Press Release

Best in Class: Scottsdale Wound Management Guide

Comprehensive pocket handbook offers differential diagnosis and treatment options at your fingertips

Malvern, PA (June 8, 2009) – Proper wound care management has become one of the top concerns for many clinicians across various medical specialties. Treatment is specific to the wound type, the patient and the long-term care plan and requires ongoing assessment. Read More

2009 Author Index

CLICK HERE TO VIEW OUR 2009 AUTHOR INDEX

Non-Accredited Education

On-Demand! Wound Healing in Today’s Healthcare Environment – How Advanced Dressing Technology Can Help Ease the Strain
Non-Accredited

Managing the Diabetic Foot: A Clinical and Economic View Complimentary Archived Webcast
Non-Accredited

Head Over Heels and Butts 2.0
Complimentary Archived Webcast
Non-Accredited

Emerging Concepts in Treating Pressure Ulcers
Complimentary Archived Webcast
Non-Accredited

Understanding Collagen Dressings and their Benefit in Wound Care
Complimentary Archived Webcast
Non-Accredited

Notes on Practice

Necrotizing Fasciitis: A Diagnostic and Management Challenge

Patient at baseline with necrotizing fasciitis of the vulva, skin, and subcutaneous tissue.

Wound post-treatment with becaplermin, saline irrigation, and sharp debridement of necrotic tissue.

Wound 12 days after initial treatment. Tunneling remains and granulation buds are still apparent at the wound base.

Hyperplasia present on wound in subsequent visits to clinic.

VOLUME: 48

Issue Number:

Background

Necrotizing fasciitis has been defined as a rapidly progressive disease characterized by extensive necrosis of skin, fascia, and subcutaneous tissue.^1-3 If not diagnosed promptly, it can be severe and potentially life-threatening.^4-6 The first reportable cases of vulvar necrotizing fasciitis were found in 1972 in the obstetric and gynecologic literature.^7,8

Reducing Epibole Using Topical Hyperbaric Oxygen and Electrical Stimulation

When she was admitted to Manor Oak Life Center, Ms. G's sacral pressure ulcer measured 3.0 cm x 4.0 cm x 3.0 cm, with undermining of 1.0 cm to 3.0 cm present on the inferior margins and a thick (4.0 mm) epibole.

After Ms. G received 13 weeks of treatment, the epibole was reduced. Full granulation and reepithelialization proceeded to complete closure and the wound healed.

Ms. H's Stage IV sacral pressure ulcer exhibited epibole that was extensive and thick at the time of initial examination.

After treatment, the epibole reduced completely, was nearing full granulation, and was beginning to reepithelialize when Ms. H died.

VOLUME: 48

Issue Number:

History

Seventy-seven-year-old Ms. G was admitted to Manor Oak Life Center, Buffalo, NY, on July 24, 2000 with a diagnosis of sacral pressure ulcer, anemia, reflex sympathetic dystrophy, hypertension, and fractured left forearm. She had fallen at home and remained in a decubitus position for a prolonged period until she was hospitalized June 15, 2000 through July 24, 2000. The acute injuries were treated (including surgical debridement of the Stage IV pressure ulcer) in the hospital through July 24 by her attending physician and various consulting specialists.

Healing a Wound with an Exposed Herrington Rod: A Case Study

View of completely healed wound, 18 weeks after VAC placement.

Pretreatment view of thoracic pressure ulcer. The wound, measuring approximately 20 cm x 15 cm, was in the area of a previous reconstruction.

VOLUME: 48

Issue Number:

T he development of chronic wounds in spinal cord patients represents a particularly challenging dilemma because of the high rate of wound recurrence. Initial surgical management limits the options for operative treatment of the recurrent wound. Traditional nonoperative management can preserve options for future surgery but requires frequent dressing changes.

An Interesting Side Effect of Home Oxygen Therapy

The scapha has become detached from the head from pressure exerted by the tubing used for home oxygen therapy.

VOLUME: 49

Issue Number:

T he concept of oxygen as a therapeutic agent was initially proposed by Alvin Barach in the 1920s.1 Well-conducted clinical trials have clearly demonstrated major therapeutic benefit for patients with chronic obstructive pulmonary disease.2,3 Currently, long-term oxygen therapy is recommended for patients with hypoxemia, defined as a PaO2 of less than or equal to 55 mm Hg or an oxygen saturation of <88%. Patients with a PaO2 of 56 to 59 mm Hg or an oxygen saturation of 89% with either cor pulmonale or polycythemia also should receive continuous oxygen therapy.4 This is a report of an unusual

Hemophilia and Maggots: From Hospital Admission to Healed Wound

Medial aspect of foot with necrotic tissue as it appeared on admission.

