Approaches to equine wound management: an update
|
|
- Kory McCormick
- 5 years ago
- Views:
Transcription
1 Vet Times The website for the veterinary profession Approaches to equine wound management: an update Author : Justine Kane-Smyth Categories : Equine, Vets Date : August 17, 2015 It is probably fair to suggest horses possess a unique talent for getting themselves into all sorts of unimaginable trouble, picking up a myriad of injuries along the way. Table 1. Initial steps to evaluate a wound Many practitioners would attest the most common equine emergency encountered in practice 1 / 13
2 involves a wound. It has been reported 40% of horses in one UK population sustained traumatic injury within a 12-month period (Owen et al, 2012). The folklore of equine wound management is shrouded in mystery, with various recipes for success passed down the generations. While some principles have stood the test of time and deserve their place in contemporary wound management, others have been shown to be detrimental. There is a surge of interest in wound management that is transforming the way equine wounds are considered and treated. This article aims to explore how some of this new thinking may be implemented on a practical level. Provided the wound is not found to involve any vital structures on initial assessment (Table 1), the following approach may be implemented and adjusted as necessary. Debridement All traumatic wounds should be classified as contaminated at first, but, left unattended, infection ensues in the majority of cases. The first goal is to convert the wound to clean or cleancontaminated status. Debridement aims to remove all foreign material, devitalised, crushed tissues and reduce the bacterial load, while preserving all viable tissue. Lavage Figure 1. Thorough but gentle lavage, performed promptly using isotonic saline can be of enormous benefit. Lavage is the simplest form of debridement and, if performed early, can greatly reduce 2 / 13
3 contamination and bacterial numbers (Figure 1). However, it is important to remain sympathetic to the tissues, as aggressive lavage with excessive pressures can traumatise and waterlog tissues. A shower head, 30ml syringe with a 19G needle, or a one-litre water bottle with holes pierced in the lid, can be an ideal lavage system. Tap water is noxious to fibroblasts, so isotonic saline (0.9%) is the ideal solution. It doesn t necessarily need to be sterile adding one tablespoon of table salt to 600ml water is inexpensive and easily done. If necessary, the wound may be cleansed with dilute solutions (0.05%) of chlorhexidine or povidone iodine, but this should ideally be followed by rinsing with saline to remove the detergents. All scrub solutions (that is, anything that lathers) are best avoided. The old adage if you wouldn t put it in your eye, don t put it on the wound applies here. Autolytic wound debridement Autolytic wound debridement, otherwise known as allowing it to fester, is the most selective debridement method preserving all vital tissue and healing factors. Leaving the naturally produced tissue fluid in contact with the wound allows leucocyte phagocytosis and enzymatic reactions to clear away necrotic tissue and microorganisms. The process is easily overwhelmed, however, and it is important to assist nature by using some form of physical debridement (lavage with or without surgical debridement) first. Sharp surgical debridement Figure 2. Sharp debridement is one of the clinician s most useful tools. Use it conservatively, but as often as necessary. Sharp surgical debridement is the next best option in terms of selectivity (Figure 2). Performed 3 / 13
4 judiciously, it is the least traumatic option the clinician can implement. It is often best to be conservative initially, when the margins between the vital and devitalised tissues may not be clear. Always give tissue the benefit of the doubt; however, sequential repeat debridement, as and when necessary, can hugely improve the wound and hasten healing. Mechanical debridement Mechanical debridement with gauze swabs or wet-to-dry dressings is the most traumatic method and is rarely, if ever, appropriate. It is entirely non-selective, removing not just contamination, but also vital healing factors and even fibroblasts. Additionally, the associated trauma is likely to create a vicious cycle of persistent inflammation. Take home message Use a garden hose/cleaners to remove heavy contamination. Then lavage with saline. Sharp debridement initially. Autolytic with or without repeat sharp debridement as necessary. Adopt a no touch approach where possible, once the wound is in the healing phase that is, no gauze swabs, no cleansing, just saline and a scalpel if necessary. Wound closure 4 / 13
5 Table 2. Suture material and pattern guidelines. Current opinion favours primary closure whenever possible, provided there is no gross evidence of infection, it is possible to clean the wound up well enough and there is sufficient viable tissue to close. However, it should be closed promptly the 12-hour golden period is no longer considered relevant. Left open, the wound surface area increases during the first 24 hours due to skin edge retraction, which may be prevented by adopting this approach. There may be greater risk of eventual dehiscence of the repair, but it offers the potential to salvage more tissue (skin in particular) and creates a biological bandage over subcutaneous tissues. Ultimately, the aim is to reduce the overall healing time, even if healing by second intention is required for some of the wound. It is important to manage the client s expectations carefully a forewarning of possible/likely breakdown will prevent disappointment. Tension-relieving suture patterns are usually required and, even if there is no skin deficit, local swelling is often well established by the time the wound is examined. Guidelines for appropriate 5 / 13
6 suture selection are listed in Table 2. Ideally, choose monofilament, non-absorbable material or absorbable suture that is monofilament or coated. Taking larger bites will minimise skin trauma and improve the holding strength of the repair, as the skin edges will be weaker for the first seven to 10 days. Figure 3. Quills made for sterile intravenous drip tubing and used with a mattress suture pattern can assist in dissipating tension and protecting the skin edges. Adding quills made from an intravenous giving set can help to dissipate tension and protect the skin edges when used with a mattress suture pattern (Figure 3). If it is not possible to convert the wound to a clean or clean-contaminated status, or if infection is already established, primary closure should be postponed. Delayed primary closure may be considered once the wound appears healthy. By being initially patient, debriding as much as possible and allowing healing by second intention to begin, it may then be possible to sharply debride the wound and perform closure of at least part of it. Take home message Perform promptly. Reduce or eliminate contamination first. Use tension-relieving suture patterns and techniques. Contraindicated if infection is established. Use drains if there is dead space. Always try to perform primary closure of eyelid, distal limb and coronary band wounds. Dressing and supportive bandage The aims of an appropriate dressing and good bandage are to: 6 / 13
