Prevention and management of biofilm and infection in wounds can be supported by using antimicrobial and antibiofilm dressings. Internationally, there has been a rising prevalence of antibiotic-resistant organisms; this has resulted in increased incorporation of antimicrobial dressings in wound...
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Bioburden: Bioburden is the number of microorganisms in a wound, and a high bioburden can cause delayed wound healing.
Biofilm: Biofilms are usually composed of mixed strains of bacteria, fungi, yeasts, algae, microbes, and other cellular debris that...
Delayed wound healing occurs in various wound types and in patients with significant comorbidities. Hard-to-heal wounds have proven to be a challenging and worldwide crisis resulting in high financial burdens.
Biofilms are found in the majority of chronic wounds and pose a critical health threat, causing nearly 80% of refractory nosocomial infections. They also have a damaging virulence mechanism, which induces resistance to antimicrobials and evasion from the host’s immune system. Over 90% of chronic...
Wound debridement is a critical strategy in treating hard-to-heal wounds. It is a process that expedites healing by removing necrotic tissue, non-viable tissue, and foreign material. It can also be used to manage biofilm to prevent infection. Debriding a wound exposes the healthy underlying...
Patients who develop stage 3 and 4 pressure injuries with prolonged wound chronicity and complexity may require surgical intervention. One surgical method used to encourage healing in pressure injuries is flap surgery, which involves taking a section of skin with an intact blood supply and...
When pressure injury prevention fails as a result of non-adherence, various comorbidities, or gaps in care, it makes a major impact on the nation’s economy and has estimated costs of more than $100 billion in the United States.
Pressure injuries are among the most significant health and patient safety issues that health care facilities face daily. Aside from the strong impact on patients’ quality of life, they also have high costs of treatment, not just to the patient, but also to the health care industry. The Agency...
The coronavirus disease 2019 (COVID-19) pandemic has forced health care professionals to take a closer look at the most effective and appropriate measures for pressure injury prevention. In 17% of all COVID-19 cases pneumonia secondary to acute respiratory distress syndrome is the most common...
Adherence: Adherence is a term used to replace "compliance" in reference to a patient following clinician orders for wound care. Compliance implies that the patient should passively comply with the health care provider’s instructions, whereas adherence allows for patients to...
Surgical site management in the post-operative time frame is paramount in preventing infection and wound dehiscence. It is essential to use practical knowledge in good wound cleansing and skin care and in providing moisture balance in surgical site wound care management.
Surgical site infections (SSIs) are a risk for the more than 10 million patients who undergo inpatient surgical procedures every year in the United States. Between 300,000 and 500,000 Americans develop SSIs annually. SSIs are defined as infections related to an operative procedure that occur at...
Aseptic: Aseptic surgical procedures are those that aim at eliminating the risk of transmission of all harmful microorganisms. Aseptic practices can prevent the cross-contamination of pathogens.
Bioburden: The number of microorganisms within a wound is...
Surgical site infections (SSIs) are wound infections that occur after invasive surgical procedures. Depending on the location of the wound and the level of post-operative care that the patient receives, the risk of developing an SSI can be as high as 20%,1 although across all patients...
Surgical complications impact many patients every year, and when post-operative complications occur, they can disrupt the normal healing cycle and introduce new challenges in patient care. It is estimated that between 3% and 27% of surgical patients have unforeseen complications related to their...
By the WoundSource Editors
Collateral circulation: A collateral blood vessel circuit that may be adapted or remodeled to minimize the use of occluded arteries. Collateralization may offset some of the physiological signs of peripheral artery disease, such as...
By the WoundSource Editors
Lower extremity wounds such as diabetic foot ulcers (DFUs), venous ulcers, and arterial ulcers have been linked to poor patient outcomes, such as patient mortality and recurrence of the wound. Although precise recurrence rates can be difficult to...
By the WoundSource Editors
Wounds of the lower extremity, such as chronic venous leg ulcers and diabetic foot ulcers, often have a severe impact on patients' quality of life. Symptoms may range from mild to debilitating, depending on the location of the injury and its severity....
By the WoundSource Editors
Chronic wounds pose an ongoing challenge for clinicians, and there needs to be a clearer understanding of the pathophysiology of wound chronicity and treatment modalities available.
By the WoundSource Editors
Lower extremity ulcers, such as venous and arterial ulcers, can be complex and costly and can cause social distress. An estimated 1% of the adult population is affected by vascular wound types, and 3.6% of those affected are older than 65 years of age....