Plantar surface with necrotic tissue on admission.

Medial aspect after completion of maggot debridement therapy.

Plantar surface after completion of maggot debridement therapy.

Medial aspect wound closed. Photo taken 1 month after discharge from outpatient clinic.

Plantar surface wound closed. Photo taken 1 month after discharge from outpatient clinic.

VOLUME: 50

Issue Number:

Background
Hemophilia A is a congenital bleeding disorder where factor VIII, a protein necessary for normal coagulation, is present in decreased amounts or is completely absent in the blood stream. Of patients with this disorder, 21% to 33% will develop an inhibitor or antibody against factor VIII,1 preventing the use of conventional treatment (replacement of the factor VIII protein). Historically, people with high titer inhibitors are treated with bypassing agents. These infusion products bypass the requirement for factor VIII or IX in the coagulation chain.1 However, bypassing agents are n

Pyoderma Gangrenosum Treatment: A Steroid-Free Option

Ms. K’s first day of treatment with the foam sponge wound dressing.

Less than 2 months after beginning treatment, Ms. K’s wound converted to two small wounds.

Foam wound dressing use and adjunctive antibiotic therapy are started on Miss B, a 3-year-old with wounds from a bug bite complicated with severe Pseudomonas infection.

Approximately 2 months after treatment began, Miss B’s wound was 70% healed and the infection completely resolved.

After an additional month of treatment, Miss B’s wound healed.

VOLUME: 50

Issue Number:

Background
Pyoderma gangrenosum (PG), a rare clinical lesion, is a morpholic description of an inflammatory response presenting as a reaction pattern in the skin. The lesions usually present on the lower extremities but also may appear on the trunk, upper extremities, face, and mouth. The papules, pustules, and plaques can evolve and resolve without passing through an ulcerative stage. Before ulceration, aspiration from these lesions shows no bacterial growth; the role of bacteria cultured from ulcerated lesions is that of secondary invaders or colonizers. Salient clinical features of PG are

Living with a Necrotic Wound: A Clinician’s Personal Journey

VOLUME: 51

Issue Number:

W ound care professionals deal with necrotic wounds daily. We instruct patients in self-care as a routine task in our management plan. The expectation is the patient will do as instructed and the wound will likely progress to healing. We are aware that the necrotic wound needs to be debrided or “cleaned up” — what we often do not acknowledge is how distressing necrotic tissue can be to the patient. As a wound care specialist, I decided to share my experience with a necrotic wound for two reasons. First, despite my education and training, when my body was involved I did not want to look

Management of a Complex Wound in a Challenging Home Health Care Patient

VOLUME: 51

Issue Number:

P roviding care to a patient with a complex wound can be challenging. When a history of diabetes, drug abuse, and apathetic self-care are factored into the wound management equation, hope for a positive outcome is further compromised. In this case, in addition to clinical management of the wound, the treatment plan required teaching related to wound care — early development and recognition of wounds, management of diabetes and its effects on wound healing, self care, nutrition, position changes, and referral to other social services for drug-related issues. An aggressive care regimen allowe

Managing Radiation Skin Injury

VOLUME: 51

Issue Number:

D uring and after radiation therapy, patients may experience dryness, itching, erythema, hair loss, rash, and dry desquamation — ie, scaly, flaking skin. Wet desquamation, which resembles a second-degree burn, is seen less frequently. Transient erythema may appear as early as the first treatment; a lasting reaction generally appears during the second or third week of treatment. The early reaction is inflammatory and results from activation of proteolytic enzymes and increased capillary permeability. Radiation skin reactions are confined to the area of treatment, which may include the site o

Hyperbaric Oxygen Therapy Used to Treat Radiation Injury: Two Case Reports

VOLUME: 52

Issue Number:

Radiation is widely used in medicine, industry, agriculture, and research. Despite improvements in radiation safety, accidents with serious health consequences still occur. The harmful effects of ionizing radiation are well documented. Radiological accidents due to radioactive substance contamination are rare; local acute reaction to radiation exposure (which can be acute, protracted, or fractioned) is seen more frequently than whole body radiation complications and may occur alone or together with other injury such as trauma or thermal burn. Symptoms observed within a few months following ra