7 minimise oedema with firm, even pressure absorb exudate maintain temperature and moisture allow gaseous exchange immobilise the wound protect from further contamination and trauma Primary dressings Table 3. A summary of the more commonly used primary dressings. Dressing technology is very sophisticated and advancing rapidly all the time. The selection of primary dressings available is, however, bewildering. While some are appropriate for a variety of wound environments, others have been specially designed for very specific circumstances and may be detrimental if used inappropriately. A brief résumé of the more commonly used primary dressings are listed in Table 3. Maintaining a moist wound environment is now considered of paramount importance. Maintaining optimum moisture at the wound surface should result in progressive re-epithelialisation in a healthy wound healing by second intention within 12 to 14 days. If the wound is desiccated, then moisture 7 / 13
8 needs to be added for example, using a hydrogel. If the wound is exudative, a dressing should be chosen based on its capacity to cope with the expected amount of discharge. Panel 1. The rules Consider what is going on in every part of the wound Wounds change every day, so reassess them frequently. A different dressing type may be indicated. It is essential to change the dressing type once the debridement phase is complete. Switch back to debridement as and when needed. Balancing act Mix it up The dressing must keep the wound moist (but not excessively so) while keeping the surrounding skin dry. This may involve adding moisture to the wound surface. Different dressing types may be used on different parts of the wound. Conditions within the wound change rapidly. Ideally, wounds should be reassessed frequently and the management protocol tweaked accordingly. The horse and the wound environment should be reappraised on each occasion to determine how to optimise conditions within the wound. Implementing the rules listed in Panel 1 may be more labour intensive, but worth considering to potentially lessen the overall time for healing to complete. Secondary layer: cotton wool/gamgee The secondary layer holds the primary dressing in place and absorbs exudate. The number of layers should be sufficient to provide adequate support or immobilisation where necessary. Tertiary layer: Vetrap, Tensoplast 8 / 13
9 The third layer secures the bandage and can provide additional limb support. Careful application of firm, even pressure is important to avoid bandaging complications. Figure 4. Be aware of all bony prominences (red areas) when bandaging the patient. Bandages should be applied very carefully as horses are very prone to developing skin rubs and tendon bows that may produce lesions worse than the original injury. Particular care should be taken over bony prominences (Figure 4) and especially at the following sites: accessory carpal bone medial malleolus of the tibia flexor/extensor tendons gastrocnemius tendon Measures should be taken promptly to prevent further deterioration if rubs or bows develop. 9 / 13
10 Affected areas may be offloaded or padded out, but it may be necessary to remove the bandage completely if they become severe. Casting Distal limb casts can be very useful, providing an economical method of immobilisation. Bandage casts are a more user-friendly alternative a thin bandage is placed initially and then several layers of casting material applied on top. The cast may be split and reused, allowing the wound to be monitored more closely. Delayed healing Table 4. Factors that may influence wound healing The potential for any factors that may impede healing (Table 4) should be considered and measures taken to eliminate (or at least limit) them in advance. For example, a wound that is initially infected and heavily exudative requires a primary dressing with sufficient absorptive capacity to prevent the wound and adjacent skin becoming macerated. It is important to recognise when the wound exudation subsides, as it may become necessary to provide some moisture to avoid desiccation. If the wound is deteriorating or even if progress is just slow, critically analyse the situation to identify and then deal with any factors likely to delay wound healing. Infection Infection results in a prolonged and less effective inflammatory phase. Many bacterial species produce collagenases, which further contribute to delays in healing. Factors that predispose to 10 / 13
11 infection and lead to persistent wound infection include: devitalised tissue foreign bodies dead space/haematoma formation excessive movement Systemic antimicrobial therapy alone is often ineffectual and may result in selection for multiresistant bacterial strains. Physical removal of all foreign material is essential to reduce the bacterial load within the wound environment; this includes any foreign bodies and debris, but also all necrotic and devitalised tissue. Topical antimicrobial therapies (for example, manuka honey and silver-impregnated dressings) may then be appropriate to further reduce the numbers of microorganisms on the wound surface. Intravenous perfusion techniques for regional administration of antimicrobials may also be considered, but are not always practical in the field as they should ideally be repeated at 36-hour to 48-hour intervals. Exuberant granulation tissue Table 5. Measures to consider when managing exuberant granulation tissue to prevent proud flesh. The maturation of fibroblasts to collagen-producing type cells is slower in horses than ponies, and particularly in the distal limb (compared with the trunk, for example) leading to problematic proud flesh. As the granulation bed becomes more prominent it impedes the already slow migration of epithelial cells across its surface and considerably contributes to delays in wound resolution. Measures to minimise and even prevent its development are listed in Table 5. Once established, treatment is simple, but may need to be repeated every three to 10 days until 11 / 13
