Archive for the ‘Infection’ Category

Learn how to determine what wound exudate is telling you

Wednesday, July 1st, 2020
wound exudate

An integral part of a wound assessment includes analyzing the type and amount of wound exudate coming from the wound.

Knowing how to correctly make those observations and documenting accordingly is critical to a comprehensive assessment. Ultimately, we want a wound with an optimal level of moisture to support healing and not an overly moist or dry environment.

However, as wound care specialists or experts, we need to take it one step further and ask a few more questions.

  • Is this the type and amount of drainage I expect to see based on the wound’s current healing path? 
  • If it is not, why is the exudate presenting this way? 
  • How do we correct that? 

A good wound care clinician does more than just make observations and note them. They are continually critically thinking and asking “why” and seeking solutions. 

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Malignant wounds: How to identify and treat them

Wednesday, May 20th, 2020
malignant wounds

Some wound care clinicians have experience caring for patients with malignant wounds.

But you may not be familiar with them at all. We recently spoke with a malignant wounds expert to learn more about them.

That expert is Joni Brinker, MSN/MHA, RN, WCC, an Ohio-based consultant and clinical nurse educator with Optum Hospice Pharmacy Services of Eden Prairie, Minn.

She is a returning speaker for our 2020 virtual Wild on Wounds (WOW) national conference in September. She offered the following explanation.

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Maggot debridement therapy and leech therapy are viable options

Wednesday, May 13th, 2020
maggot debridement therapy

Using maggots and leeches in the healthcare setting can make many people cringe, including seasoned wound care clinicians.

But the age-old treatments of maggot debridement therapy and leech therapy are relatively inexpensive and fairly effective.

“Maggot therapy can save a limb in approximately 40% to 60% of patients scheduled for amputation,” said Ronald Sherman, MD, MSc, DTM&H, director at BioTherapuetics, Education & Research (BTER) Foundation, co-founder.

Sherman also works as the laboratory director at Monarch Labs and a practicing physician in Orange County, Calif.

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How to differentiate stasis dermatitis from cellulitis

Wednesday, May 6th, 2020
stasis dermatitis

In my experience, I have encountered the confusion between venous dermatitis and cellulitis that plagues the wound care industry. 

The unlikely diagnosis of “bilateral cellulitis” is not uncommon in wound care, followed by two weeks of unnecessary antibiotic therapy.

Despite some similarities, there are many differentiating characteristics that diagnosing clinicians either overlook or misunderstand. 

In an effort to help clinicians more accurately differentiate the two conditions, we will discuss the differences in this blog post. It will help you prescribe appropriate treatments and improve patient outcomes.

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How to teach patients to manage wound care at home during COVID-19

Monday, April 20th, 2020
wound care at home

Some wound care centers are closed because of the COVID-19 pandemic.

More patients are opting to perform their own wound care at home because they are concerned about venturing out and risking exposure to the virus.

We spoke with three wound care professionals to learn more about care provided in the home and teaching patients and families to care for wounds until life returns to normal. 

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Hyperbaric oxygen therapy case: Liability can result from treatment inaction

Wednesday, March 25th, 2020
hyperbaric oxygen therapy

Many of you have worked with wound care patients needing antibiotics and hyperbaric oxygen therapy.

In the 2016 Texas case of Gonzalez v. Padilla, the issue of whether the antibiotics or hyperbaric oxygen therapy were properly prescribed was a core issue in the case.

The patient was struck while riding his motorcycle and was taken to a university-based medical center with a broken lower right leg and a de-gloved heel.

An open external fixation procedure of his compound, comminuted fracture was successfully performed and a “halo type” fixation device was placed around the leg to hold the bones in place as the fracture healed.

The patient was also placed on IV antibiotics, including Gentamicin and Cefazonlin for a period of five days. In addition, he received daily wound care treatments.

The medical center’s records indicated his right leg showed “obvious evidence of continued blood flow … and no obvious necrosis beneath the heel tissue itself.”

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Antimicrobial products: Read labels and do your own research

Wednesday, March 18th, 2020
antimicrobial products

The wound care industry has been inundated with antimicrobial products for years. 

Companies with good intentions try to improve outcomes and move away from antiquated antiseptics, such as Betadine, Dakins and acetic acid, that are not actually approved for use in wounds.

But some products are cytotoxic and lack any solid evidence that they are antimicrobial.

Instead, companies are offering modern products with little or no cytotoxicity available in multiple forms, such as cleansers and dressings. The challenge facing you in this barrage of products is knowing whether they are actually antimicrobial in the wound. 

This blog will arm you with proper ways to analyze these antimicrobial products and increase knowledge about them.

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How to prevent and treat wounds in skin folds

Wednesday, February 5th, 2020
skin folds

Wounds in skin folds can be a challenge to prevent and, once present, involve ongoing surveillance and care.

Donald Wollheim, MD, FAPWCA, WCC, DWC, a board-certified surgeon of the American Board of Surgery, shared his insight on best practices for preventing and treating wounds in skin folds if they develop.

As a clinical instructor with our Wound Care Education Institute (WCEI), Wollheim has 25 years of experience in general/vascular surgery and 13 years of experience as a wound care specialist, educator and case reviewer.

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Sharp debridement: Cutting through the confusion

Wednesday, 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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The truth about wound infection and treatment

Monday, 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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