Editorial Staff

Editor Barbara Zeiger

Associate Editor Kelsey Moroz

Web Editor Samantha Alleman

Editorial Correspondence

Barbara Zeiger, Editor, OWM

HMP Communications, 83 General Warren Blvd
Suite 100, Malvern PA, 19355

Telephone: (800) 237-7285 or
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Email: bzeiger@hmpcommunications.com

March, 2010 | Volume 56 - Issue 3

A Retrospective Data Analysis of Antimicrobial Dressing Usage in 3,084 Patients

Abstract: Knowledge about practice patterns and optimal usage criteria for topical antimicrobial dressings is limited. A retrospective data analysis was conducted to evaluate: 1) the length of time these dressings are applied in a typical episode of wound care, 2) the number of episodes of antimicrobial dressing use, and 3) whether antimicrobial dressings are applied in consideration of signs and symptoms of infection. Wound care registry data from a level-4 electronic medical record were analyzed, providing information on 3,084 patients older than 17 years seen from July 2003 through D...

A Post-hoc Analysis of Reduction in Diabetic Foot Ulcer Size at 4 Weeks as a Predictor of Healing by 12 Weeks

Abstract: Percent area reduction (PAR) after 4 weeks of diabetic foot ulcer (DFU) treatment has been suggested as a clinical monitoring parameter to distinguish DFUs that will heal within 12 weeks from those that will not despite standard wound care. The purpose of this post-hoc analysis of control DFU treatment outcomes from two published, randomized, controlled studies was to assess the relationship between PAR during early standard wound care and ulcer closure by week 12. The proportion of DFUs healed after 12 weeks was 57% (39 out of 69; 95% confidence interval [CI], 44% to 68%) in...

A Retrospective, Descriptive Study of Sacral Ulcer Flap Coverage in Nonambulatory Patients with Hypoalbuminemia

Abstract: Deep sacral pressure ulcers in nonambulatory hospitalized patients often are managed using surgical flaps. Reports about the effects of protein status on postoperative healing are inconsistent but surgery often is delayed until serum albumin levels normalize. Considering these conflicting data and the potential effects of delayed closure, the protocol at a Philippine national university hospital was changed to allow for early surgical reconstruction of sacral ulcers in hypoalbuminemic nonambulatory patients. A retrospective chart review was conducted to evaluate clinical outco...

The Effect of Intermittent and Variable Negative Pressure Wound Therapy on Wound Edge Microvascular Blood Flow

Abstract: Negative pressure wound therapy (NPWT) alters wound edge microvascular blood flow. Some preclinical data suggest that cycling between low and high negative pressure may be more beneficial than continuous NPWT. The purpose of this in vivo study was to compare the effect of intermittent negative pressure (cycled either from 0 to -75 or to -125 mm Hg) and variable negative pressure (cycled from -10 to -75 or -125 mm Hg or from -45 to -75 or -125 mm Hg) on wound edge microvascular blood flow. Using a peripheral wound model (n = 8 domestic 70-kg pigs), intermittent and variable NP...

Editor's Opinion: When Science Meets Sacred Cows

     Until a few months ago, the work of the US Preventive Task Force — first convened by the US Public Health Service in 1984 — and the wide variety of their published guidelines had gone mostly unnoticed by the public. Then, the task force’s 2009 update of the 2002 mammography guideline recommended that starting biennial screening mammograms before age 50 should not be routine but instead based on individual factors.1 As soon as the report was released, evidence and science met formidable foes: culture and politics. The former includes a love of technology, ye...

Pearls for Practice: Diabetic Foot Ulcer Management

     In a practice setting with a high incidence of diabetes and diabetic foot ulcers, patients often have numerous comorbidities. Utilizing best practice guidelines and building on our experience with our patient population, we use a multidisciplinary approach to address the underlying issues that have led to the client acquiring a wound.      We perform a complete lower limb assessment and “60-second diabetic foot exam” along with a comprehensive client history. Concerns identified as a result of sensory testing are addressed through client teaching. A ce...

Active Leptospermum Honey and Negative Pressure Wound Therapy for Nonhealing Postsurgical Wounds

     The use of negative pressure wound therapy (NPWT, V.A.C. Therapy®, KCI, San Antonio, TX) has grown rapidly over recent years. The modality creates a healing-friendly environment by promoting the growth of granulation tissue and removing exudate and infectious material. While the evidence base supporting this treatment grows, certain issues specific to NPWT require attention. According to the manufacturer’s specifications and in order to maximize the benefits of NPWT, all devitalized tissue (including eschar and hardened slough) should be removed as thoroughly as possible...

Nutrition 411: Using Laboratory Data to Evaluate Nutritional Status

     Optimizing a patient’s nutritional status is an integral part of modern medical care, particularly if the patient has a chronic wound. In order to determine the most appropriate medical nutrition therapy, a nutritional assessment is conducted to determine if the patient has any nutritional deficiencies or malnutrition. Typically, this determination is made, in part, by evaluating the patient’s biochemical or laboratory data. Healthcare professionals and registered dietitians (RDs) often rely on serum proteins such as albumin and prealbumin to identify a protein deficien...

Continence Coach: Chronic Constipation Relief for Older Patients

     Chronic constipation is quite common across the American population and responsible for 2.5 million physician office visits annually.1 Older people generally are more concerned with their bowel health than younger folks; they may be preoccupied by the myth of needing a daily bowel movement. The fact is that older individuals are more likely to routinely experience problems with constipation — researchers have found that 33% of the elderly suffer from chronic constipation.2 Women are two to three times more likely to experience constipation than men.<...

My Scope of Practice: An Enlightened Style of Nursing

Thought is the sculptor who can create the person you want to be – Henry David Thoreau      Deborah Warner, ARNP, MS, CWCN, received her Bachelor of Science and Masters degrees in Nursing in 1983 and 1991, respectively, from the College of Nursing, University of South Florida. In between, she completed the Wound Ostomy Continence Nurse (WOCN, Enterostomal Therapy) program at Arlington Heights Hospital (Arlington Heights, IL). Since she began working in wound care in 1989, Deborah’s scope of practice has expanded significantly — an independent nursing consultant s...

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