Wound Management Capital Health Network Practice Nurses 20 Feb 2018

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Wound Management Capital Health Network Practice Nurses 20 Feb 2018"

Transcription

1 Wound Management Capital Health Network Practice Nurses 20 Feb 2018 ) MNP Judith Barker RN; NP; STN; B Hlth Sc (Nurs); MN (NP) Nurse Practitioner Wound Management Rehabilitation, Aged & Community Care Adjunct Associate Professor- University of Canberra

2 Objectives Wound incidence/prevelence Wound Management in the ACT Acute and chronic wounds seen in community Stages of wound healing Factors that facilitate or delay healing TIME Which dressing to use? Case studies Role of the practice nurse

3 Incidence Population Risk factors Age group Cost & resources Hospital days

4 Wounds seen in the community Trauma Skin tears Lower limb ulceration Pressure injuries Burns Skin cancers Surgical wounds Skin infections

5 Wound Management in the ACT Community Community nursing home visits 5 health centres Link team after hour community nursing service Walk in centres nurse led General practice Podiatry private/public High risk foot clinic OPD clinics private/public Private nursing care agencies Residential Aged Care Facilities Pharmacy

6 Community Care Tuggeranong Health Centre 5 Health Centres nurses/allied health Private Phillip nursing Health Centre agencies nurses/allied health/carers General Practitioner Nurse Practitioner (NP) Clinic Residential Aged Care City Facilities Health Centre Other health care sectors Belconnen Health Centre nurses/allied health/carers

7 Tier Two Referral to CNC Wound Management/NP Wound Clinics Multidisciplinary focus Assessment/diagnosis Treatment plan Evaluation General Practitioner Nurses/allied health/other Specialists

8 venous mixed Timely Accessible service Wound Assessment Tertiary referral Diagnostics investigations Treatment plan Multidispinary/ referrals venous BCC

9 Principles of Wound Management Define aetiology Control factors influencing healing Select appropriate dressing or device Plan for maintenance

10 The Skin

11 Factors Factors influencing wound healing Systemic factors Age Nutrition BMI Vitamin and trace element deficiencies - vitamin C, vitamin A, zinc Drugs steroids, chemotherapy, immunosuppression Systemic disease diabetes, jaundice, malignancy Hypoxia Blood Supply Infection Foreign Bodies Smoking Pain Psychological factors

12 Factors influencing healing Local factors Trauma/pressure Wrong dressing Wound temperature Wound ph Moisture balance Topical infection Foreign body Wound management practices

13 Physiology of wound healing Acute wounds Haemostasis Inflammation Reconstruction Maturation Primary Intention Secondary intention Skin grafts/flaps Chronic wounds

14 Principles of Wound Healing Haemostasis Production of the fibrin clot Platelets release a cocktail of cytokines Characterised by redness, heat, pain and swelling Initiated after trauma for up to 24 hrs Initiates the healing process by stabilising the wound through platelet activity that stops bleeding & triggers the immune response The fibrin matrix becomes the scaffold rapid restoration of a temporary barrier to the external environment

15 Principles of Wound Healing Inflammatory Stage Within minutes of the initial injury, neutrophils, monocytes and macrophages are on the scene to control bacterial growth and remove dead tissue Neutrophils often kill healthy host cells Characteristic red color and warmth is caused by the capillary blood system increasing circulation & laying foundation for epithelial growth

16 Growth factors Growth factors refer to a wide range of proteins that mediate and regulate wound healing processes throughout the healing trajectory Proteases matrixmetalloproteases (MMP) promote physiological wound debridement & facilitate cellular migration & re-modelling in healing wounds MMP have been found in high levels in chronic wound fluid degrade extracellular matrix, growth factors & cytokines necessary for healing Increased MMP activity & prolonged inflammatory responses in a wound are due to increased bacterial colonisation, repeated trauma & ischaemia

