Archive for the ‘Wound Healing’ Category

Exudate: What the Type and Quantities Tell You

Thursday, January 26th, 2023

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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Understanding the Foundation of Wound Care Treatments

Friday, November 4th, 2022

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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Wound Care Basics: Types of Wounds

Friday, October 28th, 2022

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.

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What Happened to Practicing Wound Care Basics?

Friday, September 23rd, 2022

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.

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COVID-19 Complicates Skin and Wound Care

Thursday, July 7th, 2022

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.

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Treating Pediatric Burns Takes Skills and Sensitivity

Saturday, December 11th, 2021

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.

Stats on 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…)

How Do You Treat a Malignant Wound? Let’s Look at the Options

Monday, November 8th, 2021

Wounds can present in patients as a result of various etiologies. One cause of wounds not typically on most clinicians’ radars are wounds that result from primary tumors.

We spoke with Joni Brinker, MSN/MHA, RN, WCC, an Ohio-based consultant and clinical nurse educator with Optum Hospice Pharmacy Services of Eden Prairie, Minnesota, and speaker for WCEI’s Wild on Wounds (WOW) national conference, to gain insight on malignant wounds that can develop from primary tumors.

What Is a Malignant Wound?

“A malignant wound is a manifestation of malignant (cancerous) cells that have infiltrated through the skin,” said Brinker.

Other structures such as blood and lymphatic vessels also can be invaded by malignant cells and produce wounds, she said.

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Let’s Walk Through the Stages of Wound Healing

Wednesday, August 4th, 2021

When teaching, I often get the question “What’s my role in the different stages of wound healing?”

To address this common question, I thought a review of basic wound physiology and the clinicians’ role during each of the stages of wound healing (aka phases of wound healing) would be helpful.

We know that the four phases of wound healing are driven by a mixture of chemical stimuli (growth factors and cytokines). Any diminished or excessive levels of these different chemicals can have a negative impact on the wound healing process. The phases are continuous and overlap each other to some extent. However, they must occur in a particular sequence to result in a healed wound.

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Necrotic Tissue: How to Identify and Treat It

Friday, July 30th, 2021

Living with necrotic tissue is challenging for patients and requires evidence-based treatments from skilled wound care clinicians to achieve improved patient outcomes. Let’s explore what it is, how to spot it, and where to go from there.

What Is Necrotic Tissue?

First, what is necrotic tissue and necrosis? The term necrosis stems from the Greek work nekros, which means death.

“Necrosis is a loose term, and it can appear in two ways – under a microscope and grossly viewed with the naked eye,” said Brian Gastman, MD, Surgical Director of Melanoma and High-Risk Skin Cancer Program at the Cleveland Clinic in Cleveland and Professor in the Department of Surgery at Case Western Reserve University School of Medicine in Cleveland.

When tissue is necrotic, there is a loss of tissue integrity, he said. “The tissue becomes discolored, there is fluid and exudative material present, and it becomes fodder for bacterial colonization.”

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20+ Factors That Affect and Delay Wound Healing

Tuesday, July 13th, 2021

Let’s say the wound you are working on is not healing. Why is the normal healing process not occurring?

You should approach healing not only by what you see, but also by what you can’t see happening at the cellular and molecular level.

To understand the factors that delay wound healing, you must first understand what normal healing is.

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