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

July 2012 | Volume 58 - Issue 7

Pediatric Pressure Ulcer Prevalence: A Multicenter, Cross-Sectional, Point Prevalence Study in Switzerland


  Pressure ulcers (PUs) are a common concern for hospitalized children and adults, but knowledge about PU risk factors, prevalence, and incidence rates among children remains limited. To assess the prevalence of and risk factors for PUs in pediatric care settings, a 1-day cross-sectional study was conducted among all hospitalized children ages 0 to 18 years in all 14 pediatric hospitals in the German-speaking part of Switzerland. Data collection involved a direct systematic inspection and assessment of the skin. A standardized data collection instrument was used, and each patient was assessed by a previously instructed rater pair. The total number of participating children was 412 (75% of all hospitalized children). ...

The Management of Intravenous Infiltration Injuries in Infants and Children


  The intravenous administration of fluids and medications is critical for the treatment of seriously ill patients. Unfortunately, especially in infants and children, fluid infiltration into the surrounding tissue can occur. Early recognition and prompt treatment usually limits the extent of tissue damage. Early treatment may include the injection or application of medication (eg, hyaluronidase, phentolamine, or nitroglycerin ointment) and appropriate dressings. Research to guide the care of more extensive extravasation injury remains limited. At the author’s institution, the protocol of care for children and infants with extensive tissue damage and necrotic tissue consists of careful debridement followed by the use of oxidized regenerative cellulose (ORC)/collagen dressings and skin replacement if needed. Research to help clinicians develop evidence-based protocols of care for both minor and more severe intravenous fluid infiltration or extravasation injury is needed....

From the Editor: What Little We Know

  Five years ago, Ostomy Wound Management dedicated its June publication to the youngest of patients. The issue comprised an overview of pediatric skin and wound care knowledge and included several promising approaches to care that utilized regenerative healing, dressings, positioning, nutrition, and negative pressure.

  One cannot help asking how much more we have learned over the past 5 years. Of course, all information must be taken in the context that many premature and otherwise sick infants who, not long ago, probably would not have survived, triumph (albeit with much care) over their early births and troubling medical conditions. But their care regimens and prolonged hospital stays raise concerns similar to all hospital patients — eg, increased risk for pressure ulcers and intravenous infiltration injury....

Nutrition 411: 3rd Annual Nutrition Best Practices, Tips, Tricks, and Techniques

  In this annual “innovations” column, registered dietitians from across the United States offer their best practices, tips, tricks, and techniques for dealing with unintended weight loss and wounds to help improve the level of care we offer when faced with these challenging problems.

  Often patients with unintended weight loss, malnutrition, or wounds who live at home do not have the energy to shop for food or prepare meals. In addition, many caregivers lack cooking skills for special diets. One solution is to have meals delivered to the home. National and local meal providers are available, including Meals On Wheels, Mom’s Meals, or local providers who may deliver meals. Mom’s Meals, for example, has meals for diabetic, heart health, gluten-free, renal, vegetarian, and low-sodium diets. These fresh meals are delivered by FedEx® and keep in the refrigerator for up to 18 days. Just heat and eat. Ask the meal providers in your area if they are able to provide meals for people on special diets. — Dee Sandquist, MS, RD, LD, CDE, Fairfield, IA...

My Scope of Practice: A Rose by Any Other Name Could Be a Stoma

Ability is what you are capable of doing, motivation determines what you’ll do, our attitudes determine how well you do it. – Raymond Chandler, novelist and screenwriter

 Sandra Rohr, BSN, RN, CWOCN once cared for a patient who wasn’t quite ready to come to terms with her stoma when she first returned home from the hospital. When Sandra walked through this woman’s house, she noticed it was decorated with pink flowers. While she explained to the woman the steps needed to change the pouch, Sandra mentioned that the stoma looked like a pink rose. The woman, who had been so saddened by her situation, smiled and sighed, perhaps with acceptance. This small moment reflects Sandra’s ability to recognize that each patient is unique and you can utilize that specialness to provide quality care....



  If you are a member of the AAWC attending the Symposium on Advanced Wound Care (SAWC) Fall, September 12–14 in Baltimore, MD, look at these advantages:
    • Members choose from more than 40 clinical sessions and earn up to 16 credits at a discounted rate
    • Members are provided additional financial incentives (see below)...

Industry Innovations

  Every July, Ostomy Wound Management highlights product and service innovations in the fields of wound, ostomy, skin, and incontinence care. We invite manufacturers to describe products to entice readers to explore new options and add to their armamentarium of management tools. A more complete list of products is always available at www.WOUNDS360bg.com, a dynamic forum that not only features constantly updated product information along with photos, but also provides opportunity for clinician feedback. OWM hopes readers will make frequent use of all product resources and weigh in and share their experiences with the products and services presented. The editors are grateful to our industry partners for participating in this effort....

A Prospective, Longitudinal Study to Assess Use of Continuous and Reactive Low-pressure Mattresses to Reduce Pressure Ulcer Incidence in a Pediatric Intensive Care Unit


  Pressure between bony prominences and sleep surfaces, as well as pressure from the use of medical devices, put children admitted to pediatric intensive care units (PICUs) at risk of developing pressure ulcers (PUs). To assess the effect of two pediatric-specific, continuous and reactive low-pressure mattresses on the incidence of PUs, an observational, descriptive, prospective, longitudinal (2009–2011) study was conducted among PICU patients. The two pediatric mattresses — one for children weighing between 500 g and 6 Kg and another for children weighing more than 6 Kg — were provided to patients at risk for PUs (Braden-Q ≤16, Neonatal Skin Risk Assessment Scale [NSRAS] ≤13, or per nurse assessment of clinical need)....

Pearls for Practice: Preparing the Wound to Heal Using a New Hydroconductive Dressing

  The concept of wound bed preparation is now accepted in clinical practice as a framework for the management of chronic wounds.1 It is recognized that chronic wounds have become “stuck” in the inflammatory and proliferative stages of healing2 and require an approach to healing that differs from what is used in acute wound management.

  The aim of wound bed preparation is to create an optimal wound healing environment by restoring the bacterial balance and by managing slough, necrosis, and exudate. Wound bed preparation also involves correcting cellular dysfunction and restoring the biochemical balance within the wound.3,4 Clinicians who deal with chronic wounds on a daily basis aim to manage these factors by judiciously observing patients and their wounds and responding with the appropriate use of supportive techniques and/or technologies to prevent complications and promote wound progression....