Skin & Wound Management posts
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Intake + Output = Big Documentation Problems

By Keisha Smith, MA, CWCMS

Inaccurate and incomplete intake and output (I&O) records pose a problem in litigation, as well as a risk to the patient who requires monitoring of fluid balance for medical reasons.  “Would you agree that the nurses did not know how to do basic arithmetic?” Of course nurses know how to add and subtract, yet I […]

Pressure Injuries with Cartilage? Stage Away

By Keisha Smith, MA, CWCMS

When it comes to wound care, staging pressure injuries with visible or palpable cartilage doesn’t have to be complicated. Here’s what to do.   If you’ve ever treated wounds around the ear or in the area just below the bridge of the nose, you know how very little subcutaneous tissue there is. As a result, […]

Your Patient Died: Should You Send the Family a Card?

By Keisha Smith, MA, CWCMS

Bereavement care is part of the job, no matter how difficult it is to talk about death and deal with grieving family members. “Callous disregard.” These two little emotionally loaded words are how the plaintiff complaint summed up the following story from a grieving daughter named Sally.* In her deposition, Sally recounted how nice and […]

Wound Detective Series: When Wounds Won’t Heal

By Keisha Smith, MA, CWCMS

Here’s how wound care detectives can solve the mystery of chronic wounds that fail to heal. Ready for some serious detective work? In this case, our focus is on those chronic wounds that just won’t heal, including epibole (which happens in full thickness wounds). And as we know, this rolled wound edge inhibits healing. But […]

Maceration and Hydrogels? Just Say Whoa

By Keisha Smith, MA, CWCMS

How do you use hydrogel dressings to keep wounds moist without causing maceration? Very carefully.   If you’ve ever taken a long bath or spent an afternoon in a swimming pool, you’re familiar with what happens to your hands and feet: they become soft, white, and wrinkled up like prunes. This is a classic case […]

Medical-Related Skin Injury (MARSI)

By Keisha Smith, MA, CWCMS

If you practice wound care, here’s what you need to know in order to avoid Medical Adhesive Related Skin Injury – also known as MARSI. Here’s a quiz for all of you in wound care: how many medical adhesive injuries are reported each year in the United States? The answer is 1.5 million. That’s a […]

Pressure Injury (Ulcer) Staging: More Real-World Answers

By Keisha Smith, MA, CWCMS

More real-world wound care questions and answers relating to pressure injury staging, including slough, debridement and skin breakdown. Can’t get enough of pressure injury staging? Neither can we. That’s why we’re excited to present even more questions and answers about this topic, based on what wound clinicians experience out in the field (versus what we […]

Real World Pressure Injuries: Staging Can Be Tricky

By Keisha Smith, MA, CWCMS

This wound care Q&A answers five of the most common questions about pressure injury staging dilemmas (that you probably didn’t learn from textbooks). In the world of wound care, just as in real life, the phrase, “Expect the unexpected” couldn’t be more appropriate. Clinicians can do everything exactly by the book, only to find that […]

Moisture Associated Skin Damage: Know Your Type

By Keisha Smith, MA, CWCMS

Know how to correctly identify these four common types of Moisture Associated Skin Damage (MASD) for best wound care practices. It might sound reasonable to assume that Moisture Associated Skin Damage (MASD) is the result of, well … moisture. The fact is that it takes more than just moisture to cause MASD, which is the […]

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