17 Principles of Wound Healing Proliferation Stage Begins within 24 hours of the initial injury and may continue for up to 21 days It is characterized by three events: Granulation Collagen synthesis Epithelialisation

18 Principles of Wound Healing Granulation Formation of new capillaries Granulation tissue is the red tissue that bleeds easily Friable Hypergranulation

19 Principles of Wound Healing Collagen Synthesis Creates a support matrix for the new tissue that provides it with its strength Oxygen, iron, vitamin C, zinc, magnesium & protein are vital for collagen synthesis This stage is the actual rebuilding and is influenced by the overall patient condition of the wound bed

20 Principles of Wound Healing Epithelialisation Formation of an epithelial layer that seals and protects the wound from bacteria and fluid loss It is essential to have a moist environment to foster growth of this layer It is a very fragile layer that can be easily destroyed with aggressive wound irrigation or cleansing of the involved area

21 Principles of Wound Healing Maturation Final stage of wound healing Tissue remodeling Begins around day 21 and may continue for up to 2 years Collagen synthesis continues with eventual closure of the wound and increase in tensile strength Tensile strength reaches only about 80% of preinjury strength

22 Acute vs Chronic Acute High mitogenic activity Low levels proinflammatory cytokines Decrease protease activity Mitotically competent cells Chronic Stunned & Stuck in the inflammatory stage High levels of proinflammatory cytokines Increase protease activity Decreased mitogenic activity & senescent cells Premature ageing of cells impairs proliferation and their response to growth factors

23 Chronic vs Acute

24 Principles of Wound Healing Normal Age Changes Decreased epidermal cell turnover Increased capillary fragility and reduced vascularisation Reduced oxygen flow to the area Altered nutrition and fluid intake Impaired immune response Reduced dermal and subcutaneous thickness

25 Skin Tears Initial treatment Moisture balance Protection of the wound & surrounding skin Dressing products - Silicone foam eg mepilex or allevyn gentle Protective tubular bandage

26 Risk factors Age Dependence Immobility History of skin tears Poor nutritional/hydration status Sensory & cognitive deficits Polypharmacy Co morbidities

27 Leg Ulcers Origin Arterial Venous Mixed Neuropathic

28 Aims of Treatment Determine aetiology Remove or treat cause Promote circulation Promote healing Prevent recurrence

29 Causes of Leg ulcers Vascular disorders Lymphatic disorders Haematological disorders Metabolic disorders Tumours Infections Trauma Allergic response

30 Venous Disease

31 ABPI value is calculated by dividing the higher systolic pressure in each leg by the higher systolic brachial pressure

32 Assessment of venous ulcers History of DVT Valvular incompetence Obesity Peripheral oedema - leaking Haemosiderin pigmentation Previous ulcers Dilated & tortuous superficial veins Location medial malleous, anterior to pretibial ulcer, lower 1/3 leg Uneven edges Ruddy granulation tissue No necrotic tissue Maceration & puritis of surrounding skin Foot pulses present

33 Management - Venous Compression therapy Wound/skin Care treat eczema Self examination Ambulation - exercise Nutrition weight loss Elevate legs Stop smoking Calf & foot exercises Moisturise Treat the aetiology Prevent recurrence support groups

34 Compression therapy

35 Arterial ulcers

36 Assessment of arterial ulcers Arteriosclerosis Advanced age Diabetes Hypertension Smoking Thin, shiny, dry skin Thickened nails Absence of hair growth Pallor Cool limb Location: toes, over phalangeal heads, side or sole of foot Deep punched out wound Necrotic tissue Deep pale base Pain at rest May have neuropathy Diminished or absent foot/limb pulses

37 Management - Arterial No compression Avoid mechanical/thermal trauma Daily inspection Foot wear Podiatry care Moisturises Relief from pressure of clothing/shoes Elevate head of bed Consult with vascular surgeon

38 High risk foot Diabetes Neurovascular disease Neuropathic diseases Congenital or other foot abnormalities

39 Diabetic foot examination D - deformity I - infection A - atrophic nails B - breakdown of skin E - oedema T - temperature I - ischaemia C - callosities S - skin colour

40 Foot examination cont Deformity - charcot s, claw toe, hammer toe Infection - crepitus, fluctuation, deep tenderness Atrophic nails - fungal infections and sub ungal ulcers Breakdown of skin - ulcers, fissures, blisters Ischaemia - pulses may be weak or absent Callosities - plantar surface, metatarsal heads Skin colour - red = charcot s - pale = ischaemia pink, with pain and absent pulses = ischaemia.