By the WoundSource Editors
When determining the course of action for treating a given wound, it is important that wound care clinicians evaluate how advanced wound care therapies have been deemed evidence based and how the specific product technology works. Evidence-based...
By the WoundSource Editors
Diabetic foot ulcer (DFU) complications are challenging and costly. Evidence-based practice and advanced wound care technologies have the potential to maximize good outcomes and prevent ulcer recurrence, but ensuring that patients receive education on...
By the WoundSource Editors
Advanced wound care technologies have come a long way in treating chronic wounds. However, diabetic foot ulcers (DFUs) can be challenging, and not every patient should have identical treatment. Utilizing a patient-centered approach is necessary for...
By the WoundSource Editors
Diabetic foot ulcers (DFUs) continue to be a major problem, causing patient suffering, burden, infections, and high mortality. The cost of DFU treatment was estimated at $1.3 trillion globally in 2015. Despite evolving advanced wound care technologies...
By the WoundSource Editors
Wound healing is a complex biological process that involves a sequence of molecular and cellular events to restore damaged tissue. These events occur within the extracellular matrix, a complex three-dimensional acellular environment that is present...
By the WoundSource Editors
Wound reepithelialization is key in the goal of wound closure. Reepithelialization is a coordinated multifactorial systemic process that involves formation of new epithelium and skin appendages. The epithelialization process can be stalled by a number...
By the WoundSource Editors
Wound chronicity is defined as any wound that is physiologically impaired due to a disruption in the wound healing cascade: 1) hemostasis, 2) inflammation, 3) proliferation, and 4) maturation/remodeling. To effectively manage chronic wounds, we must...
By the WoundSource Editors
Wound chronicity is an ongoing challenge for patients and health care professionals around the globe. An astonishing 4.5 million people in the United States experience lower extremity wound chronicity, while an estimated 1% are affected in the Western...
By the WoundSource Editors
The venous leg ulcer (VLU) is the most common type of chronic leg wound, and it can be challenging to manage. VLUs account for up to 90% of all chronic leg ulcers. Proper diagnosis and treatment planning are key to wound healing outcomes. This fact is...
By the WoundSource Editors
The most common type of chronic lower extremity wound is the venous ulcer, affecting 1% to 3% of the U.S. population. Chronic venous ulcers significantly impact quality of life and are a financial burden for both the patient and the health care...
By the WoundSource Editors
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...
By the WoundSource Editors
Venous ulcers pose a worldwide problem that comes with high recurrence rates, risk of infection, and substantial costs to treat. Health care professionals must be knowledgeable about underlying causes and pathological features. The comorbidities that...
By the WoundSource Editors
Antimicrobial resistance is one of the greatest health threats of the 21st century. The current number of deaths attributed to drug-resistant infections is 700,000, yet this figure is expected to grow more than 10-fold by 2050. Although the rapid...
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...
By The WoundSource Editors
Antimicrobial stewardship is becoming an increasing concern for nearly all clinical professionals. Antimicrobial resistance is often considered one of the most serious health threats of the 21st century. It is estimated that currently approximately 700,...
By the WoundSource Editors
With multiple risk factors impeding wound healing and wounds often diagnosed with mixed etiology, wound healing can be complicated. Understanding the pathophysiology of wound healing can help clinicians to better comprehend the needs of a wound...
By the WoundSource Editors
Wounds resulting from surgical procedures have many commonalities with wounds of other etiologies. However, there are a few notable differences in their classification, as well as in the recommended care practices that promote the healing of these...
By the WoundSource Editors
The number of surgical procedures performed in the United States has been increasing annually by as much as 300% over a 10-year period. Although technological advances in surgical procedures have allowed some procedures to be performed using minimally...
By the WoundSource Editors
The Centers for Disease Control and Prevention (CDC) define a surgical site infection (SSI) as "an infection that occurs after surgery in the part of the body where the surgery took place." The CDC go on to say the infection can be superficial involving...
By the WoundSource Editors
With an associated cost of $3.5 billion to $10 billion spent annually on surgical site infections (SSIs) and complications in the United States, it is important to know how to assess for surgical wound complications. There is a difference between the...
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...
