Different methods exist to enhance healing. And with hyperbaric treatment, even the most complex and pervasive wounds can benefit.
The air we breathe is approximately 21% oxygen, 78% nitrogen, and small amounts of other gases such as carbon dioxide, hydrogen, and neon. Hyperbaric oxygen therapy (HBO or HBOT) is a treatment where patients breathe in near 100% oxygen in a pressurized environment.
As a wound care professional, it’s likely you frequently encounter patients with cellulitis. A solid understanding of cellulitis wounds will give you the knowledge necessary to help you properly care for this population of patients.
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.
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.
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.
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.
Wound care professionals need a baseline knowledge of the different types of wounds they encounter. Correctly diagnosing and treating the wound as well as any underlying causes, will give you and the patients you care for the best chance of success.
Types of wounds are classified as either acute or chronic. Let’s first look at acute wounds, which tend to move along the healing continuum normally and usually heal within six-eight weeks.
Having been involved in wound care for about 25 years, I have seen many changes in our understanding of wound healing, research evidence, and technology, often straying from wound care basics.
As I hear my students describe common practices today and the many myths of wound care, I’m led to wonder, “What happened to starting with wound care basics for healing?”
A colleague of mine once stated there are basically two fundamentals to healing wounds: a healthy patient and a healthy wound environment. Once those are accomplished, topical treatments will not make that big of a difference.
However, clinicians often cling to some “holy grail” treatment in the form of a dressing or adjunctive modality that will somehow overcome the need to practice solid, evidence-based wound care.
The pandemic has brought skin and wound care challenges on many levels. One challenge is that COVID-19 can compromise the skin, leading to wounds that are harder to heal, according to Dianna Dashner, DNP, WCC, CLNC, LLE, senior nurse practitioner at ProMedica Skilled Nursing and Rehabilitation.
SARS-CoV-2 infection can cause virus-mediated endothelial dysfunction, which decreases tissue tolerance, authors wrote in a paper published in the summer 2022 issue of AACN Advanced Critical Care.
Dashner said the body’s inflammatory markers remain high long after an infected person’s symptoms go away.
“Inflammation markers actually take one year from the time you’ve been infected to go back to normal. So for patients who have an autoimmune disease or an inflammatory process in their bodies from a condition they already have, their markers are going to be sky high,” said Dashner, who is presenting “COVID’s Impact on the Skin: A Look at What We Know” at the September Wild on Wounds conference in Hollywood, Florida. The conference explores skin and wound care challenges and provides hands-on learning opportunities.
Knowledgeable wound care clinicians are needed not only for adults but for the pediatric population too. Burns are common injuries incurred by children. We spoke with two experts to learn more about this important area of wound care for pediatric burns.
“Burns are a leading cause of death and disability for children worldwide,” said Tina Palmieri MD, FACS, FCCM, Assistant Chief of Burns at Shriners Hospital for Children Northern California and Burn Division Chief at the University of California, Davis.
In the U.S., the stats are staggering. “Nearly each week in 2018 in the U.S. alone, approximately six children aged 0-19 died, 139 were hospitalized, and 1,762 were taken to the emergency room due to fire and burn injuries,” said Palmieri.
According to the American Burn Association Fact Sheet, 24% of all burn injuries occur in children under the age of 15, said Jenna Leach MSN, RN, WCC, plastic surgery specialty nurse at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware.
Palmieri pointed out risk factors for pediatric fire and burn deaths are: (more…)