Blogs

Samantha Kuplicki's picture
Surgeon Changing Gloves

By Samantha Kuplicki MSN, MSN, APRN-CNS, AGNCS-BC, CWCN-AP, CWS, RNFA, CFCN

Surgical site infections (SSIs) are the most frequent complications in colorectal surgery procedures, with the documented incidence in literature ranging from 3% to 30%. (And, as we discussed in a previous installment, patient-specific risk factors can be the most challenging to control.) In response to these data, the American College of Surgeons and The Joint Commission’s Center for Transforming Healthcare launched a collaborative effort in 2012 to reduce colorectal SSIs.

Aletha Tippett MD's picture
Lidocaine Chemical Makeup

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.

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Thomas Serena's picture
The Importance of Clinical Trials

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

I do not know the origin of the phrase "...a gift from the devil's grandmother." I first read it in Einstein's letters to Schrödinger. Einstein employed the phrase to describe his fear of failing to find a unified theory of relativity and quantum physics. The problem appeared unsolvable. A similar gift in the field of clinical trial research in wound healing appeared on my doorstep recently. I started my research career conducting double-blinded pharmaceutical trials. After a string of failures, I convinced myself that advanced therapy in chronic wounds was doomed; however, cellular- and/or tissue-based products (CTPs) entered the market with encouraging results, brightening my spirits. To date, our cooperative group of investigators has published more than a dozen trials demonstrating the efficacy of CTPs in the treatment of diabetic and venous ulcers.

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Janet Wolfson's picture
Lymphatic System

by Janet Wolfson PT, CLWT, CS, CLT-LANA

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.

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Holly Hovan's picture
The Importance of Palliative Care

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.

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James McGuire's picture
View of Pressure Points on a Foot

by James McGuire, DPM, PT, CPed, FAPWH

According to the American Diabetes Association, there are 29.1 million Americans with diabetes, 8.1 million of whom are walking around undiagnosed.1 This number is dwarfed by the 86 million Americans who have been classified as having prediabetes and who are at risk for developing diabetes in the near future. Each year, 1.7 million Americans age 20 years or older — 4,660 per day, or one every 19 seconds — are added to the rolls and begin a slow but steady acquisition of the devastating complications of the disease.

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Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

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.

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WoundSource Practice Accelerator's picture
Patient with oxygen mask

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.

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WoundSource Practice Accelerator's picture
Nurse with Patient

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.

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WoundSource Practice Accelerator's picture
Periwound skin

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.

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