I have a colostomy, about 1" opening, and for 8 years I had no problem with my pouches. Then for 3 or 4 months I can't seem to have a bag on for more than a day, and there is leakage. What is deep convexity and should I have different kind of pouches that have a deep convexity? Would that help? Thank you.
Volume 55 - Issue 10 - October, 2009
Persistence of Bilayered Living-Cell Therapy Donor DNA 10 Months after Application: A Case Report
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Abstract: Bilayered living-cell therapy has been shown in clinical trials to improve the rate of healing diabetic and venous leg ulcerations. However, literature is conflicted regarding the length of time living-cell therapy persists in acute and chronic wounds. An otherwise healthy 48-year-old man with sepsis from extensive lower-extremity wounds due to ecthyma gangrenosum was admitted to the hospital. Initial treatment consisted of surgical debridement, broad-spectrum antibiotics, and stabilization in the intensive care unit. After the patient was stabilized, three units of living-cell th
A Simple Device for Closure of a Colocutaneous Fistula within the Laparotomy Wound: A Case Report
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Abstract: Colocutaneous fistulas within laparotomy wounds are rare and difficult to treat. Surgical repair may be contraindicated or not desired and negative pressure wound therapy may not be successful. A simple device made from a silicone, flexi-aid hand exerciser was used to close a colocutaneous fistula within the laparotomy wound of a 50-year old man following surgery of an esophageal carcinoma and a surgical history of Whipple’s procedure for adenocarcinoma of the ampulla of Vater. His wound developed 9 days postoperatively, measured 8 cm x 3 cm x 2 cm, and was contaminated with fec
Managing Complex, High-Output, Enterocutaneous Fistulas: A Case Study
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Abstract: Gastrointestinal (GI) fistulas are an uncommon but serious complication. Following diagnosis, management strategies may have to be adapted frequently to address changes in fistula output, surrounding skin or wound condition, overall patient clinical and nutritional status, mobility level, and body contours. Following a motor vehicle accident, a 49-year-old man with a body mass index of 36.8 and a history of multiple previous surgeries, including gastric bypass, experienced excessive output from a fistula within a large open abdominal wound measuring 45 cm x 40 cm x 5 cm. Abdominal
Acellular Bovine-Derived Matrix Used on a Traumatic Crush Injury of the Hand: A Case Study
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Abstract: Wound care options that provide quality care at a reasonable cost are integral to limb salvage and everyday treatment approaches in patients with traumatic injuries and nonhealing, chronic wounds. Human skin substitutes, or bioengineered tissues, have been available for many years but data about the use, safety, and effectiveness of bovine-derived bioengineered products are limited. A 50-year old man was seen at the wound clinic with a failing skin graft 65 days after sustaining a crush injury of his dominant hand. Following the injury, the patient underwent amputation of the ring
On Scientific Publishing: A Few Bad Apples Can Spoil the Bunch
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Descriptive publications in the medical literature, commonly in the form of case studies or case series, always have provided an important venue for clinicians to illustrate a problem, share novel observations and methods to solve clinical challenges, and/or demonstrate a need for research. In wound and ostomy care in particular, clinicians often rely on case studies to help them manage the unusual and the complex; many case study observations have provided an impetus for research. Case-in-point: this issue of OWM. Articles describe the care of a nonhealing wound following
Managing Wounds with Exposed Tendon
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Tendons are anatomical structures that connect bone to muscle. They are composed of parallel bundles of collagen fiber1 and often appear as striated white or creamy yellow structures in wound beds.
Tendons are nourished by blood vessels and by diffusion of nutrients from synovial fluid.2 Because nourishment is disrupted when the tendon is exposed, meticulous care must be provided to prevent both infection and desiccation, either of which can lead to loss of tendon viability.3 Tendons may be exposed in trauma wounds, su
Common Problems in Medical Record Documentation
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If you work in any aspect of healthcare, you are probably familiar with the adage, If it wasn’t documented, it wasn’t done. The medical record, or chart, resides at the top of the healthcare food chain as the ultimate testimony of the care rendered. While initially serving as a communication tool to aide multidisciplinary healthcare team members, the medical record now has the dubious task of serving as a key piece of evidence in the growing number of lawsuits between patients and their healthcare providers.
Litigation due to nonhealing wounds, u
Catch the Spirit of Innovation
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One the chief reasons I love working in healthcare is its pace of change and innovation. At the National Association For Continence (NAFC), we encourage consumers to periodically revisit their providers to discuss their bladder and bowel control problems because new solutions or options may be available since their last visit. Innovation is at the heart of the hope all professionals — educators, providers, and product developers — instill in the public.
According to the Advanced Medical Technology Association (AdvaMed),1 a trade organiz
Keeping Wound Care Simple
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When work, commitment, and pleasure all become one and you reach that deep well where passion lives, nothing is impossible. — Anonymous
Sarah Kuser, BA, BSN, MSHA, is the Wound Care Coordinator at Kindred Hospital, a long-term acute care facility in Tucson, Arizona. “My job is all about wound care,” she explains. “I work directly with patients and educate staff. It’s exciting being in charge of a wound care program and working to make it the best it can be.”
Sarah hails from a large family of four brothers, a sister, and a multi
AAWC October Update
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Membership
If you’re not yet a member of the AAWC, please read on to find out why membership and volunteerism are so important and how they can benefit you and your practice. If you are a member, please review what your association has been working on to advance the practice of wound care.
Wound Care Specialty Council (WocSpec)
As a valuable benefit, the AAWC provides timely information on US governmental and regulatory changes via email alerts to its members. The Council has departments tackling issues and affecting decision
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