Wound Healing

By Aletha Tippett MD It would be interesting to know how many people reading this blog have tried laser therapy for wound healing. I suspect not many, and that is unfortunate because laser therapy can be a wonderful adjuvant for wound healing.

By Mary Ellen Posthauer, RDN, CD, LD, FAND The World Union Wound Healing Society (WUWHS) held their 2016 meeting in historic Florence, Italy in September. The initial meeting of the WUWHS was held in Australia in 2000 and is convened every four years. I have had the unique opportunity to present in Paris, Toronto, Yokohama and this year in Florence on the topic of nutrition and wound healing. 4,226 clinicians attended the conference including 525 from the US. The convention center was a modern venue surrounded by the ancient walls of the Roman fortress.

By Bruce E. Ruben MD Life is a bunch of pivotal moments that move you on to the next phase. Like the moment you realize you're no longer a child. Or the moment it becomes clear that you have to change jobs. Later on, it's when you admit you can no longer maintain your home. And for many of us, there will be the moment you come to grips with the fact that you can no longer care for yourself without help.

By Janet Wolfson PT, CLWT, CWS, CLT-LANA Introduction, History, and Practitioner Background Manual lymphatic drainage (MLD) was developed by Emil and Estrid Vodder in the 1930s. They dedicated their lives to the study of lymphatic anatomy and physiology. Since then, others have modified the original techniques, including Foeldi, Leduc, Casley-Smith, and Bjork. They all involve manual contact with the client, deep diaphragmatic breathing, stimulation of the lymph nodes, and movement of fluid from proximal and then distal areas. The manual contacts are slow, gentle, and rhythmic. Practitioners are typically occupational or physical therapists, physical and occupational therapy assistants, nurses, massage therapists, and physicians. Many practitioners, after a required 135-hour training program, complete the Lymphedema Association of North America (LANA) certification exam.

By the WoundSource Editors All wounds are complex non-sterile environments, often requiring a succession of intersecting phases of wound healing to repair completely. When epithelial tissue is compromised by a wound, contamination by common skin surface microbes may result in infection or the formation of a biofilm that impedes healing. Although systemic antibiotics are necessary for treating clinically infected wounds, the use of antibiotics and antiseptics in non-healing, non-infected wounds is debated.

Necrotic wounds are characterized by devitalized, or dead, tissue. Necrosis may be caused by malignancy, infection, trauma, ischemia, inflammation, or exposure to toxins. It may also be caused by improper care of an existing wound site. Devitalized tissue has no blood supply, and its presence prevents wound healing. It is necessary for necrotic tissue to be removed to allow wound healing to occur.

By Michel H.E. Hermans, MD Most of us will treat wounds primarily with Western-medicine techniques and materials, though, occasionally a "side step" is made. MEBO Wound Ointment is a non-Western, botanical cream that is used in the Middle East and the Far East for the management of partial-thickness burns. Although the exact working mechanisms of the ointment are not known, results often are good and some Western physicians have adopted its use.

By Mary Ellen Posthauer RDN, CD, LD, FAND As we appreciate the glorious fall foliage, the crisp sunny days and marvel at the vibrant chrysanthemums in rich jewel tones, we also enjoy hearty meals and soups that incorporate seasonal vegetables. Food is a common, universal topic discussed while caring for clients with wounds. After all, everyone eats and has an opinion on what should be purchased and how meals should be prepared.

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC Providers may view off label drug use (OLDU) for wounds as the "new wave". However, if there is little or no scientific evidence supporting the practice, it can possibly lead to more problems than good. Keep in mind that not every health care setting embraces off label drug use. For example, state surveyors view OLDU differently in long-term care versus home care. Providers should avoid any risk of being involved in a pressure injury investigation. OLDU may be considered a factor in the event of such an investigation. Hospice patients are considered to be in more of a "dying with dignity" category, therefore OLDU may be considered more acceptable.