but the application of topical lidocaine is very effective to help alleviate local pain of wounds.

by Holly Hovan MSN, APRN-ACNS-BC, CWOCN-AP

As wound care clinicians, one of the first steps we take after meeting our patient and assessing their wound is identifying our treatment goals. Much like managing a complex medical problem, we need to identify if our goals of care are curative or palliative. This is important with all wounds, not just those present at end of life. There are many patients with vascular disease, diabetes, or other co-morbidities that may want to take a palliative approach versus aggressive debridement or amputation. You may have heard the term, “keeping it dry and stable.” This can work at times, but as with any wound, we need to keep an eye out for signs of an active infection and determine if/when we need to further intervene. Wounds can and do resolve with a palliative approach, but it is very important to understand, and explain to our patients, the difference.

Christchurch, New Zealand – March 28, 2018 – Two new smart-phone based imaging products, SilhouetteLite+ and SilhouetteLite, recently launched by ARANZ Medical Limited have been adopted by Promore Pharma AB (Solna, Sweden) for a multi-site clinical trial, and by New Zealand's Capital and Coast District Health Board for their community-based nurses.

Easy-to-use, SilhouetteLite+ and SilhouetteLite apps are highly portable, yet deliver robust accuracy and image consistency. The measurement and documentation data collected is securely synchronized in ARANZ Medical's proprietary, cloud database, SilhouetteCentral, for ease of analysis and reporting.

Evolving negative pressure wound therapy (NPWT) technology including instillation therapy, nanocrystalline adjuncts, and portable systems can further improve results if used with correct indications. In diabetic foot management, NPWT has had a significant impact on limb salvage. However, it is important to emphasize that diabetic foot management is a multidisciplinary effort, and NPWT is only one of the essential tools in overall management. Successful outcome is heavily dependent on all treatment modalities, including adequate wound debridement, appropriate antibiotic therapy, optimization of healing markers, and meticulous wound monitoring.

by the WoundSource Editors

When developing the plan of care for the patient with a chronic wound, it is imperative first to look at the "whole" patient and not just the "hole" in the patient.1 As we do, we are able to review any medical conditions or disease states that may affect wound repair and healing. Millions of Americans are affected by chronic wounds each year. These wounds include causes such as diabetic foot ulcers, venous leg ulcers, arterial insufficiency, and pressure ulcers. Common comorbid conditions that can affect healing include diabetes, venous insufficiency, peripheral arterial disease, cardiopulmonary and oxygen transport conditions, immune deficiencies, and dementia.2 This discussion is focused on these conditions and factors that contribute to chronic wounds and their management.

by WoundSource Editors

Chronic wounds are any types of wounds that have failed to heal in 90 days. Identifying the cause of a chronic wound is most important in the healing process. We as clinicians must help bolster advanced wound care by sharing advances in education in evidence-based treatment, prevention, and wound assessment.

by The WoundSource Editors

The periwound is as important as the wound. As clinicians, we should carefully assess the wound bed, but we need to remember also to assess the periwound and surrounding skin. The periwound should be considered the 4cm of surrounding skin extending from the wound bed. Chronic wounds may manifest any of the following characteristics, depending on wound type: erythema, induration, epibole, ecchymosis, hyperkeratosis, and changes in shape.