Practice Accelerator

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wound debridement instruments

by The WoundSource Editors

There are five types of non-selective and selective debridement methods, but many factors determine what method will be most effective for your patient.1 Determining the debridement method is based not only on the wound presentation and evaluation, but also on the patient's history and physical examination. Looking at the "whole patient, not only the hole in the patient," is a valuable quote to live by as a wound care clinician. Ask yourself or your patient these few questions: Has the patient had a previous chronic wound history? Is your patient compliant with the plan of care? Who will be performing the dressing changes? Are there economic factors that affect the treatment plan? Take the answers to these questions into consideration when deciding on debridement methods.

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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.

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Wound Healing

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 is possible for a patient to move forward or backward through the wound healing phases due to intrinsic and extrinsic forces.

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Selecting a Debridement Method

by The WoundSource Editors

Debridement is essential to promote healing and prevent infection. There are five main types of debridement methods. BEAMS is the common mnemonic to remember all types: biological, enzymatic, autolytic, mechanical, and surgical. In recent years, new types of debridement technology have been introduced, such as fluid jet technology, ultrasound debridement therapy, hydrosurgery, and monofilament polyester fiber pad debridement.

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by the WoundSource Editors

Calciphylaxis: A disorder, generally found in end stage renal disease, but not limited to renal patients, with widespread calcification of small and medium sized vessels, that leads to occlusion, thrombosis, and tissue necrosis. Extreme cases can be life-threatening.

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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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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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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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Necrotic Foot

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 quality of life, as well as the increased risk of death for those patients affected by them.1 A 2014 study of Medicare data showed that chronic non-healing wounds and associated complications affect nearly 15% or 8.2 million Medicare beneficiaries. The study also estimated the cost to treat these wounds at between $28.1 billion and $31.7 billion annually.2 The highest costs were associated with infected or reopened surgical wounds, and outpatient care had the highest site-of-service costs. In addition to being older, most of these patients have obesity and diabetes. Underlying causes often include diabetic foot ulcers, venous leg ulcers, arterial insufficiency, and pressure ulcers. The list of complications contributing not only to chronicity but also to further deterioration is quite lengthy.

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by the WoundSource Editors

Chronic wound: Any wound failing to heal in 90 days.

Periwound: The periwound is the tissue surrounding the wound itself, limiting to 4cm. This tissue provides a barrier to the wound.

Undermining: Presents as a space between intact skin and the wound bed, resulting from shearing forces and sustained pressure.

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