41 Alert! Remember diabetics may have micro or macro vascular disease or both Always be suspicious of infection Do not use occlusive dressings on foot wounds

42 Skin cancers

43 Surgical wounds

44 Infection Critical colonisation Local infection Topical infection Systemic infection Increased bacterial burden S & S include: Static healing Rolled edges Changes in granulation tissue Bright friable hypergranulation, pocketing, bridging of tissue, increased exudate and discomfort.

45 Dressings Which one to use?

46 TIME

47 CDE: colour, depth and volume of exudate Select the most appropriate dressing according to Wound bed tissue Colour Volume of exudate Depth of the wound Surrounding tissue

48 Ideal dressing Provide mechanical protection Protect against secondary infection Non adherent and easily removed without trauma Leave no foreign particles in the wound Remove excess exudate Be cost effective Offer effective pain relief Protects surrounding skin or peri wound

49 Generic dressings Impregnated mesh dressings Low adherent lightly absorbent pads Super absorber pads Protective film wipes Film sheets Foam and foam like absorbent dressings Hydrocolloid wafers and paste Hydrogel sheets and amorphous with or without additives. Calcium alginates Hydrofibre Hypertonic salt Cadexomer iodine Silver Medicated honey Zinc bandages.

50 Matching colour with product

51 Necrotic black - hydrate

52 Dry necrosis

53 Yellow/Sloughy Wet yellow - antimicrobial dressing Dry yellow - rehydrating dressing

54 Red/sloughy

55 Hypergranulation - antimicrobial

56 Pink/red - protect

57 Infection green - antimicrobial

58 Acute/trauma wounds

59

60 Wounds that fail to heal further investigations and assessment - multidisciplinary focus Infection Foreign body Diabetes DVT Arterial disease Lymphoedema Osteoarthritis Gout Rheumatoid arthritis Osteomylitis Atrophie blanche Vasculitis Pyoderma gangrenosum Neoplasm Blood dyscrasias

61 Case study Leg ulcer

62 Additional Resource For further information refer to the wound dressing guide via the following link. data/assets/pdf_file/0003/451767/book 2-wound-dressing-guide.pdf

63 Thank you Questions

Lower Extremity Neuropathic Disease (LEND)

Lower Extremity Neuropathic Disease (LEND) Lower Extremity Neuropathic Disease (LEND) LEND Ulcer Clinical Presentation Etiology Neuropathic ulcers result from neurologic and musculoskeletal changes leading to a lack of protective sensation and

More information

Foam dressings have frequently

Foam 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 information

Leg ulcer assessment and management

Leg ulcer assessment and management Leg ulceration The views expressed in this presentation are solely those of the presenter and do not necessarily represent the views of Smith & Nephew. Smith & Nephew does not guarantee the accuracy or

More information

PRODIGY Quick Reference Guide

PRODIGY Quick Reference Guide PRODIGY Quick Venous leg ulcer infected How do I assess a venous leg ulcer? Chronic venous insufficiency and venous hypertension result from damage to the valves in the veins of the leg and inadequate

More information

Normal wound healing, and the enemies! Esther White Tissue Viability Nurse

Normal wound healing, and the enemies! Esther White Tissue Viability Nurse Normal wound healing, and the enemies! Esther White Tissue Viability Nurse A wound - definition A wound may be defined as the interruption of continuity in a tissue, usually following trauma. Skin is predominantly