12 healing is complete. The granulation bed should be surgically excised to approximately 0.5cm below the skin edge paying particular care to avoid disturbing the epithelial margin (Figure 5). Removal of darkly discoloured or irregular areas is also beneficial, aiming to create a smooth and uniform bed of tissue. The wound should remain bandaged to apply pressure to the surface and to provide limb immobilisation. Figure 5. Debride granulating wounds as often as is necessary to prevent healing delays due to proud flesh and to create an even and uniform granulation bed. Also remember to warn the clients about the inevitable blood bath. Topical therapies are generally not necessary and the majority are contraindicated. Judicious use of topical corticosteroid ointment can be considered in some situations (for example, where it is impossible to sufficiently reduce movement), but should only be used on a completely healthy 12 / 13
13 Powered by TCPDF ( granulation bed, avoiding the epithelial margins. In cases where proud flesh becomes persistently problematic, consider the possibility of underlying disease for example, sarcoid transformation or an unidentified focus of necrotic tissue. Hoof wall and coronary band Although, in principle, the same rules of wound healing apply, the hoof wall and coronary band region is specialised as it has a lower healing rate due to constant movement, its proximity to the ground and, therefore, contamination, and little scope for wound contraction due to the rigid hoof wall. Preservation of the germinal layer of the coronary corium is essential for future hoof wall growth as serious damage may result in a permanent hoof wall defect. A partially avulsed hoof wall will not just heal back into place and should be debrided. Casts are enormously beneficial for these injuries, providing effective immobilisation and accelerating healing. They should only be applied once infection is controlled and exudation is minimal to avoid soiling. The heel bulbs should be padded for protection and, provided the horse remains comfortable, the cast may be left in place for two weeks. References Note some drugs in this article are used under the cascade. Owen K R, Singer E R, Clegg P D, Ireland J L and Pinchbeck G L (2012). Identification of risk factors for traumatic injury in the general horse population of north-west England, midlands and north Wales, Equine Veterinary Journal, 44(2): Further Reading The Veterinary Wound Library ( coordinated by Georgie Hollis, is an excellent reference, providing individual case advice and general information about advances in wound management. 13 / 13
I ve a drawer full of dressings i don t know how to use!
I ve a drawer full of dressings i don t know how to use! Introduction: Originating from battlefield medicine much of what we use today is an evolution of material science combined with our understanding
More informationYour guide to wound debridement and assessment. Michelle Greenwood. Lorraine Grothier. Lead Nurse, Tissue Viability, Walsall Healthcare NHS Trust
Your guide to wound debridement and assessment Michelle Greenwood Lead Nurse, Tissue Viability, Walsall Healthcare NHS Trust Lorraine Grothier Clinical Nurse Specialist, Tissue Viability, Central Essex
More informationAppropriate Dressing Selection For Treating Wounds
Appropriate Dressing Selection For Treating Wounds Criteria to Consider for an IDEAL DRESSING Exudate Management Be able to provide for moist wound healing by absorbing exudate or adding moisture Secure
More informationWound Management for Nurses/Technicians What do we need to know?
Wound Management for Nurses/Technicians What do we need to know? Laura Owen European Specialist in Small Animal Surgery Lecturer in Small Animal Surgery, University of Cambridge The Acute Open Wound PPE
More informationUnderstanding Debridement
Understanding Debridement Figure 1. Wound Healing Process Wound Blood Clot Blood Blood Vessel Fat Tissue The wound in the skin exposes deep tissue layers to the air. Scab Scab Exudate Granulation Tissue
More informationAcute and Chronic WOUND ASSESSMENT. Wound Assessment OBJECTIVES ITEMS TO CONSIDER
WOUND ASSESSMENT Acute and Chronic OBJECTIVES Discuss classification systems and testing methods for pressure ulcers, venous, arterial and diabetic wounds List at least five items to be assessed and documented
More informationFundamentals Of Wound Management. Julie Hewish Senior Tissue Viability Nurse
Fundamentals Of Wound Management Julie Hewish Senior Tissue Viability Nurse Wound Management What are we trying to achieve? Maintaining a controlled set of local conditions that is able to sustain the
More informationDEBRIDEMENT. Professor Donald G. MacLellan Executive Director Health Education & Management Innovations
DEBRIDEMENT Professor Donald G. MacLellan Executive Director Health Education & Management Innovations DEBRIDEMENT Principles - CSD Methods of Debridement Biopsy options PRINCIPLES OF WOUND MANAGEMENT
More informationSAMPLE. HLTEN406A Undertake basic wound care. Learner resource. HLT07 Health Training Package. Version 2
HLT07 Health Training Package HLTEN406A Undertake basic wound care Learner resource Version 2 Training and Education Support Industry Skills Unit Meadowbank Acknowledgments The TAFE NSW Training and Education
More informationDRESSING SELECTION SIMPLIFIED
10 DRESSING SELECTION SIMPLIFIED It must be recognised that no one dressing provides the optimum environment for the healing of all wounds (Mahoney, 2015) DRESSING SELECTION SIMPLIFIED Selecting the correct
More informationINTRODUCTION TO WOUND DRESSINGS
WOUND CARE INTRODUCTION TO WOUND DRESSINGS JEC 2017 Wound Care Successfully completed specialized skills training in Wound Management. WOUND CONDITIONS & SYMBOLS BY COLOURS Yellow Black Necrotic tissue
More informationAdvazorb. Hydrophilic foam dressing range
Advazorb Hydrophilic foam dressing range Advazorb A comprehensive range of patient friendly, absorbent foam dressings Non-adhesive and atraumatic silicone adhesive options Designed to manage exudate whilst
More informationWHY WOUNDS FAIL TO HEAL SIMPLIFIED
WHY WOUNDS FAIL TO HEAL SIMPLIFIED 10 Some of the common signs of failure to heal with possible causes and some interventions WHY WOUNDS FAIL TO HEAL There must be adequate supplies of nutrients and oxygen
More informationWound debridement: guidelines and practice to remove barriers to healing
Wound debridement: guidelines and practice to remove barriers to healing Learning objectives 1. The burden of wounds and the impact to the NHS 2. Understand what debridement is and why it is needed 3.
