Unpleasant odor is a frequent and distressing concern of persons who have wounds, as well as their family members and caregivers. In some instances, standard nursing interventions such as increasing the frequency of dressing changes will not be sufficient to address wound malodor. A review of the literature to summarize research findings about topical metronidazole used to decrease wound odor was conducted. Fifteen (15) studies were identified: seven case reports/series; six descriptive longitudinal studies; and two controlled clinical trials. Metronidazole was used as a 1% solution or, more frequently, as a 0.75% or 0.80% gel. Two reported adverse effects were skin irritation and a burning sensation. Generally, topical metronidazole was reported to result in a reduction or eradication of wound odor, decrease in wound drainage, improvement in wound appearance, decrease in surrounding cellulitis, halting of tissue necrosis, and decrease in pain. Although nurses report success with spri

Silver dressings are used to manage wounds at risk of infection or locally infected. This in vitro study was conducted to assess the prevalence of silver resistance genes in 112 bacterial isolates obtained from the diabetic foot ulcers of patients attending the Diabetic Foot Clinic at Tameside General Hospital, UK. Using polymerase chain reaction to screen for three silver-resistance transcriptional units — silE, silS and silP — two silver-resistant bacteria were identified; both are strains of Enterobacter cloacae, an organism rarely implicated as a primary pathogen in chronic wounds. No recognized wound pathogens (Staphylococcus aureus — 24 isolates and Pseudomonas aeruginosa — nine isolates) were found to contain silver-resistant genes. Analysis of the efficacy of silver-containing dressings on the silver-resistant strains of Enterobacter cloacae using confocal laser microscopy showed that, despite evidence of genetic resistance to silver, all strains were killed following a maximu

One of the most important principles of wound management is periodic assessment and documentation of wound healing. Documentation of healing progress over time allows providers to assess the effectiveness of care to maximize healing. Several methods to determine wound healing progress currently exist and include dimensional, visual, and physiological assessments. However, because existing tools often require correlation of subjective assessments, are time-consuming, and may not consider that wound healing occurs from the “bottom up,” a more objective and quicker approach to monitor healing progression was pursued. The purpose of this case study is to describe a once pen-and-paper tool that has now been computerized (the Barber Measuring Tool©) that builds a graphical representation of a patient’s individual wound healing progress to facilitate clinical decisions regarding the patient’s plan of care. The tool, which is currently used for all wound patients in the author’s facility, cal

Venous ulcers are a common, costly occurrence. Treatment typically includes the use of short-stretch and four-layer bandages — both with demonstrated ability to increase venous return and healing rates. Which is superior is unclear. To determine whether short-stretch bandages or four-layer compression systems provide shorter healing times and fewer adverse events when used in adults with venous ulcers, a search of English-language literature was conducted using the search terms short-stretch bandages and wound care, compression bandages and wound care, compression and venous ulcers, four-layer compression and venous ulcers, and multilayer compression and venous ulcers. Data from 25 studies published between 1997 and 2006 were examined. Short-stretch and four-layer compression bandages were found to be equally as effective in managing the edema that compromises venous ulcer healing. Time to healing was found to be shorter using four-layer or one- to two-layer compression when compared t

Infection, pain, and cosmetically unacceptable scarring frequently complicate full-thickness burns. Outpatient management can be difficult without specialized care. A retrospective case series study was conducted in a rural wound center lacking specialized burn care to assess the clinical effectiveness of acoustic pressure wound therapy, a noncontact low-frequency, nonthermal ultrasound wound therapy that accelerates healing through positive pressure, stimulating fibroblasts, clearing bacteria and debris, and relieving pain. Data from the records of 14 consecutively treated outpatients (age range 5 months to 78 years old) with mixed partial- and full-thickness burns involving the trunk, extremities, or both, averaging 7% of body surface area (range: 1% to 24%), were reviewed. Patients received acoustic pressure wound therapy with standard burn care. Burn thickness was determined by clinical appearance. Treatment effectiveness was evaluated based on scarring characteristics of healed wo

The Exhibitor Preview gives readers a sample of the companies, products, and services participating in the upcoming Symposium on Advanced Wound Care. Dedicated hours in the Exhibit Hall facilitate hands-on product consideration, group demonstrations, and one-on-one discussions with company representatives, providing practical take-home information. Shopping the Exhibit Hall is a must for all Symposium participants.