More information

Kelly Spong, RN, BSN, MBA, CWOCN, CHRN & Sandra Macfarlane, PT, DPT

Kelly Spong, RN, BSN, MBA, CWOCN, CHRN & Sandra Macfarlane, PT, DPT Kelly Spong, RN, BSN, MBA, CWOCN, CHRN & Sandra Macfarlane, PT, DPT List the characteristics of lower extremity ulcers Compare and contrast arterial and venous leg ulcers Verbalize what an ABI test is

More information

Wound Assessment Report

Wound Assessment Report Wound Assessment Report Single Assessment, Single Wound Mary Taylor Assessment Patient ID MT4367147 Date of Birth 1939-4-18 Left Foot, Sole: Wound A Image taken 16-45-43 Area 1.7cm2 Perimeter 48mm Maximum

More information

Venous Leg Ulcers. Care for Patients in All Settings

Venous 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 information

Wound Jeopardy: Name That Wound Session 142 Saturday, September 10 th 2011

Wound 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 information

Wound assessment is a

Wound assessment is a Wound assessment part 2: exudate Wound exudate provides the moist environment required for cell regeneration. However, in chronic wounds exudate can become excessive and prevent healing. Changes in the

More information

Wound Management Documentation

Wound Management Documentation Wound Management Documentation Renee Anderson MSN, RN, CWON Objectives 1. To describe the essential elements to include in wound management documentation. 2. To identify tools utilized for the assessment

More information

Address: Left Leg. other: Nails: thick yellow brittle fungus abnormal thick yellow brittle fungus abnormal

Address: Left Leg. other: Nails: thick yellow brittle fungus abnormal thick yellow brittle fungus abnormal South West Regional Wound Care Toolkit: Interdisciplinary Lower Leg Assessment Form Instructions for use: Competent/ Proficient/ Expert level HCP to complete if lower leg ulcer present or risk of ulcer

More information

Tissue Viability Service Wound Management Primary Care Formulary 2017

Tissue Viability Service Wound Management Primary Care Formulary 2017 Tissue Viability Service Wound Management Primary Care Formulary 2017 WMPF/TVS: March 2017 Review date: March 2019 Product Group Current Product Sizes Price per Item Hydrogel 1st Activheal Hydrogel 2nd

More information

HyaloMatrix Product Profile

HyaloMatrix Product Profile HyaloMatrix Product Profile Thank you for your interest in this product. If you have questions please contact; Malcolm Pearson MalcolmPearson@hospitalinnovations.co.uk 07715 335 218 HyaloMatrix: Patient

More information

Independent evaluation of BEMER physical vascular regulation therapy

Independent evaluation of BEMER physical vascular regulation therapy of BEMER Liezl Naudé Advanced nurse specialist: wound management Advanced lower limb and wound management centre, Pretoria Heart 4 the Wounded 5-7 July Pretoria Introduction Lower limb wounds have always

More information

Diabetes mellitus is a complex

Diabetes mellitus is a complex Impaired wound healing in the diabetic foot Diabetic foot ulcers and their consequences are a tragedy for the person affected and a considerable financial burden on healthcare services and society. This

More information

Best practice wound management. Liz Milner Wound Consultant

Best practice wound management. Liz Milner Wound Consultant Best practice wound management Liz Milner Wound Consultant The goals of wound care: reducing risks that inhibit wound healing, enhancing the healing process, and lowering the incidence of wound infections.