More information8-5cover.qxd 11/14/2006 5:09 PM Page 1 $20.00 (US)
$20.00 (US) CASE REPORT Peer Reviewed Wound Management in a Trumpeter Swan using Honey and a Sustained Release Ionic Silver Hydrogel Christoph Mans, med vet; Janet Sunohara-Neilson, MSc; Geraldine Higginson,
More information2008 American Medical Association and National Committee for Quality Assurance. All Rights Reserved. CPT Copyright 2007 American Medical Association
Chronic Wound Care ASPS #1: Use of wound surface culture technique in patients with chronic skin ulcers (overuse measure) This measure may be used as an Accountability measure Clinical Performance Measure
More informationAssessment & Management of Wounds in primary practice.
Assessment & Management of Wounds in primary practice. Nutrition Successful wound management depends on appropriate nutritional support. Poor nutrition is recognised as one of the major causes of poor
More informationChapter 14 8/23/2016. Surgical Wound Care. Wound Classifications. Wound Healing. Classified According to. Phases
Chapter 14 Surgical Wound Care All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Wound Classifications Classified According to Cause Incision
More informationUnderstanding Debridement of Sores
Understanding Debridement of Sores Introduction Some sores have trouble healing on their own. Sores that will not heal are also known as wounds or chronic wounds. A chronic wound is a sore that is having
More informationWound Dressing. Choosing the Right Dressing
Wound Dressing Choosing the Right Dressing Benefits of using the correct Drsg Helps create the optimal wound environment Increases healing rates Reduces pain Decreases infection rates Cost effective Care
More informationTHAL EQUINE LLC Regional Equine Hospital Horse Owner Education & Resources Santa Fe, New Mexico
THAL EQUINE LLC Regional Equine Hospital Horse Owner Education & Resources Santa Fe, New Mexico 505-438-6590 www.thalequine.com Equine Wounds: What Horse Owners Should Know Wounds are one of the most common
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Medical technology guidance SCOPE Debrisoft for the debridement of acute and chronic wounds 1 Technology 1.1 Description of the technology The Debrisoft
More informationUnderstanding Debridement of Sores
Understanding Debridement of Sores Introduction Some sores have trouble healing on their own. Sores that will not heal are also known as wounds or chronic wounds. A chronic wound is a sore that is having
More informationHydroTherapy: A simple approach to Wound Management
Copyright Paul Hartmann Pty Ltd material may not be reproduced or used without written permission HydroTherapy: A simple approach to Wound Management HARTMANN Education Agenda Agenda Acute vs Chronic wounds:
More informationVenous. Arterial. Neuropathic (e.g. diabetic foot ulcer) Describe Wound Types & Stages of. Pressure Ulcers. Identify Phases of Healing & Wound Care
A dressing the situation at hand Describe Wound Types & Stages of Pressure Ulcers Identify Phases of Healing & Wound Care Goals Clarify Referral Protocol Lacerations- The goal is nearest to complete approximation
More informationProntosan. Clean. Easy Wound Healing. Wound Cleansing
Prontosan Clean. Easy Wound Healing. Wound Cleansing CoE Infection Control Prontosan the unique combination of Betaine & Polihexanide reduces healing time removes and prevents biofilm prevents infections
More informationTopical antimicrobials (antiseptics) Iodine, Silver, Honey
Topical antimicrobials (antiseptics) Iodine, Silver, Honey Iodine Honey Silver Enzymatic debridement Proteolytic enzyme, also called Proteinase Proteinase breaks the long chainlike molecules of proteins
More informationFoam dressings have frequently
The practical use of foam dressings Efficient and cost-effective management of excessive exudate continues to challenge clinicians. Foam dressings are commonly used in the management of moderate to heavily
More informationManaging Wounds. Esther White Tissue Viability Nurse
Managing Wounds Esther White Tissue Viability Nurse First things first.. Assess, measure and photograph Know what you re dealing with, look at anatomical position and the bigger picture to look for extra
More informationDressings do not heal wounds properly selected dressings enhance the body s ability to heal the wound. Progression Towards Healing
Dressings in Wound Care: They Do Matter John S. Steinberg, DPM FACFAS Associate Professor, Department of Plastic Surgery Georgetown University School of Medicine Dressings do not heal wounds properly selected
More informationPrinciple Management of Wound and Fracture in Emergency Department
Principle Management of Wound and Fracture in Emergency Department Presented in Clinical Update Seminar January 15 th 2011 dr. Tedjo Rukmoyo, SpOT (K) Spine Initial Management ATLS Procedure A : airway
More informationSkin Integrity and Wound Care
Skin Integrity and Wound Care By Dr. Amer Hasanien & Dr. Ali Saleh Skin Integrity and Wound Care Skin integrity: the presence of normal Skin & Uninterrupted skin layers by wounds. Factors affecting appearance
More informationConsider the possibility of pressure ulcer development
Douglas Fronzaglia II, DO, MS LECOM Institute for Successful Aging LECOM Institute for Advanced Wound Care and Hyperbaric Medicine Consider the possibility of pressure ulcer development 1 Identify ulcer
More informationDecision-Making in the Acute Management of Blunt and Penetrating Wounds Mary Somerville, DVM, DACVS
Decision-Making in the Acute Management of Blunt and Penetrating Wounds Mary Somerville, DVM, DACVS Providing the best quality care and service for the patient, the client, and the referring veterinarian.
