I'm interested in taking the CWCA exam, but a friend of mine mentioned that the WCC is better. What is the difference between the two?
Volume 54 - Issue 1 - January, 2008
What is Bariatrics?
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As the specialty of caring for larger, heavier individuals evolves, it becomes increasingly important to recognize the need for an appropriate corresponding lexicon. The challenge to healthcare clinicians is to develop a vocabulary that accurately, functionally, and sensitively describes individuals with weight issues.
The word obesity originates from the Latin language and refers to the state of becoming “fattened by eating.”1 Bariatrics is derived from the Greek word baros and refers to issues pertaining to weight.2 In some circles, bariatrics is thought to address weight loss surgery. However, the word comprises a much broader meaning; currently, it refers to the practice of healthcare that relates to the treatment of weight and weight-related conditions. This includes weight-loss surgery as well as reconstruction after massive weight loss, medical weight management, and more.
Phew! What’s That Smell?
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Odor is a problem in many aspects of wound care. Generally, foul smell relates to anaerobic colonization; the presence of aerobic organisms of gut origin and yeasts also can exacerbate unpleasant smells. Controlling odor or the perception of odor is important to patients and everyone with whom they interact. Patients may acclimate to odors emanating from wounds but remain concerned how others perceive the smell.
A topical metronidazole product can work wonders, eliminating the patient’s wound odors within an hour or so of application. Metronidazole gels can help dry out weeping wounds; some patients prefer the aesthetics of a cream. Although this is not therapy for a frank tissue infection, it provides a way to deodorize what is often a thin but tenacious biofilm.
OWM People
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OWM author appointed professor
OWM is pleased to acknowledge the appointment of biomedical scientist Richard White, PhD, as the University of Worcester’s (UK) first tissue viability professor. The appointment was made to expand the institution’s teaching and research capabilities in the rapidly evolving area of research and practice that covers all aspects of wound care management, including pressure ulcers, leg ulcers, trauma injuries, superficial burns, and abdominal wounds. Increasingly, nurses are specializing in tissue viability to provide patients with expert services in this particular field.
Professor White has held a variety of research, education, and clinical practice roles. He is currently a part-time Senior Research Fellow in Tissue Viability at Aberdeen Royal Infirmary, with responsibility for clinical research in wound management. He has held a number of posts within the health industry, all involving links with universities. He has written for OWM on topical antimicrobials in the control of wound burden as well as on critical colonization.
A Patient-Centered Approach to Treatment of Morbid Obesity and Lower Extremity Complications: An Overview and Case Studies
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Index: Ostomy Wound Manage. 2008;54(1):20-32.
A recent a random-digit telephone survey of US households by Sturm1 (N = approximately 250,000) reported that the prevalence of morbid obesity as indicated by body mass index (BMI) >40 and >50 rose by 50% and 75%, respectively, between 2000 and 2005. This increase in the population of morbidly obese individuals is far greater than the 24% concurrently reported for the person classified as obese (BMI 30 to 40).1 Patients presenting to the authors’ clinic reflect this trend, one with major implications for healthcare.
Obesity increases body size. Limbs enlarge and redundant skin folds develop. Additional adipose tissue can interfere with the lymphatic system, exacerbating existing secondary lymphedema2 or triggering it. In addition, patients with lipedema (a genetically linked disease that involves the pathological accumulation of fat on the lower body, most commonly observed in women3,4 will eventually develop secondary lymphedema as fatty tissue occludes lymphatic channels.
Lymphedema in the Morbidly Obese Patient: Unique Challenges in a Unique Population
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Index: Ostomy Wound Manage. 2008;54(1):44-56.
In the majority of US states, 20% to 24% of the population – approximately 40 million individuals – is considered obese (20% over the ideal body weight).1 Morbid obesity is defined as weighing >100 lb more than ideal body weight or having a body mass index (BMI) of >40; its prevalence increased from 2.9% in 1988 to 1994 to 4.7% in 1999 to 2000.2 The healthcare costs for morbidly obese patients are nearly double those of normal weight patients due to the additional costs of obesity-linked chronic health conditions, such as diabetes, hypertension, and cardiovascular disease.3 Moreover, results from Fontaine et al’s4 epidemiological research study using National Health and Nutrition Examination Survey I and II cohort data (N = 14,407 and 9,282, respectively) show that morbidly obese Caucasian men and women ages 20 to 30 years are estimated to lose 13 and 8 years, respectively, from their life expectancies. For young African American men, this figure is even higher at 20 years. Conservative estimates based on two prospective studies5,6 of morbidly obese bariatric surgery candidates and a comparative retrospective study7 approximate that 75% of morbidly obese people have at least one comorbid condition that may explain the observed risk of premature death.
Low-Frequency, Noncontact, Nonthermal Ultrasound Therapy: A Review of the Literature
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An estimated 2% of the US population suffers from chronic wounds resulting from diabetes mellitus, venous insufficiency, and excessive pressure.1 It is estimated that 15% of patients with diabetes have foot ulcers, one in 150 patients with diabetes will undergo an amputation, and 84% of these amputations were related to a simple ulcer that did not heal.2 Significant clinician time and hospital resources are consumed in the outpatient setting by patients with chronic wounds,3,4 causing morbidity, decreased quality of life, and economic strain on the healthcare system. While a variety of approaches exist to treat chronic wounds, evidence-based information is limited regarding how to best treat chronic wounds, when to initiate treatment, and for how long. Evidence-based medicine5 is fast becoming a requirement in wound care, with clinicians demanding evidence before the introduction of new products or a change in wound care practices.6
Managing Skin Health in Obese Children with Spina Bifida: An Overview and Case Study
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Index: Ostomy Wound Manage. 2008;54(1):34-43.
In the author’s experience, obese pediatric patients with chronic skin care issues tend to be concentrated in specific disease-related populations. Unlike their adult counterparts, overweight children rarely have chronic skin care issues because they have not developed the comorbid conditions that predispose to skin failure. However, in the author’s experience, wounds tend to be chronic in obese patients with neural tube deficits (NTD). Life issues affect the patient/family unit in a myriad of ways, creating challenges in the provision of care. While the incidence of NTD has declined in recent years and as many as 50% to 70% of NTD cases in the US could be prevented with adequate ingestion of folic acid,1 healthcare professionals will continue to see children with NTD.
The purpose of this overview is to summarize the etiology of spina bifida and to discuss skin health management issues encountered by patients, families, and medical professionals. A case study is included to illustrate these challenges.
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