More information

Definitions and criteria

Definitions and criteria Several disciplines are involved in the management of diabetic foot disease and having a common vocabulary is essential for clear communication. Thus, based on a review of the literature, the IWGDF has

More information

Palliative Care. EPUAP/NPUAP Publish New Pressure Ulcer Guidelines for. Treatment. Improving Quality of Care Based on CMS Guidelines 39

Palliative 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 information

Assisted Living Resident Assessment (To be used when yes is indicated for skin issues under Section 5 of Assisted Living Resident Assessment)

Assisted Living Resident Assessment (To be used when yes is indicated for skin issues under Section 5 of Assisted Living Resident Assessment) Skin Assessment Current open skin areas: Yes No Current pressure ulcer: Yes No A. Stage 1 Ulcers Report based on highest stage of existing ulcers at its worst; do not reverse stage. Number of existing

More information

Silver Dressings. Sajida Khatri PrescQIPP Primary Care Lead.

Silver Dressings. Sajida Khatri PrescQIPP Primary Care Lead. Silver Dressings Sajida Khatri PrescQIPP Primary Care Lead www.prescqipp.info Available at: www.prescqipp.info/silverdressings 2 Introduction PrescQIPP Silver dressings bulletin published in March 2014

More information

Assessment, diagnosis and management of leg ulcers. Sarah Gardner, Clinical lead, Tissue viability service

Assessment, diagnosis and management of leg ulcers. Sarah Gardner, Clinical lead, Tissue viability service Assessment, diagnosis and management of leg ulcers Sarah Gardner, Clinical lead, Tissue viability service What are the challenges of leg ulcer management? How do you feel when a patient is referred with

More information

EWMA Educational Development Programme. Curriculum Development Project. Education Module. Wound Infection

EWMA Educational Development Programme. Curriculum Development Project. Education Module. Wound Infection EWMA Educational Development Programme Curriculum Development Project Education Module Wound Infection Latest revision: February 2014 ABOUT THE EWMA EDUCATIONAL DEVELOPMENT PROGRAMME The Programme is designed

More information

WOUND CARE UPDATE. -Commonly Used Skin Substitute Products For Wound. -Total Contact Casting. Jack W. Hutter DPM, FACFAS, C. ped.

WOUND CARE UPDATE. -Commonly Used Skin Substitute Products For Wound. -Total Contact Casting. Jack W. Hutter DPM, FACFAS, C. ped. WOUND CARE UPDATE -Commonly Used Skin Substitute Products For Wound Closure -Total Contact Casting Jack W. Hutter DPM, FACFAS, C. ped. Commonly Used Skin Substitute Products for Wound Closure why are they

More information

Guidelines for the Treatment of Pressure Ulcers (Adapted from EPUAP & NPUAP 2009)

Guidelines 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 information

An investigation of Cutimed Sorbact as an antimicrobial alternative in wound management

An investigation of Cutimed Sorbact as an antimicrobial alternative in wound management An investigation of Cutimed Sorbact as an antimicrobial alternative in wound management G Kammerlander, E Locher, A Suess-Burghart, B von Hallern, P Wipplinger Abstract Background: Antimicrobial dressings

More information

Wound Management Guidelines

Wound Management Guidelines Rationale /Background Wound Management Guidelines This guideline has been developed to support healthcare professionals to ensure standardised quality evidence based practice is delivered across the Trust.

More information

THE DIABETIC FOOT. Gillian Harkin Podiatrist

THE DIABETIC FOOT. Gillian Harkin Podiatrist THE DIABETIC FOOT Gillian Harkin Podiatrist Foot Problems In Diabetes Ischaemia Neuropathy Foot Deformity Combination Infection Ischaemic Foot Absent Pulses Cold Cyanotic/pale Dry, shiny skin Lack of hair

More information

CV Disorders Peripheral Vascular Disorders

CV Disorders Peripheral Vascular Disorders CV Disorders Peripheral Vascular Disorders 1 Mary DeLetter, PhD, RN Associate Professor Dept. of Baccalaureate & Graduate Nursing Eastern Kentucky University 1 Venous: Varicose Veins Venous dilatation

More information

Wound Assessment & Management

Wound Assessment & Management Wound Assessment & Management Kim Krog, RN, BScN, CRN(C ) Contributors: Carol Thompson, RN, BScN, CRN(C ) Mary Scarlet, RN, BScN, CRN (C) Objectives Review: Anatomy and physiology of skin Enhance knowledge