By the WoundSource Editors
A vast percentage of wounds become chronically stalled because of mixed etiology and other underlying comorbid medical conditions. This means the wound is multifactorial, and using a singular approach won’t be enough. Lower extremity wounds, for example...
By the WoundSource Editors
Although complex wounds typically present with clinical challenges in treatment, there are certain types of wounds that clinicians are used to facing: pressure wounds , arterial wounds, venous wounds, diabetic wounds, moisture-related wounds, end-of-...
By the WoundSource Editors
Complex wounds pose a significant challenge for many health care providers. These wounds are often multifaceted, making treatment tremendously difficult. They represent a substantial burden on the health care industry, with annual costs in North America...
By the WoundSource Editors
Wound treatment plans are frequently ineffective because of a widespread failure to identify wound etiology accurately. One study found that up to 30% of all wounds lack a differential diagnosis, and this poses a real barrier to administering effective...
By the WoundSource Editors
The prevalence of non-healing wounds is a challenge and concern for all levels of health care professionals. Clinical evidence has proven that using a multidisciplinary team approach to wound care is key in providing quality of care across the continuum...
By the WoundSource Editors
The concept of wound bed preparation has been utilized and accepted for over two decades. Wound bed preparation techniques can only be accurately employed after a thorough and complete assessment of the wound. Poor assessments result in a negative...
By the WoundSource Editors
Wound bed preparation is a well-established concept, and the TIME framework is the standard tool used to assist clinicians with the management of patients’ wounds throughout the care cycle. Recent clinical and technological breakthroughs are enhancing...
By the WoundSource Editorsr
Lymphedema is defined as “an accumulation of lymph fluid in the soft tissues, most frequently in the arms or legs.” It impacts approximately one in every six patients in the United States who are undergoing solid tumor treatment. Lymphedema has become...
By the WoundSource Editors
As health care professionals, we see patients with lymphedema every day. However, do we know how to manage lymphedema? Are we confident in successful management of lymphedema? The answer, many times, is no. The lymphatic system goes hand in hand with...
By the WoundSource Editors
Lymphedema is edema—swelling of tissues caused by fluid in the intracellular space—that is caused by dysfunction or disruption of the lymphatic system. The lymphatic system uses lymphatic vessels to absorb, transfer, and filter fluids from peripheral...
By the WoundSource Editors
The lymphatic system is an incredibly complex network of tissues and organs. Together, this network regulates fluid balance, transports fatty acids from the gastrointestinal tract, and contributes to the immune system. Dysfunction in the lymphatic...
By the WoundSource Editors
Cellulitis: A common bacterial skin infection that appears as a swollen, red area of skin that feels hot and tender; also known as lymphangitis. Treatment should begin promptly to avoid having the infection spread rapidly and become...
by the WoundSource Editors
Chronic wounds affect over 6.5 million people annually in the United States, with a total cost of over $26.8 billion per year. Proper identification of chronic wounds is necessary to develop an effective treatment plan, although many elements—such as...
by the WoundSource Editors
Wound healing is a complex process that is highly dependent on many skin cell types interacting in a defined order. With chronic wounds, this process is disrupted, and healing does not normally progress. Although there are different types of chronic...
by the WoundSource Editors
The returning wound patient is in for reassessment. They are positioned for maximum visualization of the wound. You remove the dressing. Clean the wound. After a few additional steps, it's time to measure the wound's progress. Using your measurement...
by the WoundSource Editors
In approaching the management of a chronic wound, the first step in developing a treatment plan that will combat chronicity and promote healthy healing of damaged tissue begins with understanding the different types of wounds.
by the WoundSource Editors
Epidermis: the outer layer of the skin, which is the protective layer against the outside elements.
Epithelialization: the growth of the epidermis over a wound during the remodeling stage.
...
by the WoundSource Editors
There has been extensive research on how to prevent skin care-related skin breakdown, and most research agrees on a few main components. Eliminating skin contact with sweat, urine, and stool reduces the risk of maceration and incontinence-associated...
by the WoundSource Editors
Those working with at-risk populations must be aware of how to address the skin care needs of our patients and prevent pressure ulcers and injuries. At-risk populations, such as older adults, persons who are incontinent, pediatric patients, immobile...
by the WoundSource Editors
Periwound skin management is just as important as wound bed preparation in wound healing. The goal of periwound management is to maintain an optimal moist wound healing environment while preventing skin breakdown and infection. Skin is more vulnerable...