More informationSpinal Cord Injury Info Sheet An information series produced by the Spinal Cord Program at GF Strong Rehab Centre.
Spinal Cord Injury Info Sheet An information series produced by the Spinal Cord Program at GF Strong Rehab Centre. What does skin do? 1. It protects you. 2. It provides sensory information. 3. It helps
More informationSurgical Wounds & Incisions
Surgical Wounds & Incisions A Comprehensive Review Assessment & Management Alex Khan APRN ACNS-BC MSN CWCN CFCN WCN-C Advanced Practice Nurse / Adult Clinical Nurse Specialist www.woundcarenurses.org 1
More informationComprehensive Cast Care Instruction Upper Limb
Comprehensive Cast Care Instruction Upper Limb Please try to continuously exercise all your joints not covered by your cast: fingers, elbow and shoulder. Regular exercise will significantly reduce post-injury
More informationPressure Ulcer Prevention Guidelines
EUROPEAN PRESSURE ULCER ADVISORY PANEL Pressure Ulcer Prevention Guidelines INTRODUCTION Pressure damage is common in many healthcare settings across Europe, affecting all age groups, and is costly both
More informationWound management: effective treatment factors and strategies
Vet Times The website for the veterinary profession https://www.vettimes.co.uk Wound management: effective treatment factors and strategies Author : Moses Brennan Categories : Equine, Vets Date : March
More informationGalen ( A.D) Advanced Wound Dressing
Galen (120-201A.D) Advanced Wound Dressing Wounds heal optimally in a moist environment นพ.เก งกาจ ว น ยโกศล Wound assessment Ideal wound dressing Type of wound Clinical appearance Wound location Measurement
More informationDRESSING SELECTION. Rebecca Aburn MN NP Candidate
DRESSING SELECTION Rebecca Aburn MN NP Candidate Should be individually tailored in conjunction with the patient to meet their individual needs. WOUND MANAGEMENT: Comprehensive health assessment Wound
More informationWOUNDS. Emergency Procedures in PT
WOUNDS Emergency Procedures in PT Types of Wounds Abrasions uppermost layer scraped away, minor capillary bleeding occurs, nerve endings exposed Lacerations skin tear with edges jagged and uneven Incisions
More informationDebridement: treatment, options and selection.
This document is the Accepted Manuscript version of a Published Work that appeared in final form in Independent Nurse, copyright MA Healthcare, after peer review and technical editing by the publisher.
More informationWound Care in the Community. Lisa Sutherland MSc Tissue Viability Senior Lead Ipswich Hospital & Community NHS Trusts
Wound Care in the Community Lisa Sutherland MSc Tissue Viability Senior Lead Ipswich Hospital & Community NHS Trusts What are the key elements? What is the patient s goal or aim for the wound? What are
More informationLower Extremity Wound Evaluation and Treatment
Lower Extremity Wound Evaluation and Treatment Boni-Jo Silbernagel, DPM Describe effective lower extremity wound evaluation and treatment. Discuss changes in theories of treatment in wound care and implications
More informationBeyond the Basics ImprovingYour Wound Care Knowledge. Berna Goldentyer RN, BSN, CWOCN Kathy Hugen RN, BSN, CWOCN
Beyond the Basics ImprovingYour Wound Care Knowledge Berna Goldentyer RN, BSN, CWOCN Kathy Hugen RN, BSN, CWOCN Projects and Posters These resources were developed by creative VA nurses who had no special
More informationCASE 1: TYPE-II DIABETIC FOOT ULCER
CASE 1: TYPE-II DIABETIC FOOT ULCER DIABETIC FOOT ULCER 48 YEAR-OLD MALE Mr. C., was a 48-year old man with a history of Type-II diabetes over the past 6 years. The current foot ulcer with corresponding
More informationVenous Leg Ulcers. Care for Patients in All Settings
Venous Leg Ulcers Care for Patients in All Settings Summary This quality standard focuses on care for people who have developed or are at risk of developing a venous leg ulcer. The scope of the standard
More informationPatient Care Information
Patient Care Information A Guide to Healing Diabetic Foot Ulcers Questions? Contact us: Clinician: Phone #: In case of emergency, dial 9-1-1 Dermal Regeneration Matrix Overview Diabetic foot ulcers are
More informationAbilar Questions and Answers
Abilar Questions and Answers Question Answer Product Information What is Abilar Resin Salve? What are the main properties of Abilar? How is Resin different from colophony (rosin)? Abilar Resin Salve is
More informationEssity Internal. Taking the fear out of wound infection: conquering everyday issues