More information

Advanced Wound Assessment. Jan Rice Director Jan Rice WoundCareServices

Advanced Wound Assessment. Jan Rice Director Jan Rice WoundCareServices Advanced Wound Assessment Jan Rice Director Jan Rice WoundCareServices woundconsultant8@gmail.com 1 Difference between basic, fundamental and advanced? Basic/fundamental-- Serving as, or being an essential

More information

Wound culture. (Sampling methods) M. Rostami MSn.ICP Rajaei Heart Center

Wound culture. (Sampling methods) M. Rostami MSn.ICP Rajaei Heart Center Wound culture (Sampling methods) M. Rostami MSn.ICP Rajaei Heart Center Infection is a major impairment in delayed and nonhealing chronic wounds. Cultures of chronic wounds are not routinely performed

More information

THE 1 ST MICRO TECHNOLOGY THAT ACCELERATES WOUND HEALING

THE 1 ST MICRO TECHNOLOGY THAT ACCELERATES WOUND HEALING THE 1 ST MICRO TECHNOLOGY THAT ACCELERATES WOUND HEALING 1 st Active Technology With efficacy at cellular level, stimulates patient s cells to restart healing Accelerates healing Accelerated granulation

More information

d e c u t a s t ar Modern wound care in all wound phases

d e c u t a s t ar Modern wound care in all wound phases d e c u t a s t ar Modern wound care in all wound phases Adhesive and non adhesive foam dressings Hydrocolloids Hydro gel Films Alginates Collagen pads Hyaluron silver Wound hygiene sets necrosis necrosis

More information

WHAT IS ARTHRITIS OF THE BIG TOE (HALLUX RIGIDUS)?

WHAT IS ARTHRITIS OF THE BIG TOE (HALLUX RIGIDUS)? Mr Laurence James BSc MBBS MRCS(Eng) FRCS(Tr&Orth) Consultant Orthopaedic Surgeon Foot, Ankle and Sports Injuries WHAT IS ARTHRITIS OF THE BIG TOE (HALLUX RIGIDUS)? A common term for arthritis of the metatarsophalangeal

More information

The Proven Multifunctional Dressing

The Proven Multifunctional Dressing The Proven Multifunctional Dressing belongs to an innovative class of multifunctional wound care dressings. dressings effectively cleanse, fill, absorb and moisten wounds throughout the healing continuum.

More information

Topical Oxygen Wound Therapy (MEDICAID)

Topical Oxygen Wound Therapy (MEDICAID) Topical Oxygen Wound Therapy (MEDICAID) Last Review Date: September 8, 2017 Number: MG.MM.DM.15C8v2 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or

More information

Skin Tear Management Guide South West Regional Wound Care Program Last Updated April 10,

Skin Tear Management Guide South West Regional Wound Care Program Last Updated April 10, Developed in collaboration with the Wound Care Champions, Wound Care Specialists, Enterostomal Nurses, and South West Regional Wound Care Program (SWRWCP) members from Long Term Care Homes, Hospitals,

More information

WOUND DRESSING IN DIABETIC FOOT

WOUND 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 information

Advanced Clinical Solutions. Pressure Ulcer. Carilex Medical Group 1

Advanced Clinical Solutions. Pressure Ulcer. Carilex Medical Group 1 Advanced Clinical Solutions Pressure Ulcer Carilex Medical Group 1 Advanced Clinical Solutions Contents About Pressure Ulcer! 2 Stages of Pressure Ulcer! 5 Reference! 7 Carilex Medical Group 1 About Pressure

More information

ALLEVYN Life Advanced Foam Wound Dressings

ALLEVYN Life Advanced Foam Wound Dressings ALLEVYN Life Advanced Foam Wound Dressings ALLEVYN Life Dressings have a multi-layered design incorporating hydrocellular foam, a hyper-absorber lock away core and a masking layer that has been designed

