Lower Extremity Ulcers and Angiosomes

May 16th, 2018

What is an angiosome and how does it relate to wound healing? A grand prize-winning Wild On Wounds poster presenter discusses how angiosomes can help identify patients who need vascular intervention.

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Nutrition Tips for Wound Patients With Cancer

May 11th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

Patients with wounds usually have multiple medical problems, and often the other diagnoses make meeting the nutritional plan difficult, such as when the wound patient also has cancer.

Nutrition Tips for Wound Patients With Cancer

 

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

I often discuss the increased nutritional requirements to fuel wound healing. Patients need extra calories and protein each day, plus an adequate amount of fluids, the right mix of vitamins and minerals, and any adjuvant treatments, such as targeted amino acids. A question that I often am asked is how you accomplish this when the patient has an additional diagnosis that impedes or supersedes the recommended nutritional plan. It is rare that a patient presents with only a single medical problem, and sometimes the other problems pose challenges to the nutritional plan.

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Helping Wounds Heal With Amino Acids

April 6th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

The use of targeted amino acids is becoming more common as a strategy to help heal a variety of conditions, including wounds, because of the role key amino acids have in rebuilding tissue.

Helping Wounds Heal With Amino Acids

 

Chronic wounds, meaning those that have not healed in 12 weeks, affect approximately 6.5 million patients in the United States annually at a cost of $25 billion.1 The term chronic wound refers to various types of skin integrity problems, such as pressure injuries, diabetic foot ulcers, venous ulcers, arterial ulcers, burns, and traumatic wounds to name a few.

The Role of Nutrition

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

Nutrition often is not the first thing you think of when talking about wounds, but it is important to understand the link between poor nutrition and wound healing. Essentially, when a body has a wound, it has competition for the nutrients it needs. Wound healing is very energy dependent; energy is another word for calories. If your patient is not eating well and not meeting his or her caloric and protein goals every day, weight loss typically occurs.

When nutritional substrate is in short supply, the body decides whether to use the available substrate to build new tissue for the wound or to use it to keep its vital organs functioning. If weight loss continues unchecked, wound healing is impaired and eventually it will cease altogether in favor of the body’s vital organs.2

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Ostomy Minute: How to Get a Good Seal Without Skin Residue

March 30th, 2018

How can you create a good seal under the skin barrier of an ostomy appliance without leaving residue on the skin? In this one-minute video, WCEI Instructor Joy Hooper, RN, BSN, CWOCN, OMS, WCC discusses new products you should explore.

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Stinging. Burning. Painful. Wounds Hurt!

March 10th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

The pain of a wound is sometimes difficult to quantify, but if a patient complains of pain, this requires effective and timely pain management.In the midst of the war on narcotics, that might mean looking for alternative pain management techniques and learning new approaches.

Wound Pain

 

Several months ago, I was attacked by the most venomous scorpion in North America, the Arizona bark scorpion. This stealth attack happened while I slept in my own bed at home in our southern Nevada desert home. I woke up with a jolt knowing that something was terribly wrong with me, but not quite sure what was happening. I felt a fiery tingling pain in both my hands and my abdomen, yet at the same time I also had a total loss of feeling in those areas. I remember yelling to my family that I was paralyzed, but they were confused because I was running around and frantically waving my arms obviously not paralyzed at all. We only figured out what had happened when I tried to crawl back into bed and saw the scorpion on my pillow.

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

My scorpion stings were an indescribable sensation and unlike any type of pain I had ever experienced. Even today, I am struggling to find the words to tell you what it felt like. All I knew was that it hurt and was unlike any pain I had previously experienced or could even compare it to. For the record, I did some research afterward—people describe it as feeling quite similar to being electrocuted.  Luckily, I can say that I was never electrocuted, but that is how people describe it.

Just as luckily, I have never had a pressure injury or a diabetic foot ulcer, so I am not really sure what those feel like either. My patients tell me they hurt. Some patients seem like they are in extreme pain, while others seem to have only mild pain. How do we quantify pain, and more importantly, how do we manage it effectively?

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Wound Temperature and Healing

February 23rd, 2018

You’ve probably heard that it’s important to keep wounds moist and warm, But what’s the optimal temperature for healing a wound, and how do you maintain it? Read on for details.

Wound Temperature and Healing

 

When moisture evaporates from a surface, the surface cools. Sweat operates by this principle. So, unfortunately, do wounds. Whenever a wound loses moisture, the tissues of the wound drop in temperature.

The cells and enzymes of the body function best at normal temperature, around 37° C (98.6° F).  When wound temperature decreases by as little as 2° C, healing can slow or even cease. In short, when the temperature drops, the healing stops.

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Ostomy Minute: Is Ostomy Paste an Adhesive?

February 18th, 2018

When you need extra adhesion under a skin barrier, is ostomy paste the way to go? WCEI instructor Joy Hooper sets the story straight in this short video.

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Discover the Benefits of Wound Care Nutrition Certification

February 9th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

Whether you are looking to increase your wound care nutrition knowledge or advance your career, a new wound care certification course for Registered Dietitians (RD) and Registered Dietitian Nutritionists (RDN) will help you meet your goals, while improving outcomes for your wound care patients.

Discover the Benefits of Wound Care Nutrition Certification

 

I often get funny reactions when I tell people I specialize in wounds. Lay people always assume I mean bullet wounds. I notice them nodding with confusion when I go on to explain that I do not see many bullet wounds, but treat plenty of pressure injuries and diabetic foot ulcers.

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

When I have the same conversation with nurses, patient care assistants, and other healthcare providers who do not specialize in wounds, they seem to nod with a similar amount of confusion. They immediately think of topical care and turning and repositioning—all important to wound healing—but they overlook the fact that in order to build new tissue it is necessary to have adequate nutritional substrate onboard.

Clearing up this confusion is one of the reasons I am so excited to share the new nutrition certification available from the National Alliance of Wound Care and Ostomy® (NAWCO®). Hopefully every skin and wound care team will soon have a certified nutrition member to help heal wounds from the inside out!

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Lower Extremity Ulcers and the Toe Brachial Pressure Index

January 19th, 2018

When treating patients with lower extremity ulcers, you need to find out if there’s impaired arterial blood flow. But for some patients, the standard Ankle Brachial Index (ABI) yields  misleading results. Fortunately, there’s an easy alternative: the Toe Brachial Pressure Index (TBPI).  Here’s when and how to perform this simple test.

 

Lower Extremity Ulcers and the Toe Brachial Pressure Index

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Diabetes: Eight Reasons to Get It Under Control Now!

January 12th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

Patients with diabetes are more likely to suffer many serious health issues besides foot wounds and amputations. This makes it imperative that they resolve to get their blood glucose levels under control.

Diabetes: 8 Reasons to Get It Under Control Now!

 

All of the lawsuits I review have a common theme. The plaintiff suffers from a chronic wound and some degree of malnutrition and/or dehydration. I have started to notice that in addition to these problems, the plaintiff also quite often has diabetes. This trifecta of problems leads to pain, suffering, disability, and discontent.

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

People with diabetes are 10 to 20 times more likely to have a lower extremity amputation than those without diabetes.1 This is a scary statistic compounded by the fact that people with diabetes may not even notice a foot wound developing because they cannot feel it because of neuropathy. A foot ulcer is the initial event in more than 85% of major amputations that are performed on people with diabetes.2 Knowing this should provide enough motivation for patients to get their diabetes under control, but some people need even more reasons. Here are eight more consequences you can discuss with your patients. Hopefully, one will hit home.

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