by the WoundSource Editors
The skin is the largest organ of our body, covering 18 square feet and weighing approximately 12 pounds. Despite positive characteristics, the skin is always susceptible to and at risk of injury and breakdown. Maintaining skin integrity equals...
by the WoundSource Editors
Venous leg ulcers can be painful, cause distress, and affect quality of life, from the weekly wound center visits, multilayer wraps, debridements, compression hose, elevation of legs above the heart, to the odor from heavy exudate.
by the WoundSource Editors
Chronic non-healing venous ulcer wounds are an economic burden to the health care system and are the most common type of leg ulcer, affecting around 1% of the population, with 3% of people aged over 80. With obesity and diabetes on the rise, the burden...
by the WoundSource Editors
Venous leg ulcers (VLUs) are difficult to treat, and when they are present a variety of complications may arise. These complications can be challenging to treat and may often contribute to the prolonged healing times resulting from chronicity found with...
by the WoundSource Editors
A venous leg ulcer (VLU) is caused by vein disease that primarily affects older adults. As a prevalent problem among older patients, providing care for individuals with VLUs is time-consuming and costly. The direct costs vary from country to country,...
by the WoundSource Editors
Enzymatic debridement: The use of a prescribed topical agent that can chemically liquefy necrotic tissue with enzymes. It is often less painful but can be more expensive than other forms of debridement.
Gaiter area:...
by the WoundSource Editors
Advancements in molecular microbiology, microscopy technology, and techniques for study of bacteria have increased the ability to identify the existence of biofilms, but there still remains the unknown, such as differentiating between planktonic...
By the WoundSource Editors
Wound biofilms not only impede healing but also increase the risk of infection. It is essential that wound biofilms be addressed and treated in a prompt, consistent manner. Biofilms have been an ongoing challenge because of the majority of resistant...
by the WoundSource Editors
Wound infection is a complex process that can be affected by a variety of factors, some of which inhibit the ability to heal. The first stage of healing, the inflammatory stage, is particularly susceptible to chronicity. Chronicity can be influenced by...
by the WoundSource Editors
The human skin microbiome is incredibly diverse and can contain up to one billion microorganisms on a single square centimeter, including bacteria, fungi, viruses, and arthropods. These dynamic environments often become more complicated when wounds are...
by the WoundSource Editors
Aerobic microorganisms: Organisms thriving in an oxygen-rich environment.
Anaerobic microorganisms: Organisms thriving in an oxygen-depleted environment.
Autolytic debridement: A selective...
by the WoundSource Editors
by the WoundSource Editors
Pressure Injury/Ulcer Risk Management in Palliative Care and Hospice
Palliative care and hospice care are not the same, but they both share one goal. They both focus on a patient's physical, mental, social, and spiritual needs. Palliative care...
by the WoundSource Editors
by the WoundSource Editors
by the WoundSource Editors
Surgical site infections (SSIs) account for 20% of total documented infections each year and cost approximately $34,000 per episode. SSIs are responsible for increased readmission rates, length of stay, reoperation, morbidity, and mortality, as well as...
by the WoundSource Editors
Surgical site infections (SSIs) are the most prevalent surgical wound complications, comprising approximately 15% of all health care–associated infections, with more than 500,000 reported yearly.1 Preventing SSIs is perhaps the best way to...
by the WoundSource Editors
Appropriate surgical wound and incision management in the post-operative time period is imperative to prevent complications...
by the WoundSource Editors
The Centers for Disease Control and Prevention (CDC) estimate approximately 30 million surgical procedures are performed annually in the United States.1 Advances in technology have afforded patients options such as minimally invasive surgery...
by the WoundSource Editors
Comprehensive treatment of diabetic foot ulcers (DFUs) includes moist local or topical wound care, serial sharp debridement,...
by the WoundSource Editors
Diabetic foot ulcers (DFUs) are ostensibly the most challenging types of chronic ulcerations to manage, given their multifactorial nature. Thorough, systematic assessment of a patient with a DFU is essential to developing a comprehensive plan of care....
by the WoundSource Editors
Overview
Diabetic foot ulcers (DFUs) are arguably among the most difficult types of wounds to manage; the etiology of these wounds poses some of the greatest clinical challenges for healing, considering the multifaceted nature of diabetes...
by the WoundSource Editors
Successful utilization of the TIME model for wound bed preparation requires a working knowledge of chronic wound tissue types. In addition, building on this foundational knowledge is the development of accurate wound assessment skills. These components...
by the WoundSource Editors
Before embarking on the journey of wound bed preparation, the goals for wound care should be carefully considered. A realistic look at the goals and expectations from the perspective of the patient as well as the wound care team is the first step in...
by the WoundSource Editors
by the WoundSource Editors
Bioburden: In wound care, this refers to the number of microorganisms that...
