Archive for the ‘Compression’ Category

Non-Weightbearing vs. Offloading: Is There a Difference?

Wednesday, October 14th, 2020
offloading

Have you ever been confused about the difference between non-weightbearing and offloading?  

These wound care terms are often used when referring to the treatment of diabetic and neuropathic ulcers and pressure injuries.

Both can be critical in the successful healing of either type of wound. However, they are not the same thing.

Let’s begin with defining the terms.

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Compression Therapy: Why Patients Might Become Nonadherent

Wednesday, December 18th, 2019
A woman puts on compression stockings.

Many clinicians encounter patients who follow their plans of care regarding compression therapy without question or delay.

Other clinicians, however, can find themselves dealing with patients who appear unwilling to adhere to their compression plans.

Wound care clinicians may at times scratch their heads and wonder why some patients are nonadherent with their therapy.

Understanding why some patients are nonadherent and taking action to help improve adherence can increase the likelihood of reaching both short- and long-term goals and improve outcomes.

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Is the Ankle Brachial Index for Compression Therapy Necessary?

Thursday, 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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A Stinky Situation: When Wound Odor is a Problem

Monday, November 10th, 2014

You may have become desensitized to it, but if your patient has odor in the wound bed, consider it a problem that you need to fix.

A Stinky Situation: When Wound Odor is a Problem

As healthcare clinicians, in a way, we are lucky.  We become desensitized to things we encounter over and over again, they just don’t bother us like the first time we were exposed. This stands true for those wounds with odor. We almost become immune, yes we are aware the odor is there; but to our noses it is not an issue. The real issue is for our patients and their friends and family. Odor is subjective. Depending on the patient and family members ability, they may be very much aware of the odor. It can be very bothersome to the patient and their loved ones. The patient maybe embarrassed by it, and may try to self-isolate. They may not want to have people around them because of the way their wound smells. This is something as wound care clinicians we need to fix.

The first thing we need to look at is, what is causing the odor? Is it from necrotic tissue that supports the growth of anaerobic bacteria? Is it from a high level of wound exudate? Is there an actual wound infection? Do we have the wrong wound dressing on the patient?

Once we figure out the cause then we need to remove it, whether its debridement of necrotic tissue, managing the high level of exudate with dressings or using Negative Pressure Wound Therapy; we need to find what works. With an actual wound infection, treating with antimicrobial dressings or antiseptic’s/antibiotic’s are a must to remove the organism causing the infection and the odor. Sometimes just changing the dressing more frequently will help. Using dressings like those with activated charcoal, or those dressings with medical grade honey in them may help the wound odor. Another option is topical Metronidazole Gel to the wound bed, this may help eliminate wound odor as well.

Just because the odor in the wound bed isn’t offensive to us as wound care clinicians, doesn’t mean it isn’t offensive to others. As a rule, if your patient has odor in the wound bed, consider it a problem that you need to fix.

Wound Care Education Institute® provides online and onsite courses in the fields of Skin, Wound, Diabetic and OstomyManagement. Health care professionals who meet the eligibility requirements may sit for the prestigious WCC®, DWC® and OMS national board certification examinations through the National Alliance of Wound Care and Ostomy® (NAWCO®). For more information see wcei.net.