Editorial Staff

Editor Barbara Zeiger

Assistant Editor Lauren Mateja

Web Content Coordinator Katherine Blessing

Editorial Correspondence

Barbara Zeiger, Editor, OWM

HMP Communications, 70 E Swedesford Rd
Suite 100, Malvern PA, 19355

Telephone: (800) 237-7285 or
(610) 560-0500, ext. 4244
Fax: (610) 560-0501

Email: bzeiger@hmpcommunications.com

April 2012 | Volume 58 - Issue 4

From the Editor: Inspiring… but Imperfect

  Today’s lesson, Students, is that the world isn’t perfect. It’s flawed. Capricious. Ephemeral. Hold firm, if you must, to all the definites you perceive, but know: At some point, there will be a shattering. A reckoning. And from the gathering of the pieces hopefully will come an acceptance for imperfection and perhaps (Eureka!) something more realistic (dare I say “evidence-based?”) on which to cling, if but for a while....

Pearls for Practice: Discovering Hydroconductive Dressings

  Topical therapy is one of the most confounding issues in wound care. Currently, more than 50 different classes of dressings and more than 3,000 products are available to clinicians. Each has various properties designed to enhance the body’s ability to heal a wound; many dressing choices and strategies have merit. It is up to the clinician to develop a formulary and select the most suitable dressing for each wound at each evaluation.1

  Ideal dressings should be impermeable to bacteria, able to absorb excess exudate, allow for gaseous exchange, facilitate a moist wound environment, be removed without pain to the patient or trauma to the wound bed, promote wound healing, not adhere to the wound bed, and be easy to use, cost effective, and acceptable to the patient.2 Clinicians also consider the length of time a dressing can be worn (particularly in this era of reimbursement challenges in wound care) and its ability to be used in conjunction with multilayered compression therapy. Inappropriate dressing selection can delay wound healing. ...

The Ostomy Files: Getting the Right Body Fit

  Living with an ostomy is a personal journey. It is a life-changing experience that touches individuals both physically and psychologically.

  More than 120,000 people of all ages in the United States undergo ostomy surgery every year. Because bodily function and emotional well-being are affected, the person with an ostomy may have a number of concerns, including leakage, sexual problems, fear of odor and alterations in body appearance, and changes in mood and sleep patterns. A market research study1 confirmed that approximately 80% of all people with a stoma have either one or more of these concerns; anxiety about such complications could result in lifestyle and quality-of-life changes.2 ...

Nutrition 411: Are Vegetarian Diets Adequate for Wound Healing?

  Healthcare professionals who work in wound management know the routine: When faced with a patient with compromised skin integrity, they pump up the protein — typically, by recommending increased amounts of meat, poultry, fish/seafood, eggs, dairy products, and sometimes protein supplements. But well-meaning health practitioners who offer these suggestions to their vegetarian patients will likely encounter strong resistance. Vegetarianism is not simply a diet plan that a person goes on (and off); it encompasses an entire lifestyle. In fact, not only do some vegetarians abstain from eating anything derived from animals, but they also may abstain from using animal products such as silk, leather, wool, and similar items.1 ...

Continence Coach: Differential Assessment of Trunk Wounds: Pressure Ulceration versus Incontinence-associated Dermatitis versus Intertriginous Dermatitis

  All wound clinicians know that accurate determination of etiology (and implementation of measures to address etiology) is the critical first step in effective management of any wound; attention to glycemic control, perfusion, nutrition, and evidence-based topical therapy are unlikely to result in wound healing if the cycle of injury is not interrupted. When dealing with trunk wounds, the clinician must accurately differentiate between wounds that are pressure-related and those caused by some combination of moisture and friction (incontinence-associated dermatitis [IAD] and intertriginous dermatitis [ITD]).1 Guidelines for differential assessment are the focus of this column. ...

My Scope of Practice: Educator, Entrepreneur

The mind is not a vessel to be filled, but a fire to be kindled. — Plutarch

  “Wound and ostomy professionals are a special breed,” says Nancy Morgan, RN, BSN, MBA, WOCN, WCC, DWC. “They are amazingly talented and caring. If an individual shares that passion and has a little rush every time he/she sees a patient with a wound or ostomy, it affirms the calling.”  Undoubtedly, Nancy has experienced that rush when caring for a patient with a wound or ostomy. But it’s the rush she gets when teaching a colleague something new about wound care that helped her realize her calling as an educator. As one of the founders of the Wound Care Education Institute (WCEI), Nancy puts her wound care knowledge, nursing skills, and entrepreneurial spirit to the test every day....

Special to OWM: Venous Ulcer Guideline Update Accepted by National Guideline Clearinghouse

  The Association for the Advancement of Wound Care (AAWC) Guidelines Task Force 5-year update of its Venous Ulcer Guideline was accepted for publication on the Agency for Healthcare Research and Quality’s National Guideline Clearinghouse (NGC), www.guideline.gov....

Internal Medicine Interns’ and Residents’ Pressure Ulcer Prevention and Assessment Attitudes and Abilities: Results of an Exploratory Study

Abstract

  To evaluate and determine differences between attitudes of internal medicine interns and residents toward pressure ulcer (PU) prevention and to evaluate the interns’ abilities to accurately identify wounds and stage PUs, an exploratory, quantitative study was conducted in a 639-bed, safety net academic center. Participants (21 internal medicine interns and 21 internal medicine residents) attending an educational session on PU prevention and care were eligible to participate. The 1-hour conference session was prepared and provided by a physician and wound care nurses. Before the lecture, participants were asked to complete an 11-question paper-and-pencil PU attitude survey. ...

A Retrospective, Longitudinal Study to Evaluate Healing Lower Extremity Wounds in Patients with Diabetes Mellitus and Ischemia Using Standard Protocols of Care and Platelet-Rich Plasma Gel in a Japanese Wound Care Program

Abstract

  Chronic wounds, especially in patients with diabetes mellitus (DM), are a major health challenge in Japan. The goal of wound care centers (WCCs) in Japan is to facilitate healing and prevent lower extremity amputations (LEAs) using standardized protocols of patient and wound care. The standard treatment algorithm includes a complete patient and wound assessment, history, physical exam, and a variety of diagnostic tests that determine the need for infection control intervention, revascularization, excision and debridement, growth factor/platelet rich plasma (PRP) gel therapy, skin graft/flap, wound protection, and education. All patient and wound data are entered in a secure central database for all WCCs. ...

Developing Evidence-Based Algorithms for Negative Pressure Wound Therapy in Adults with Acute and Chronic Wounds: Literature and Expert-based Face Validation Results

Abstract

  Negative pressure wound therapy (NPWT) is used extensively in the management of acute and chronic wounds, but concerns persist about its efficacy, effectiveness, and safety. Available guidelines and algorithms are wound type-specific, not evidence-based, and many lack clearly described relative and absolute contraindications and stop criteria. The purpose of this research was to: 1) develop evidence-based algorithms for the safe use of NPWT in adults with acute and chronic wounds by nonwound expert clinicians, and 2) obtain face validity for the algorithms. Using NPWT meta-analyses and systematic reviews (n = 10), NPWT guidelines of care (n = 12), general evidence-based guidelines of wound care (n = 11), and a framework for transitioning between moisture-retentive and NPWT care (n = 1), a set of three algorithms was developed....