Alginate: Highly absorptive, non-occlusive dressing derived from brown seaweed or kelp.
Antimicrobial dressing: Delivers a sustained release of antimicrobial agents to the...
by the WoundSource Editors
by the WoundSource Editors
by the WoundSource Editors
Dressing selections can be overwhelming for clinicians and providers in health care. There are now well over 6,000...
by The WoundSource Editors
To witness the normal wound healing process is extraordinary. However, the systematic process of healing is not always perfect....
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...
by The WoundSource Editors
by the WoundSource Editors
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...
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...
by the Wound Source Editors
Chronic non-healing wounds affect millions of patients each year and contribute significantly to their morbidity and mortality. These wounds have a substantial impact because of their economic burden and the significant effect on the reduction in...
by the WoundSource Editors
Acute wound: Alteration in skin integrity such as a simple laceration or a surgical wound that moves normally through the healing process and heals in a predictable timeframe without complication.
by the WoundSource Editors
Of the millions of surgical procedures performed annually, most surgical site wounds heal without complications. Surgical site infections (SSIs) are common complications that may occur after surgery, and that may delay healing, therefore increasing the...
by the WoundSource Editors
Among the greatest triumphs of modern medicine were the identification and naming of the Penicillium mold by Alexander Fleming in 1928, and its ability to inhibit bacteria growth on culture medium. Penicillin was then developed by the team of...
by the WoundSource Editors
by the WoundSource Editors
Given the impact of infection on delayed wound healing, determining the presence of colonization and infection is imperative to achieving healed outcomes.Chronic wounds are always contaminated, and timely implementation of management and treatment...
by the WoundSource Editors
It has long been known in clinical practice that long-term exposure of the skin to moisture is harmful and can lead to extensive skin breakdown. The term moisture-associated skin damage was coined as an umbrella term to describe the spectrum of...
by the WoundSource Editors
Although clinical practice is hampered by a lack of rigorous studies, standardized terminology, or definitions of incontinence-associated skin damage, it is well known among health care providers that this damage places patients at increased risk for...
by the WoundSource Editors
Best practice in skin care focuses on the prevention of skin breakdown and the treatment of persons with altered skin integrity. When we ask what causes skin damage we should consider the conditions that can harm the skin, including excessive moisture...
by the WoundSource Editors
The performance of an accurate and complete skin assessment is of utmost importance to obtaining and maintaining healthy skin. Understanding the structure and function of the skin is key to the differentiation of normal from abnormal findings. Having...
by the WoundSource Editors
One of the greatest challenges when dealing with biofilms in chronic wounds is identifying their existence in the first place. The extracellular polymeric substance or EPS on biofilms essentially is an invisible cloak that protects and hides biofilms...
by the WoundSource Editors
Have you ever had plaque buildup on your teeth, seen a thin clear film on the top of your pet's water bowl, or stepped into a locker room shower where the floor felt slick and slimy? If so, then did you realize these were all forms of...
by the WoundSource Editors
Identifying and managing biofilms have become two of the most important aspects of wound care. Biofilms can have a significant impact...
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...
By the WoundSource Editors
Pressure ulcers/injuries pose a major risk to patients by increasing morbidity and mortality and causing significant discomfort.1 They are also prevalent, particularly in long-term care facilities, where patient populations may be at higher...
By the WoundSource Editors
Pressure ulcers/injuries are extremely prevalent, particularly in long-term and other care facilities, and primarily affect older adults, those with cognitive impairment, mobility issues or individuals who are bedfast. Understanding the best ways to...
By the WoundSource Editors
Nurses and other health care professionals providing care to patients regularly face challenges that can make it more difficult to perform routine tasks and ensure patient comfort and well-being, especially with regard to pressure ulcer/injury...
By the WoundSource Editors
Pressure ulcers/injuries are among the most costly and prevalent conditions faced by health care professionals. It is estimated that in the United States alone, pressure injuries cost up to $11.6 billion each year with an estimated per-injury cost of $...