Wound Healing

by the WoundSource Editors Biofilm is a complex microbial community containing self- and surface-attached microorganisms that are embedded in an extracellular polymeric substance.1,2 The extracellular polymeric substance is a primarily polysaccharide protective matrix synthesized and secreted by the microorganisms that attaches the biofilm firmly to a living or non-living surface. This protective covering does not allow the body's immune system to recognize the presence of the microorganism; therefore, the bacteria evade an immune response, avoid detection by standard diagnostic techniques, and avoid destruction by standard treatments.3 Because of the tenacity of the attached biofilm, the microoganisms are able to resist physical forces, such shear, and are able to withstand nutrient and moisture deprivation, altered pH, and the impact of antibiotics and antiseptics. For the purposes of this discussion we break down the formation and actions of biofilms and discuss their impact on wound healing.

By the WoundSource Editors Biofilm: this term is frequently used in the wound care space, but biofilm continues to be largely undertreated in wound care. What do the bedside nurse or clinician need to know about biofilm? Should clinicians care less about biofilm on a maintenance or palliative wound versus a wound they are actively trying to heal? Let's address these questions and get to the root of the biofilm in managing complex wound cases.

By Holly Hovan MSN, APRN, ACNS-BC, CWON-AP In patients with end stage renal disease (ESRD), there is a decreased renal clearance that causes an increase in phosphorus, then calcium, in the body. Elevation of these two electrolytes causes the parathyroid gland to secrete additional parathyroid hormone to compensate. This, however, leads to increased movement of phosphorus and calcium throughout the body.

When a wound fails to progress through the phases of healing in a timely fashion despite the standard of care wound treatment provided, advanced therapies may be warranted. Wound care often needs a multifaceted approach that involves the treatment of entire patient, not just the wound. Clinicians should obtain a comprehensive medical history of the patient and conduct a thorough skin and wound assessment of the patient. This medical history and assessment will lay the foundation of initial treatment.

By Martin D. Vera LVN, CWS What is a chronic wound? What changes must happen within a wound for clinicians to classify it as "chronic"? Is there a time frame for healing chronic wounds? And what should we clinicians do to prevent and/or reverse chronic wounds? These are all great questions that keep us on our toes, from the dedicated seasoned clinician to the clinicians new to our field. In this blog I will define what a chronic wound is, what it consists of, and whether there is a way to convert or reverse a wound.

Wound healing is a complicated process that restores the skin's barrier function to prevent further damage or infection. The healing process normally progresses through 4 phases: hemostasis, inflammation, proliferation, and remodeling. However, a chronic wound may result when a wound fails to progress through the normal phases of healing.

Venous ulcers are known to be complex and costly. There is an array of evidence-based treatment options available to help formulate a comprehensive treatment plan toward wound closure. Health care professionals should utilize treatment options while encompassing a holistic approach to venous ulcer management. Involving the patient and/or caregiver in developing a treatment plan will increase the chances of successful wound healing outcomes. Wound closure is the primary goal of a treatment plan; however, preventing recurrence and infection should be considered just as important.