Taking the fear out of wound infection: conquering everyday issues Learning objectives 1. Identifying the cost which wound infection can have on both the patient and healthcare organisations 2. Understanding
More informationSynevovet Symposium, Bucharest October 25 th, Difficult wound closure. what works best for me. Tumour resections
Difficult wound closure what works best for me Guenter Schwarz Dr. med. vet., Dipl. ECVS, FTA f. Kleintiere Tierklinik Hollabrunn A-2020 Hollabrunn www.tierklinik-hollabrunn.at g.schwarz@tierklinik-hollabrunn.at
More informationPOLYHEAL MICRO - INSTRUCTIONS FOR USE
POLYHEAL MICRO - INSTRUCTIONS FOR USE PRODUCT DESCRIPTION PolyHeal Micro is a medical device indicated for the treatment of wounds. It is comprised of a suspension of polystyrene negatively charged microspheres
More informationThe Triangle of Wound Assessment
The Triangle of Wound Assessment A simple and holistic framework for wound management CPWSC_TOWA_Brochure_210x210_2018.indd 1 10/01/2018 15.13 ? We asked healthcare professionals around the world about
More informationNPUAP Mission. Clinical Practice Guidelines: Wound Dressings for the Management of Pressure Injuries. npuap.org
Clinical Practice Guidelines: Wound Dressings for the Management of Pressure Injuries Margaret Goldberg, MSN, RN, CWOCN June 29, 2016 NPUAP Mission The National Pressure Ulcer Advisory Panel (NPUAP) serves
More informationCategorisation of Wound Care and Associated Products
Categorisation of Wound Care and Associated Products Version 9 March 2018 Surgical Dressing Manufacturers Association 2018 TAPES AND TRADITIONAL DRESSINGS Wound Dressings Swabs Taping Traditional Wound
More informationPalliative Care. EPUAP/NPUAP Publish New Pressure Ulcer Guidelines for. Treatment. Improving Quality of Care Based on CMS Guidelines 39
Treatment EPUAP/NPUAP Publish New Pressure Ulcer Guidelines for Palliative Care Dealing with the end of a loved one s life is difficult enough, but when wound and skin care issues are involved, the decisions
More informationWound Management. E. Foy White-Chu, MD, CWSP
Wound Management E. Foy White-Chu, MD, CWSP E. Foy White-Chu, MD, CWSP Assistant Professor, OHSU Wound Medical Director, VAPORHCS List the Four Principles of Wound Bed Preparation Determine safe debridement
More informationDisclosures for Tarik Alam. Wound Bed Preparation. Wound Prognosis. Session Objectives. Debridement 4/26/2015
Disclosures for Tarik Alam Challenges in Managing Bioburden and Devitalized Tissue Tarik Alam RN, BScN, ET, MClSc(WH) Enterostomal Therapy Nurse tarikalam@hotmail.com Clinical Affairs Manager for Hollister
More informationWound Healing: General Principles. Mansour Dib MD
Wound Healing: General Principles Mansour Dib MD Normal Wound Healing Chronic Wounds: Stuck Where does it get stuck? Mostly Proliferation Sometimes Remodeling Why? Systemic factors Local factors How do
More informationTIME CONCEPT AND LOCAL WOUND MANAGEMENT
TIME CONCEPT AND LOCAL WOUND MANAGEMENT B. BRAUN WOUND CARE INTRODUCTION: TIME is a global care framework used to implement appropriate care plans and promote wound healing Tissue Management Inflammation
More informationWound Care Program for Nursing Assistants-
Wound Care Program for Nursing Assistants- Wound Cleansing,Types & Presentation Elizabeth DeFeo, RN, WCC, OMS, CWOCN Wound, Ostomy, & Continence Specialist ldefeo@cornerstonevna.org Outline/Agenda At completion
More informationLecture 1 Surgical preparation
Lecture 1 Surgical preparation 1. Standard instrument set 2. Preparation for surgery 3. Suture Patterns 1. Standard instrument set female set Preparation of instrument pack Video: Female set preparation
More informationA Pilot Study of Oxygen Therapy for Acute Leg Ulcers
A Pilot Study of Oxygen Therapy for Acute Leg Ulcers Background: The concept of increasing the oxygen concentration in healing wounds developed originally with hyperbaric oxygen therapy and from the fact
More informationAdvanced Wound Care. Cut Shape Innovate
Advanced Wound Care Cut Shape Innovate Vacutex incorporates a patented three layer construction of poly-cotton elements that promotes an accelerated capillary action on wound interfaces. Effectively lifting,
More informationApplication Guide for Full-Thickness Wounds
Application Guide for Full-Thickness Wounds PriMatrix Dermal Repair Scaffold PriMatrix Ag Antimicrobial Dermal Repair Scaffold Application Guide for Full Thickness Wounds PriMatrix is a unique dermal repair
More informationTHERAPIES. HAND IN HAND. Need safe and efficient infection prevention and management? 1 The Cutimed. Closing wounds. Together.
