Let’s Walk Through the Stages of Wound Healing

stages of wound healing

When teaching, I often get the question “What’s my role in the different stages of wound healing?”

To address this common question, I thought a review of basic wound physiology and the clinicians’ role during each of the stages of wound healing (aka phases of wound healing) would be helpful.

We know that the four phases of wound healing are driven by a mixture of chemical stimuli (growth factors and cytokines). Any diminished or excessive levels of these different chemicals can have a negative impact on the wound healing process. The phases are continuous and overlap each other to some extent. However, they must occur in a particular sequence to result in a healed wound.

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Necrotic Tissue: How to Identify and Treat It

necrotic tissue

Living with necrotic tissue is challenging for patients and requires evidence-based treatments from skilled wound care clinicians to achieve improved patient outcomes. Let’s explore what it is, how to spot it, and where to go from there.

What Is Necrotic Tissue?

First, what is necrotic tissue and necrosis? The term necrosis stems from the Greek work nekros, which means death.

“Necrosis is a loose term, and it can appear in two ways – under a microscope and grossly viewed with the naked eye,” said Brian Gastman, MD, Surgical Director of Melanoma and High-Risk Skin Cancer Program at the Cleveland Clinic in Cleveland and Professor in the Department of Surgery at Case Western Reserve University School of Medicine in Cleveland.

When tissue is necrotic, there is a loss of tissue integrity, he said. “The tissue becomes discolored, there is fluid and exudative material present, and it becomes fodder for bacterial colonization.”

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20+ Factors That Affect and Delay Wound Healing

band aids forming an x

Let’s say the wound you are working on is not healing. Why is the normal healing process not occurring?

You should approach healing not only by what you see, but also by what you can’t see happening at the cellular and molecular level.

To understand the factors that delay wound healing, you must first understand what normal healing is.

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Wound Care Nurse Salary and How Some Skills Can’t Be Monetized

pay day circled on a calendar

If you’re a nurse with a passion for skin and wound care, you may want to consider expanding your professional marketability by becoming wound care certified.

Average Salary for a Certified Wound Care Nurse

So how much do wound care nurses make? According to some online sources for wound care nurse salary data, the average annual wound care nurse salary ranges from $47,000 to $86,000 and an average annual wound care nurse salary at just over $69,000.

Keep in mind that salaries for wound care nurses can vary greatly from the annual rates, depending on a few other factors, including the state and city you in which you practice, your level of education, the size of the organization, and whether or not you have wound care certification. All of these play a role in your earning potential.

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Explore 3 Types of Wound Closure: Primary, Secondary, and Tertiary

sutures

You are called in to care for a patient with a full thickness wound. Now what?

Your goal should be to heal the wound as soon as possible and to keep it healed. There are three types of wound closure techniques to consider, and they include:

  • Primary Intention
  • Secondary Intention
  • Tertiary Intention

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Physical Therapists Have a Long History and Bright Future in Wound Care

Physical therapist and patient
When some think of wound care providers, they don’t typically think of physical therapists (PTs). But many PTs are actively engaged in wound care and committed to making progress in the field.

So many PTs practice wound management that the American Physical Therapy Association (APTA) has a component group known as the Academy of Clinical Electrophysiology and Wound Management (ACEWM).

The ACEWM consists of nearly a thousand physical therapists and students interested in electrophysiology, biophysical agents, wound management, and neuromusculoskeletal ultrasonography. Within the ACEWM is another group known as the Wound Management Special Interest Group (WMSIG) whose focus is solely on wound management.

WCEI spoke with Patricia Larkin-Upton, PT, DPT, MS, CWS, CEEAA, vice chair of the ACEWM and WMSIG. Larkin-Upton collaborated with the WMSIG board of directors and the ACEWM president and vice president to provide insight into the history of these wound care organizations and some goals they have for the future.

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Research Study Reveals Nurses’ Importance in Stoma Care

Visiting nurse with patient in her home

The study was conducted by nurses and nurse faculty in Spain at two university hospitals and one public hospital in Spain. Twenty-one adult ostomy patients were asked for their insights before and after their ostomy surgery.

Fourteen of the patients had a gastrointestinal stoma due to cancer, six due to inflammatory bowel disease, and one due to familial polyposis. About 48% of the sample had an ileostomy and 52% had a colostomy. More than half (62%) had a permanent stoma, while 38% had a temporary stoma.

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Make Sure the Cost of Wound Care Makes Sense for Everyone

Health Insurance Claim Form

Most of us are familiar with the saying “you get what you pay for.” And when it comes to the cost of wound care products, there is definitely truth to that.

However, when considering the overall treatment plan, spending more doesn’t always equate to best practice or best results.

Cost-effective wound care means providing the most successful treatment to heal the wound at the least amount of cost. And with annual treatment costs of wound care in the billions in the U.S. alone, there’s plenty of reason to be cost conscious when choosing treatment strategies. Let’s take a look at some of the basic concepts behind this approach.

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From Transparent Dressings to Hydrogels, Wound Care Dressings You Use Every Day

Doctors treating girl's leg with bandages

As wound care professionals, wound care dressings are an important tool.

Keeping up to date on the types of wound care dressings available to treat patients in our care is our duty.

Wound care dressings come in various shapes, sizes and have indications for their use.

Professionals who treat wounds must remain aware of the types of wound care dressings they can use, as well as their contraindications. Here’s a list.

Transparent Film Dressings

Transparent wound care dressings are thin, transparent sheets of polyurethane coated with an adhesive and are available in a variety of shapes and sizes. They are semi-permeable, allowing the one-way passage of oxygen and moisture vapor, but are waterproof and impermeable to bacteria.

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Fungal Wound Infections: Identification, Treatment, and More

fungal wound infections

Some clinicians generally think of bacteria as the sole pathogen for chronic wounds.

But another culprit to consider when dealing with delayed wound healing is the presence of fungi that lead to fungal wound infection.

Romney Humphries, Ph.D., ABMM, professor and medical director of clinical microbiology at Vanderbilt University Medical Center in Nashville, Tennessee, shared her expertise on fungal wounds.

“Wound infections caused by fungi occur when wounds are contaminated with spores,” Humphries said.

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