Despite the availability of assessment tools, analgesic medications, and technologically advanced dressings, achieving adequate pain control in wound care continues to present challenges for healthcare practitioners, patients, and their families. Pain in general has been the subject of much clinical and scientific investigation, but most has focused on the biological aspects of pain management. The psychological aspects of pain management and factors stemming from the relationship between caregivers and care recipients have received less attention. Relational issues are particularly relevant when dealing with medical procedures that involve a caregiver actively touching a care recipient. This paper explores pain management in chronic wound care, particularly at dressing change, with an emphasis on the relational aspects of care. Work from a recently completed hermeneutic phenomenological study of 18 registered nurses performing wound care in long-term, acute, and community care suggest

Evidence suggests that skin temperature is elevated in the lower legs of individuals with the most severe stages of chronic venous disorder-related skin inflammation. Fifteen (15) patients (average age 67.7 years) with several chronic health conditions, chronic venous disorders, and a history of leg ulcers volunteered to participate in a prospective, descriptive, two-part (hourly and daily) study to test two hypotheses: 1) that skin temperature variations of chronically inflamed skin of lower legs affected by chronic venous disorders exhibit no differences in hour-to-hour and day-to-day rhythmic patterns associated with sleep and activities such as walking, exercise, or compression stocking use among four selected skin sites (two per leg) or between the legs of individuals with chronic venous disorders; and 2) that the difference in temperature between sites is unequal between legs. All study participants were at high risk for developing venous ulcers (CEAP stage 4 and 5). Skin tempera

Tacrolimus, a calcineurin inhibitor, has become an increasingly valuable tool in the treatment of dermatological disorders during the last few years. However, its effect on wound healing is still under investigation and remains the subject of safety concerns. A 75-year old woman with lichen planus, diabetes mellitus, and a foot ulcer was prescribed tacrolimus for the treatment of her lichen planus. After starting the treatment, her ulcer healed and the medication was discontinued. Shortly thereafter, re-ulceration occurred, treatment was re-introduced, and the wound continued to heal until treatment was discontinued. When the third course of tacrolimus was prescribed, the ulcer started healing again but a diagnosis of osteomyelitis necessitated surgical intervention. A review of the literature suggests that tacrolimus does not adversely affect healing in vivo or in vitro and may facilitate healing lower extremity skin ulcers, especially those of inflammatory origin. Studies are needed

Prompt diagnosis and treatment of necrotizing fascitis reduces the morbidity and mortality rates of this devastating disease. To examine the clinical outcomes of using negative pressure wound therapy in the adjunctive management of wounds secondary to necrotizing fascitis, a retrospective review of medical records was conducted. Participants included 11 consecutive patients (16 wounds) with a diagnosis of necrotizing fascitis admitted to a teaching hospital between 2000 and 2005 and treated on an inpatient basis with negative pressure wound therapy. The patients included seven men, four women (average age 54 years; range 18 to 82 years). Variables abstracted from the medical records and consultation notes included: demographic information, tissue and blood bacteriological data, wound history, wound healing outcomes, duration of negative pressure wound therapy, length of hospital stay, and mortality and morbidity information. Variables were entered into an electronic database and analyz

Digital vasculopathy and subsequent digital ulceration are common and painful complications of limited cutaneous systemic sclerosis. Although the use of hydrocolloid occlusive dressings has been found to reduce pain, frequently required surgical or chemical debridement can be intensely painful in such ulcers. Acoustic pressure wound therapy is a noncontact, low-frequency ultrasound therapy used for painless debridement in a variety of acute and chronic wounds. It was administered to treat an intensely painful, methicillin-resistant Staphylococcus aureus-infected finger ulcer resulting from peripheral, bilateral vasculopathy in a 68-year-old man with a history of three prior fingertip amputations secondary to limited cutaneous systemic sclerosis-associated digital vasculopathy. At treatment initiation, 90% of the 11 cm2 wound was covered with firmly adherent fibrin slough. Acoustic pressure wound therapy was performed three times weekly for 5 minutes per treatment and the wound was cove

This year, more than 350 abstracts were accepted for presentation at the SAWC/WHS in San Diego. Of those, 24 were accepted for oral presentation. The abstracts featured here will be presented during sessions 38, 55, 59, 63, and 68. The accepted poster presentations may be viewed throughout the entire meeting and during the scheduled poster sessions, which will be held Friday, April 25, 7:00 am – 8:45 am, and Saturday, April 26, 7:00 am – 8:45 am. The first ever Poster Gala and Awards will be held from 7:00 pm – 10:00 pm on Friday, April 25. To access the entire SAWC/WHS brochure, including session titles, faculty, and abstracts, visit www.sawc.net.