Closing wounds. Together. Need safe and efficient infection prevention and management? 1 The Cutimed Sorbact range. A responsible choice. THERAPIES. HAND IN HAND. www.bsnmedical.co.uk TOGETHER WE CAN MAKE
More informationSDMA Categorisation of Wound Care and Associated Products
Version 7 - February 2015 TAPES AND TRADITIONAL DRESSINGS Traditional Wound Dressings Wound Dressings Packs Swabs Swabs Swab Products Adhesive Tapes Taping Sheets Absorbent Wadding Absorbent Dressings
More informationWound management for nurses. Soft tissue wounds undergo several phases of healing, each merging seamlessly into the next. These are classified as:
Wound management for nurses Soft tissue wounds undergo several phases of healing, each merging seamlessly into the next. These are classified as: Coagulation (clotting) phase Inflammatory phase Proliferative
More informationRN Cathy Hammond. Specialist Wound Management Service at Nurse Maude Christchurch
RN Cathy Hammond Specialist Wound Management Service at Nurse Maude Christchurch 14:00-14:55 WS #141: Wound Infection - What You Need to Know 15:05-16:00 WS #153: Wound Infection - What You Need to Know
More informationDEVELOPMENTS IN WOUND CARE
Vet Times The website for the veterinary profession https://www.vettimes.co.uk DEVELOPMENTS IN WOUND CARE Author : JOHN WILLIAMS, ANNA CONDON Categories : Vets Date : August 11, 2014 JOHN WILLIAMS MA,
More informationEvaluation of the Use of a Silver Collagen Amorphous Gel in the Healing of Post Surgical and Dehisced Lesions
Evaluation of the Use of a Silver Collagen Amorphous Gel in the Healing of Post Surgical and Dehisced Lesions Presented by: Kathryn Khandaker, RN, BSN, CWCN and Deanna Sue Kohl, RN, BSN, CWOCN, CFCN Introduction:
More informationCHAPTER 16 LOWER EXTREMITY. Amanda K Silva, MD and Warren Ellsworth, MD, FACS
CHAPTER 16 LOWER EXTREMITY Amanda K Silva, MD and Warren Ellsworth, MD, FACS The plastic and reconstructive surgeon is often called upon to treat many wound problems of the lower extremity. These include
More informationMaking the Most of your Dressing Products Catherine Hammond CNS/CNE
Making the Most of your Dressing Products 2013 Catherine Hammond CNS/CNE What do you need in your dressings cupboard? 2 Skin tear 3 4 Lack Confidence in Selecting Dressings? 5 Appropriate Use of Product
More informationDEBRIDEMENT. Four Methods of Debridement
Wound Definition Debridement is the removal of devitalized tissue and foreign matter from a wound. These materials support the growth of harmful organisms and may delay wound healing. Although debridement
More informationACOFP 55th Annual Convention & Scientific Seminars. New Physicians and Residents: Introduction to Wound Care. Katherine Lincoln, DO, FAAFP
8 ACOFP 55th Annual Convention & Scientific Seminars New Physicians and Residents: Introduction to Wound Care Katherine Lincoln, DO, FAAFP Introduction to Wound Care KATHERINE LINCOLN, DO, FAAFP ACOFP
More informationAgenda (45 minutes) Some questions for you. Which wound dressing? Dressing categories/types. Summary
Dressing selection Agenda (45 minutes) Some questions for you. Which wound dressing? Dressing categories/types Summary Which wound dressing poster Ref: Which wound dressing? Practice Nursing, September
More informationMean percent reduction in ulcer area from baseline at six weeks 62 % SANTYL Ointment + supportive care* + sharp debridement 1 (P<0.
Evaluating two common adjuncts to sharp debridement in the treatment of diabetic foot ulcers Mean percent reduction in ulcer area from baseline at six weeks 62 % 40 % SANTYL Ointment + supportive care*
More informationUncovering the Pressure Ulcer Coverup Rhonda Kistler RN MS CWON Wound Care Concepts Gentell
Uncovering the Pressure Ulcer Coverup Rhonda Kistler RN MS CWON Wound Care Concepts Gentell Objectives Identify the stages of pressure ulcer according to the depth of tissue destruction. Discuss the differences
More informationENLUXTRA E-LEARNING VIDEO COURSE TRANSCRIPT
ENLUXTRA E-LEARNING VIDEO COURSE TRANSCRIPT #1. Welcome to the Enluxtra Knowledge Base. #2. This video is about: Enluxtra technology Dressing application key points, including Sizing Peri-wound coverage
More informationPinch and punch skin grafting: something not to be scared of
Vet Times The website for the veterinary profession https://www.vettimes.co.uk Pinch and punch skin grafting: something not to be scared of Author : Sarah Boys Smith Categories : Equine, Vets Date : October
More informationGP Practice Woundcare Formulary
Agreed jointly by Ipswich and East Suffolk and West Suffolk Clinical Commissioning Groups GP Practice Woundcare Formulary Version 28 October 2017 Formulary items should be prescribed wherever possible.
