Eschar

WoundSource Practice Accelerator's picture
Chronic Wound Tissue

by The WoundSource Editors

To witness the normal wound healing process is extraordinary. However, the systematic process of healing is not always perfect. Chronic wounds are complex and present an immense burden in health care. Identifying the wound etiology is important, but an accurate wound assessment is just as important. The color, consistency, and texture of wound tissue will lead you to the most appropriate wound management plan.

Cheryl Carver's picture
eschar on heel pressure ulcer

by Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC

Knowing the difference between a scab and eschar may not seem like a big deal. However, if you are being audited, or your facility is in survey, you might think otherwise. Here are a couple of scenarios for you to think about.

Laurie Swezey's picture

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Necrotic tissue that is present in a wound presents a physical impediment to healing. Simply put, wounds cannot heal when necrotic tissue is present. In this article, we'll define necrotic tissue and describe ways to effect its removal from the wound bed.

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Beth Hawkins Bradley's picture

by Beth Hawkins Bradley RN, MN, CWON

Finding the key to unlocking a non-healing chronic wound keeps us awake at night. Though we have, as bedside clinicians, learned much about the physiology and biochemistry of chronic wounds over the past decade, wound healing is not an exact science. Negative pressure wound therapy (NPWT) has become standard care for certain chronic wounds. Sometimes, however, wounds treated with this therapy do not progress as readily as we think that they should. This has led us to consider combining other wound care products with NPWT. This article will examine the rationale for using three products in combination with negative pressure.

Laurie Swezey's picture

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Arterial ulcers can cause much pain for patients and consternation for the wound care professionals tasked with managing them. Arterial ulcers can be a catch-22 in that many patients with arterial ulcers present with edema, but due to the nature of their problem cannot be safely compressed.

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Laurie Swezey's picture

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Whirlpool therapy, or hydrotherapy, is one of the oldest adjuvant forms of treatment for wounds still in use today. It was originally used in pain management, but later found a use in wound management, particularly in the management of burn patients.

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Aletha Tippett MD's picture

by Aletha Tippett MD

In my work with wounds, I frequently find the absence of a diagnosis of ischemia, or worse, I find a misdiagnosis. Ischemia is caused by severe obstruction of the arteries, which seriously decreases blood flow. If the arteries are in the heart, you will find a heart attack. If the arteries are in the brain, you will find a stroke. In the skin, you will find a wound.

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Laurie Swezey's picture

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

The sheer number of dressings available makes choosing the correct dressing for clients a difficult proposition. Clinicians today have a much wider variety of products to choose from, which can lead to confusion and, sometimes, the wrong type of dressing for a particular wound. Knowing the types of dressings available, their uses and when not to use a particular dressing may be one of the most difficult decisions in wound care management.

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Laurie Swezey's picture

by Laurie Swezey RN, BSN, CWOCN, FACCWS

Heels are particularly vulnerable to skin breakdown. The posterior heel is only covered by a thin layer of skin and fat, and that makes breakdown a very real risk. When patients lie supine, all of the pressure of their lower legs and feet rest on the heels, which have relatively poor skin perfusion and a paucity of muscle tissue to absorb stress.

Prevalence rates for heel pressure ulcers vary, but have been estimated to be as high as 25% across a mixture of continuing care and acute care settings. Heel ulcers represent approximately one third of pressure ulcers acquired, resulting in increased morbidity and mortality. In some cases, heel pressure ulcers can lead to amputation of the affected limb.

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