You are called in to care for a patient with a full thickness wound. Now what?
Your goal should be to heal the wound as soon as possible and to keep it healed. There are three types of wound closure techniques to consider, and they include:
The loss of moisture from any surface by evaporation is accompanied by cooling of the surface. So, as wound tissues lose moisture, a cooling effect occurs resulting in lower wound temperature.
Even a decrease of only 2 degrees Celsius is sufficient enough to affect the biological healing process of your patients. This is because cells and enzymes function optimally only at normal body temperature.
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The two words are acronyms pertaining to clinical categories related to comprehensive wound assessment, management and wound bed preparation for hard-to-heal wounds, said Donald Wollheim, MD, FAPWCA, WCC, DWC, a board-certified surgeon of the American Board of Surgery and clinical instructor with the Wound Care Education Institute (WCEI).
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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.
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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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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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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Wound packing is just a necessary part of performing good wound care treatments in the event your patient has notable depth in their wound.
However, there is a purpose and a proper way to pack a wound with the goal of promoting healing in the most effective and efficient manner.
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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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This applies to wound care clinicians, especially certified wound care clinicians, and includes all aspects of wound care — even applying Dakin’s solution and acetic acid.
Unfortunately, in my 25 years of wound care experience, I still see many practices that do not meet those criteria. I am guilty too.
Back in the early days of my wound care career, I promoted practices that didn’t meet those criteria because I trusted the clinicians teaching me were doing the right thing.
However, I began to question things as my knowledge grew. After doing the research, I was shocked to learn some tried-and-true practices weren’t so tried and true after all.
In this blog post, we delve into one of those methods — the use of Dakin’s solution and acetic acid in wound care.
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By Bill Richlen, PT, WCC, DWC
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.