More informationWOUND DRESSING IN DIABETIC FOOT
Chapter XII WOUND DRESSING IN DIABETIC FOOT OVERVIEW OF DRESSINGS AND WOUNDS FUNCTIONS OF DRESSING TYPES OF DRESSING SELECTION OF DRESSING MATERIAL TOPICAL AGENTS AND ANTISEPTIC CLEANSERS NEWER OPTIONS
More informationWound Jeopardy: Name That Wound Session 142 Saturday, September 10 th 2011
Initial Wound Care Consult History Physical Examination Detailed examination of the wound Photographs Cultures Procedures TCOM ABI Debridement Management Decisions A Detailed History and Physical (wound)
More informationo Venous edema o Stasis ulcers o Varicose veins (not including spider veins) o Lipodermatosclerosis
Wound Care Equipment and Supply Benefits to Change for Texas Medicaid July 1, 2018 Effective for dates of service on or after July 1, 2018, wound care equipment and supply benefits will change for Texas
More informationWound Healing Basic Concept
Department of Orthopaedic & Traumatology The Chinese University of Hong Kong Wound Healing Basic Concept Dr TSE Lung Fung ( 謝龍峰醫生 ) MBChB(CUHK),FRCS(Edin),FRCSEd(Orth),FHKCOS,FHKAM(Ortho) Tissue Damage
More informationNovoSorb BTM. A unique synthetic biodegradable wound scaffold. Regenerating tissue. Changing lives.
NovoSorb BTM A unique synthetic biodegradable wound scaffold Regenerating tissue. Changing lives. Overview NovoSorb BTM is a unique synthetic biodegradable wound scaffold that delivers good cosmetic and
More informationDrainage Frequency: PATIENT GUIDE. Dressing Frequency: Every Drainage Weekly Drainage. Physician Contact Information. Dr. Phone:
Drainage Frequency: PATIENT GUIDE Dressing Frequency: Every Drainage Weekly Drainage Physician Contact Information Dr. Phone: CHEST DRAINAGE Pleural Space Insertion Site Cuff Exit Site Catheter Valve Connector
More informationINJURIES AND THEIR MANAGEMENT
INJURIES AND THEIR MANAGEMENT INJURIES AND THEIR MANAGEMENT An injury is damage to the body caused by external forces, which may be physical or chemical. 1) Incisions 2) Types of wounds and their closure
More informationHow Wounds Heal: A Guide for the Wound-care Novice
C L I N I C A L P R A C T I C E How Wounds Heal: A Guide for the Wound-care Novice BY Christine Pearson Christine Pearson, RN, IIWCC, is a wound clinician for Vancouver Coastal Health and has worked in
More informationEssential intervention No. 2 Wound management
Essential intervention No. 2 Wound management Essential intervention No. 2 Wound management KEY OBJECTIVES To know the function of skin and understand the phases of normal tissue repair in the healing
More informationWound Management in the Elderly
Wound Management in the Elderly Stephanie Yates, MSN, ANP, ANP-BC, CWOCN Nurse Practitioner/CNS Duke University Medical Center Durham, NC stephanie.yates@duke.edu Skin Condition Key quality indicator To
More informationTraumatic injury to the skin is common among. National Athletic Trainers Association Position Statement: Management of Acute Skin Trauma
Journal of Athletic Training 2016;51(12):1053 1070 doi: 10.4085/1062-6050-51.7.01 Ó by the National Athletic Trainers Association, Inc www.natajournals.org position statement National Athletic Trainers
More informationMedical technology guidance
NICE provided the content for this booklet which is independent of any company or product advertised Medical technology guidance The Debrisoft monofilament debridement pad for use in acute or chronic wounds
More informationOrthopaedica Belgica 2018
POSTTRAUMA WOUND MANAGEMENT PRONTOSAN. Polyhexanide + Betaine: Slows growth of bacteria, Removes the biofilm, Cleans the wound. BVOT Congress Brussels May 3th PRIMARY SOFT TISSUE LESIONS prepatellar bursitis-skin
More informationClinical guideline Published: 22 October 2008 nice.org.uk/guidance/cg74
Surgical site infections: prevention ention and treatment Clinical guideline Published: 22 October 08 nice.org.uk/guidance/cg74 NICE 18. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).
More informationDIAGNOSIS AND TREATMENT OF BUMBLEFOOT IN RAPTORS
Vet Times The website for the veterinary profession https://www.vettimes.co.uk DIAGNOSIS AND TREATMENT OF BUMBLEFOOT IN RAPTORS Author : LESA THOMPSON Categories : Vets Date : September 15, 2014 LESA THOMPSON
More informationGuidelines for the Treatment of Pressure Ulcers (Adapted from EPUAP & NPUAP 2009)
Guidelines for the Treatment of Pressure Ulcers (Adapted from EPUAP & NPUAP 2009) This guidance should be read in conjunction with your local dressing formulary and anti-biotic prescribing guidelines.
More informationWound Healing Community Outreach Service
Wound Healing Community Outreach Service Wound Management Education Plan January 2011 December 2011 Author: Michelle Gibb Nurse Practitioner Wound Management Wound Healing Community Outreach Service Institute
More informationSupporting healthcare professionals in taking control of the infection risk with ACTICOAT Flex TAKE CONTROL. of the infection risk in chronic wound
Supporting healthcare professionals in taking control of the infection risk with ACTICOAT Flex TAKE CONTROL of the infection risk in chronic wound Introduction The impact of infection on patients is well
More information