More information

Burns and Scalds. Treatment and Management. Accident and Emergency Department. Royal Surrey County Hospital. Patient information leaflet

Burns and Scalds. Treatment and Management. Accident and Emergency Department. Royal Surrey County Hospital. Patient information leaflet Patient information leaflet Royal Surrey County Hospital NHS Foundation Trust Burns and Scalds Treatment and Management Accident and Emergency Department A Burn is an injury caused to the skin by thermal

More information

Patient Product Information

Patient Product Information Patient Product Information REGEN-D 150 (India's First Recombinant Human Epidermal Growth Factor (rhegf) Gel for Diabetic Foot Ulcers) Generic name: [Recombinant Human Epidermal Growth Factor (rhegf)]

More information

Arterial Leg Ulcer Clinical Pathway

Arterial Leg Ulcer Clinical Pathway Waterloo Wellington Integrated Wound Care Program Evidence-Based Wound Care Arterial Leg Ulcer Clinical Pathway 0-7 Days Expected Outcomes Notes Patient admitted to service/facility Most Responsible Physician(MRP)/Nurse

More information

Treatment of severe burn wound using unique bacteria-binding dressing with a fatty acid contact layer Kazu Suzuki, DPM CWS

Treatment of severe burn wound using unique bacteria-binding dressing with a fatty acid contact layer Kazu Suzuki, DPM CWS Cutimed Sorbact physical attraction Hands-on Case Report 9 Treatment of severe burn wound using unique bacteria-binding dressing with a fatty acid contact layer Kazu Suzuki, DPM CWS 2 KAZU SUZUKI, DPM

More information

After this presentation and discussion, the participants should be able to:

After this presentation and discussion, the participants should be able to: Tissue Repair Robert F. Diegelmann, Ph.D. OBJECTIVES After this presentation and discussion, the participants should be able to: 1. Define the biochemical responses to tissue injury 2. Describe the mechanisms

More information

Wound healing and Wound care. Odunayo M. Oluwatosin, FMCS (Nig) Department of Surgery

Wound healing and Wound care. Odunayo M. Oluwatosin, FMCS (Nig) Department of Surgery Wound healing and Wound care. Odunayo M. Oluwatosin, FMCS (Nig) Department of Surgery Learning outcome by the end of this presentation, you should be able to: Describe the process of wound healing. Discuss

More information

Impregnated tulle dressing containing silver promotes healing of wounds and treats the wound margins Atrauman Ag tested in clinical practice

Impregnated tulle dressing containing silver promotes healing of wounds and treats the wound margins Atrauman Ag tested in clinical practice Impregnated tulle dressing containing silver promotes healing of wounds and treats the wound margins Atrauman Ag tested in clinical practice Wound management Conclusion In an observational study of 86

More information

Suprasorb Moist Wound Management The right dressing for each wound.

Suprasorb Moist Wound Management The right dressing for each wound. Suprasorb Moist Wound Management The right dressing for each wound. www.lohmann-rauscher.com 2 Contents The complete range of moist wound management 15 Wound healing a three-phase process 16-7 Suprasorb

More information

UPDATES ON THE MANAGEMENT OF THE DIABETIC FOOT ULCER- WHAT EVERY ENDOCRINOLOGIST SHOULD KNOW

UPDATES ON THE MANAGEMENT OF THE DIABETIC FOOT ULCER- WHAT EVERY ENDOCRINOLOGIST SHOULD KNOW UPDATES ON THE MANAGEMENT OF THE DIABETIC FOOT ULCER- WHAT EVERY ENDOCRINOLOGIST SHOULD KNOW Ann M. Zmuda, DPM Associate Professor, Sections of Endocrinology, Vascular Surgery & Orthopedic Surgery Objectives

More information

Skin grafting is a method that is

Skin grafting is a method that is Acute WOUNDS Top tips for skin graft and donor site management Although skin grafting has been associated with plastic surgery and specialist nursing historically, the procedure and postoperative management

