Index: Ostomy Wound Manage. 2012;58(9):32–40.

Abstract

  Despite extensive use of negative pressure wound therapy (NPWT) and reported patient safety concerns, evidence-based algorithms to guide its safe and appropriate use in various wounds have only recently been developed. Preliminary content validity was established using literature review and expert-based face validity with a small sample of experts (N = 12). To examine the content validity of this set of three NPWT algorithms and to enhance understanding about previously identified wound terminology issues, a cross-sectional, mixed-methods, quantitative study was conducted among wound experts. The paper/pencil survey instrument consisted of the algorithms, a demographic questionnaire, and request to provide definitions of five commonly used terms: acute wound, chronic wound, and primary, secondary, and tertiary intention healing. A Likert scale (range 1 to 4) was included to rate the relevance of each of the 34 unique steps/statements/decision points contained in the algorithms, and space was provided to comment on each component. Convenience-sampling methods were used in three different settings: an international professional wound care meeting; a regional wound, ostomy, continence (WOC) nurses meeting; and an urban university with a suburban satellite campus. Of the 190 wound care experts invited to participate, 114 accepted. Participants’ average age was 48 (range 23 – 68) years, and most were registered nurses (72%) practicing in the United States (94%).

Index: Ostomy Wound Manage. 2012;58(9):50–55.

Abstract

  Numerous physical modalities have been used in attempts to augment the healing process, including ultrasound, low-energy light therapy, and electrical stimulation (ES). ES has been shown to benefit tissue repair in a variety of wound types, but variations in study designs, administration, and parameters render its application in clinical practice somewhat unconventional. A dressing was designed to generate an electric potential of 0.6 V to 0.7 V in the presence of moisture, thereby delivering a sustained micro-current without the need for an external power source. The purpose of this study was to examine the effects of this bio-electric dressing (BED) on deep, partial-thickness wounds using six female specific pathogen-free animals and a well established porcine model for wound healing. Wounds (10 mm x 7 mm x 0.5 mm) were created in paravertebral and thoracic areas of these animals using a specialized electrokeratome and covered with the active polyester BED and a polyurethane film dressing (n = 30) (treatment) or an inactive polyester and film dressing (n = 30). Using an epidermal migration assay, wounds were assessed daily from day 4 through day 8 post-wounding. Differences in the proportion of wounds healed were statistically significant (P <0.001) on days 5 and 6 post-wounding. These results show BED is more effective than a control dressing treatment with moisture-retentive dressings in this animal model. Controlled clinical studies are warranted to elucidate the potential clinical implications of this treatment modality.

  Patients in skilled nursing facilities (SNFs) have seen institutional life change dramatically over the past several years. SNFs, often called long-term care (LTC) communities, operate under vastly different guidelines than traditional acute care hospitals. Although patients average a 3- to 4-day length of stay, LTC patients often reside in the facility for years, frequently until their death. This necessitates a different approach to care and a more homelike environment. A culture change revolution has taking been shape for several years and is gaining speed.

  Understanding related changes can help healthcare providers (HCPs) treat patients and their wounds more effectively.

Life’s challenges are not supposed to paralyze you, they’re supposed to help you discover who you are. — Bernice Johnson Reagon, American historian

  Wound, ostomy, and continence care is a vocation and avocation for Paula Erwin-Toth, MSN, RN, CWOCN, CNS. Born with multiple birth defects involving her urinary system and pelvic and hipbones, Paula spent a good part of her childhood in care facilities. “My passion for WOC nursing stemmed from personal experiences,” Paula says. “My first memories are of hospitals, casts, nurses, and doctors. My experiences left me with good and bad memories. Rather than generating fear, my healthcare professionals were generally helpful and supportive, inspiring me to pursue a career in healthcare.”