Sharp debridement: Cutting through the confusion

November 13th, 2019
Tools to perform sharp debridement rest on a surgical tray.

I have been training wound care clinicians in sharp debridement for more than 16 years, yet questions and confusion still abound about this practice.

Many clinicians have either received no education or incorrect education regarding sharp debridement and its use in wound care. 

This often leads to infrequent use of sharp debridement or worse, the inappropriate use of the practice. This is a skilled procedure and one should be properly trained before engaging in it.

My hope is to cut through the confusion and offer a solid explanation of this highly effective treatment for managing wounds.

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Some hospital-acquired pressure injuries are unavoidable, says study

November 5th, 2019
A clinician measures a patient's hospital-acquired pressure injuries on his backside.

Pressure injuries are the bane of wound care clinicians and other healthcare professionals who work diligently to provide the best patient care.

When patients develop hospital-acquired pressure injuries, financial penalties are placed on the organization by the federal government.

And high rates of hospital-acquired pressure injuries are perceived as a negative indicator on the quality of nursing care — the more hospital-acquired pressure injuries, the lower the quality of care is the consensus.

However, a new study revealed that sometimes even if everything is done right for a patient, a pressure injury can still form, and especially in critical care patients, said Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, a nurse practitioner and coordinator in the wound/ostomy department at Indiana University Health Academic Health Center in Indianapolis, and associate professor at the University of South Alabama in Mobile.

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Where to find negative pressure wound therapy photos and videos

October 30th, 2019
Clinicians try a negative pressure wound therapy device at our Wild on Wounds conference.

When treating patients with negative pressure wound therapy systems, the effective use of photographs can play an important part in providing optimum care.

“The reason photos are so integral is there are more wound patients than there are wound care clinicians,” said Beth Hawkins-Bradley, MN, RN, CWN, principal clinical educator in medical affairs at Cardinal Health in Dublin, Ohio. “For many patients, the reality is they may have a nurse assigned to manage their wound via a negative pressure wound therapy system who is not a wound care expert.”

One example of how resources can be valuable for negative pressure wound therapy system users is V.A.C. Therapy.

It’s a multi-step process that can be hard to describe in words, but is much simpler to visually demonstrate with photos, said Ron Silverman, MD, FACS, chief medical officer at KCI, an Acelity Company based in San Antonio.

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Buzz Report recaps wound care news from past year

October 23rd, 2019
Clinicians sitting on the subway read the latest about wound care news.

The wildly popular Buzz Report is one of the main attractions of our annual Wild On Wounds (WOW) conference.

Wound care clinicians from across the U.S. look forward to attending our Buzz Report session each year to learn the latest about wound care news, research and products that came out.

The Buzz Report is the brainchild of Donna Sardina, MHA, RN, WCC, CWCMS, DWC, OMS, co-founder of WCEI and the WOW conference.

Sardina said she created the first Buzz Report in 2004 as an overview for clinicians, in response to WCEI student requests on how to stay current on the latest developments in the world of wound care news.

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Wound photos can help determine a clinician’s legal liability

October 16th, 2019
A clinician documents wound photos on a company phone.

In many instances, wound care involves pressure wounds, such as decubiti and poor vascular conditions, such as diabetic foot wounds.

In the following case, the improper administration of chemotherapy agents through an IV line caused a wound that resulted in severe pain and limited the use of two fingers on the patient’s non-dominant hand.

Key evidence in the trial were wound photos of the open wound that occurred because of the negligent administration of chemotherapy by two nurses who were named defendants in the suit — Iacano v. St. Peter’s Medical Center.

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How to treat diabetic foot ulcers with a total contact cast

October 10th, 2019
A man sits with his total contact cast elevated on a chair.

There are times when clinicians and patients have done all they can to prevent diabetic foot ulcers, and they still develop.

“The patients who develop a diabetic foot ulcer are the ones who fell through the cracks,” said Don Wollheim, MD, FAPWCA, WCC, DWC, a board-certified surgeon of the American Board of Surgery.

Wollheim has 25 years of experience in general/vascular surgery and 13 years as a wound care specialist and educator. He also is a medical-legal consultant, college science instructor and clinical instructor for the Wound Care Education Institute.

“Once a diabetic foot ulcer develops, it’s essential it is treated aggressively with proven, standardized methods, as 85% of the amputations performed on diabetic patients began as a diabetic foot ulcer,” Wollheim said.

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The truth about wound infection and treatment

October 7th, 2019
wound infection

Does it seem like clinicians are quick to assume infection in a wound requiring systemic treatment?   

The tragic part is the wound infection diagnosis is often made with a lack of proper cultures or symptoms. 

Is it because clinicians are fearful? Is it their lack of knowledge of what confirms a wound infection? 

I would say it is likely a combination of both. Instead of looking at the evidence, clinicians fall into a “we have always done it this way” approach and the patient is the one who ultimately suffers.

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Expert advice on complete decongestive therapy for lymphedema

October 2nd, 2019
lymphedema

When healthcare professionals treat patients afflicted with lymphedema, some believe not much can be done to provide relief from swollen limbs and pain.

But much can be done to redirect lymph that’s collecting in the wrong place and send it back to the lymphatic system where it belongs, said Denise Richlen, PT, WCC, DWC, CLT, director of program development and area manager in Southwest Indiana for Paragon Rehabilitation in Louisville, Ky.

Millions of patients in the U.S. suffer with lymphedema, Richlen said.

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PT embraces passion for wound care teaching

September 24th, 2019
wound care teaching

For some people, teaching is in their blood and is a big part of who they are.

Scott Batie, MPT, RPT, MEd, WCC, a clinical instructor with our Wound Care Education Institute (WCEI) for 14 years, is one of those people.

He has been involved in the teaching profession for much of his life.

During college, Batie was a wrestler. After receiving his undergraduate degree, he taught high school English while coaching a high school wrestling team.

Batie realized he loved teaching and caring for others but wanted a change of pace and profession. After some thought and consideration, he decided to pursue a degree in physical therapy.

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Is the ankle brachial index for compression therapy necessary?

September 19th, 2019
A blood pressure cuff helps determine compression therapy.

If you are OK with the status quo, then do not read any further. 

However, if you want to look at whether guidelines that have been established and promoted for years are based on evidence and science, then read on. 

For years, clinicians (including myself) have been using the ankle brachial index (ABI) as a guide to determine whether a patient is a candidate for:

  • High (therapeutic) compression
  • Low-level compression
  • No compression

It was only after listening to a colleague’s lectures on myths in wound care that inspired me to look deeper into this practice. 

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