More information

AGONY FEET. The. of the. Prevention and management of diabetic foot ulcers

AGONY FEET. The. of the. Prevention and management of diabetic foot ulcers The AGONY of the FEET Prevention and management of diabetic foot ulcers By Margaret Falconio-West, BSN, rn, APN/CNS, CWOCN, DAPWCA Nearly 25 percent of people with diabetes will develop a diabetic foot

More information

Wound Management in the Elderly

Wound 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 information

Cost and dressing evaluation of hydrofiber and alginate dressings in the management of community-based patients with chronic leg ulceration

Cost and dressing evaluation of hydrofiber and alginate dressings in the management of community-based patients with chronic leg ulceration Cost and dressing evaluation of hydrofiber and alginate dressings in the management of community-based patients with chronic leg ulceration Harding K G, Price P, Robinson B, Thomas S, Hofman D Record Status

More information

CHAPTER 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 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 information

GUIDELINES FOR THE MEASUREMENT OF ANKLE BRACHIAL PRESSURE INDEX USING DOPPLER ULTRASOUND

GUIDELINES FOR THE MEASUREMENT OF ANKLE BRACHIAL PRESSURE INDEX USING DOPPLER ULTRASOUND GUIDELINES FOR THE MEASUREMENT OF ANKLE BRACHIAL PRESSURE INDEX USING DOPPLER ULTRASOUND AIM To provide evidence based principles for the measurement of Ankle Brachial Pressure Index (ABPI) using a BACKGROUND/EVIDENCE

More information

GUIDELINES FOR THE ASSESSMENT & MANAGEMENT OF WOUNDS

GUIDELINES FOR THE ASSESSMENT & MANAGEMENT OF WOUNDS GUIDELINES FOR THE ASSESSMENT & MANAGEMENT OF WOUNDS DOCUMENT CONTROL SUMMARY Author: Kate Brawn Tissue Viability Nurse Approved by and date: IPPC 8.2.17 Any other linked CLP006 Policy for Consent to Examination

More information

Wound Healing Basics & How Skin Grafts Take. Bansari Shah 11/01/2008 MS III

Wound Healing Basics & How Skin Grafts Take. Bansari Shah 11/01/2008 MS III Wound Healing Basics & How Skin Grafts Take Bansari Shah 11/01/2008 MS III Phases of Wound Healing nsubstrate Phase (0-2 days) nproliferative Phase (3-30 days) nmaturation Phase (30 days-years) SUBSTRATE

More information

SECTION M: SKIN CONDITIONS. M0210: Unhealed Pressure Ulcer(s) Item Rationale

SECTION M: SKIN CONDITIONS. M0210: Unhealed Pressure Ulcer(s) Item Rationale SECTION M: SKIN CONDITIONS Intent: The items in this section of the April 1, 2014 release of the LTCH CARE Data Set Version 2.01 document the presence, appearance, and change of pressure ulcers. If warranted

More information

Traditional Silicone Technology

Traditional Silicone Technology Innovative Non-Silicone Low Trauma Adhesives versus Traditional Silicone Technology A Review and Comparison Alan Neil Medical Industry Consultant Advanced Wound Care Lohmann Corporation 2016 Chronic wound

More information

Exudate in the early stages of wound healing

Exudate in the early stages of wound healing Products & technology Wound management with the Biatain Silicone foam dressing: A multicentre product evaluation Authors: Hugues Cartier, Simon Barrett, Karen Campbell, Jan Forster, Mike Schmalzbauer,

More information

Wound management. and compression with L&R Solutions from a single source. Wound management. Debridement. Compression.

Wound management. and compression with L&R Solutions from a single source. Wound management. Debridement. Compression. Wound management and compression with L&R Solutions from a single source. Wound management Debridement Compression www.lohmann-rauscher.com Table of contents Introduction Systematic wound management and

More information