Wound Care Education Institute Blog

Diabetic Toenails: Watch for Change

Changes in the diabetic foot can happen fast: here are the signs and types clinicians in wound care need to look for. As a wound care professional, chances are you’ve treated a number of nail conditions and abnormalities that occur among the general population.

But when you’re working with diabetic patients, noticing and identifying variations is even more crucial. This is because change can happen more rapidly in the diabetic foot, and pathologies in diabetic toenails can ultimately lead to skin breakdown, foot ulcerations and infection.

So, what causes the nails to change? What exactly should you look for? We’ve got you covered.

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3 Types of Wound Closure and What They Mean

As a wound care clinician, you know the wound healing process has many moving parts, including types of wound closures.

In wound care, the goal should be to heal the wound as soon as possible and to keep it healed. And with wound healing, there are three types of wound closure techniques to consider to achieve this — primary intention, secondary intention, and tertiary intention.

The selection of wound closure type depends on how the wound is presented. Noting physical characteristics like exudate color or wound size can help you identify the correct course of treatment and the most appropriate type to use.

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Venous Ulcers vs. Arterial Ulcers

wound care supplies sit on white surface

Understanding the differences between arterial and venous ulcers is important in the effective treatment of lower leg and foot wounds. Determining the type of vascular wound you are dealing with can save vast amounts of time in the healing process. Let’s look at some of those differences and how to treat each type.

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Burn Wound Care

person washes their hands with apparent burn wound in sink

Our skin is the largest organ of our body. It is our protection from injury and harmful substances. It prevents moisture loss, regulates our internal temperature, shields us from germs, protects us from the sun’s harmful ultraviolet rays, and allows us to feel sensations such as touch.

Burns are common trauma wounds that disrupt skin’s protective function. The consequences of that disruption range from minor to fatal. A burn may be caused by heat, electricity, chemicals, friction, and radiation. Providing proper burn wound care as soon as possible will benefit treatment.

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Exudate: What the Type and Quantities Tell You

For successful wound treatment and healing, it’s vital to understand the different types of exudate and how much is present.

Ooze. Pus. Secretion. The drainage that seeps out of wounds can go by many names, but as wound care clinicians, you know the technical term is exudate. This liquid is produced by the body in response to tissue damage and tells you all you need to know about the wound.

Dianna Dashner, DNP, FNP-C, WCC, CLNC, LLE, Senior Nurse Practitioner at ProMedica Skilled Nursing and Rehabilitation said it’s important to know the type and amount of exudate because this will direct the type of treatment.

“For example, the use of a calcium alginate necessitates moderate to heavy exudate,” she said. “If the wound has purulent drainage, you will want to thoroughly cleanse the wound to remove all the exudate and then culture the wound.” She added that if an infection is suspected and there is moderate to heavy drainage, a calcium alginate with silver may be a good choice for treatment. Her example highlights the significance that the amount and type of exudate makes in wound treatment.

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Learn the Latest in Wound Care at Wipeout Wounds 2023: March 14 – April 13

Join hundreds of clinicians from across the U.S to network, participate in hands-on workshops, and learn new treatments and technologies that will enhance your knowledge and ability to care for patients.

As the world of wound care evolves and changes, so must caregivers. This conference tour includes updated practice guidelines, new therapeutic options hitting the market, reimbursement changes, contact hours, and more.

Wound care management and treatment continues to be a necessary skill for caregivers. Whether you are new to wound care or a seasoned veteran, this 5-hour interactive hands-on conference will provide you with the education and tools you need.

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Wound Debridement

nurse prepares sterile wound care treatment tray

According to the National Library of Medicine, wound debridement, or the removal of nonviable tissue, biofilm, and bioburden from the wound bed, is an essential part of standard wound treatment.

Bioburden consists of microorganisms on the surface of the wound bed, while biofilm is a substance created by the presence of bacteria, microbes, and cellular debris. The removal of these tissues optimizes the wound bed for ongoing granulation of healthy tissue and promotes epithelialization.

Tissues like these act as barriers to wound healing, and chronic wounds will be unable to heal if these tissues are present — making debridement an essential part of the healing process.

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The Essential Role of Nutrition in Wound Care

When tackling the complexities of wound healing, it is easy to overlook your patient’s nutritional status on this journey. We often glaze over nutrition in wound care and focus on other concerns when the healing process is not optimal, posing questions like: Have we ordered vascular studies? Have we gotten them on to the most adequate support surface? Is there an underlying infection we need to address? Why has healing stalled?!

The frustration can be overwhelming. Which is one of the reasons to remember the importance of nutrition in wound healing.

According to the National Library of Medicine, good nutrition is essential for healing, though this is often the last box we check when reviewing wound healing requirements. Nutrition in wound healing is so much more important than the attention we often give it, and conversations surrounding nutrition should take place with patients and their caregivers at the beginning of treatment. Ongoing reinforcement of this education is also critical. Let’s look at some of those essential nutrients.

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Diabetes Wounds: Caring for Foot Ulcers and Other Wounds

A patient extends his foot to his clinician to inspect his diabetic foot ulcer.

Diabetes wounds can be some of the most challenging to treat, even for the most experienced wound care professionals. As the prevalence of diabetes continues to grow, with 38% of U.S. adults having prediabetes, whether you are new to wound care or a seasoned professional, you will most likely encounter patients with diabetes on an increasing basis.

The American Diabetes Association recognizes November as American Diabetes Month, and as of 2022, diabetes has affected 37.3 million people in the United States. Having diabetes can complicate and delay the healing process of any type of wound, including pressure injuries, venous ulcers, arterial ulcers, or trauma wounds.

However, diabetes wounds can be especially pervasive, as they are known to be slow to heal, and there are numerous reasons why. One reason is that the cells most responsible for healing cannot correctly function when the patient has elevated blood sugars or has developed hyperglycemia with an increased risk for arterial disease.

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Understanding the Foundation of Wound Care Treatments

A healthy wound environment is essential for healing. The type of wound care treatment chosen can have either a positive or a negative effect on this process. Starting with the basics and adding on treatments as needed can make a big difference.

Treatment choices are based on the etiology of the wound, wound environment, and the patient’s underlying medical conditions. We’ll begin with the basics of wound care and then look at additional treatments and adjunct therapies.

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