Ask the treatment expert

Ask the Treatment Expert about ... eschar

Ask the Treatment Expert about ... eschar

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When eschar is present, what are the best practices for treating pressure injuries that occur on the heel?

Ask the Treatment Expert about ... how pressure injury staging descriptions have changed

Ask the Treatment Expert about ... how pressure injury staging descriptions have changed

In addition to the change in terminology from pressure ulcer to injury, NPUAP's April 13, 2016, press release announced refined descriptions of pressure injury (ulcer) stages.

Ask the Treatment Expert about ... what NPUAP's new "pressure ulcer" definition means for providers?

Ask the Treatment Expert about ... what NPUAP's new "pressure ulcer" definition means for providers?

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The National Pressure Ulcer Advisory Panel announced a number of changes in April, including replacing the term "pressure ulcer" with "pressure injury" and modifying stage definitions.

Ask the Treatment Expert about ... improve wound documentation

Ask the Treatment Expert about ... improve wound documentation

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Information sharing is essential to promote quality wound care. Although there are no national, state or local regulations related to wound care documentation, individual skilled nursing facilities must have well thought-out and written policies and procedures.

Ask the Treatment Expert about ... surgical incisions

Ask the Treatment Expert about ... surgical incisions

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I recently admitted my first resident with a surgical incision with staples intact in a hip wound. Do you have tips on how to care for this wound?

Ask the Treatment Expert about ... blisters

Ask the Treatment Expert about ... blisters

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Are all blisters pressure ulcers and if they are, how should they be staged?

Ask the Treatment Expert about ... maggot therapy

Ask the Treatment Expert about ... maggot therapy

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I have a colleague who would like to trial maggot therapy. Can you provide some information about it?

Ask the Treatment Expert about... palliative ulcer care

Ask the Treatment Expert about... palliative ulcer care

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I am treating a resident who is receiving palliative care with a Stage III pressure ulcer on the right trochanter and a Stage IV pressure ulcer on the sacrum. How should I treat these pressure ulcers?

Ask the Treatment Expert about... support surface linens

Ask the Treatment Expert about... support surface linens

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Do you have any guidance about the type of linen to use on support surfaces with a resident who is high-risk for pressure ulcer development?

Ask the Treatment Expert about... addressing pressure ulcers with staff

Ask the Treatment Expert about... addressing pressure ulcers with staff

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Do you have any ideas on how to address the problem of pressure ulcers with my staff?

Ask the Treatment Expert about... nutrition and wound healing

Ask the Treatment Expert about... nutrition and wound healing

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Are there any changes related to nutrition and wound healing we should know about?

Ask the Treatment Expert about... lower extremity problems

Ask the Treatment Expert about... lower extremity problems

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What is the lower-extremity problem we're most likely to see?

Ask the Treatment Expert ... about foot ulcers

Ask the Treatment Expert ... about foot ulcers

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How should we deal with what seems to be a deluge of foot ulcers?

Ask the Treatment Expert ... about leg sores

Ask the Treatment Expert ... about leg sores

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How do you handle people obsessed with leg sores?

Ask the Treatment Expert ... about pressure ulcers

Ask the Treatment Expert ... about pressure ulcers

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Turning, repositioning and mobilization are important interventions to assist in pressure ulcer prevention. Many clinicians continue to maintain an every two-hour turning intervention that has been indicated for years.

Ask the treatment expert ... about basic wound care principles

Ask the treatment expert ... about basic wound care principles

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As a foundation to heading into the rest of 2015, here is a review of the basic wound care principles.

Ask the treatment expert ... about updated guidelines

Ask the treatment expert ... about updated guidelines

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What can you tell us about the new 2014 edition of "Prevention and Treatment of Pressure Ulcers: Clinical Practice Guidelines"?

Ask the treatment expert ... about skin tears

Ask the treatment expert ... about skin tears

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Can you give some guidance on skin tears?

Ask the treatment expert ... about linens and pads

Ask the treatment expert ... about linens and pads

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Does placing multiple pads and linens under residents who are incontinent protect their skin?

Ask the treatment expert ... about unavoidable pressure ulcers

Ask the treatment expert ... about unavoidable pressure ulcers

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Have you heard that most clinicians are in agreement that there are unavoidable pressure ulcers?

Ask the treatment expert ... about wound drainage

Ask the treatment expert ... about wound drainage

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While moisture promotes wound healing, what about those wounds that have a lot of drainage?

Ask the treatment expert ... about wound healing myths

Ask the treatment expert ... about wound healing myths

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Did your mom or grandmother ever tell you to leave a wound open so it could get air?

Ask the treatment expert ... about staging an ulcer

Ask the treatment expert ... about staging an ulcer

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What do you do when staff disagree about the stage of an ulcer?

Ask the treatment expert ... about measuring wounds

Ask the treatment expert ... about measuring wounds

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What is your advice about measuring wounds?

Ask the treatment expert ... about timing negative pressure wound therapy

Ask the treatment expert ... about timing negative pressure wound therapy

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Can you give me some guidelines regarding when I should start negative pressure wound therapy and when it should be discontinued?

Ask the treatment expert ... about wound healing principles

Ask the treatment expert ... about wound healing principles

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I am a registered nurse and very interested in wound care. I understand that there are some general "wound healing principles." Can you explain?

Ask the treatment expert ... about pressure maps

Ask the treatment expert ... about pressure maps

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Can you explain the purpose of a pressure map and the usefulness when evaluating the function of a therapeutic support surface?

Ask the treatment expert ... about wound cultures

Ask the treatment expert ... about wound cultures

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Are wound cultures the best method to determine if a wound is infected?

Ask the treatment expert ... about signs and symptoms of wound infection

Ask the treatment expert ... about signs and symptoms of wound infection

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Can you supply a good primer for aides and others to determine whether a wound is infected?

Ask the treatment expert ... about incontinence briefs

Ask the treatment expert ... about incontinence briefs

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Should incontinence briefs be used in the long-term care setting?

Ask the treatment expert ... about treating pressure ulcer pain

Ask the treatment expert ... about treating pressure ulcer pain

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I am treating a patient with two Stage IV pressure ulcers and he is complaining of extreme pain. What do you recommend?

Ask the treatment expert ... about pressure ulcer documentation

Ask the treatment expert ... about pressure ulcer documentation

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How much do we have to document risk and implemented interventions to prevent pressure ulcer development?

Ask the treatment expert ... about negative pressure wound therapy

Ask the treatment expert ... about negative pressure wound therapy

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Q: What are your thoughts on accelerating wound healing in chronic wounds with adjunctive therapies? A: With chronic wounds, the healing process is slowed or in some cases, completely stalled. Therefore, the healing time exceeds four weeks. Some examples of chronic wounds include pressure ulcers, vascular ulcers and ulcers related to inflammatory diseases.

Ask the treatment expert ... about identifying pressure ulcers

Ask the treatment expert ... about identifying pressure ulcers

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How do you deal with the age-old question "Is it a pressure ulcer or not?" Many healthcare professionals are frequently faced with the dilemma of how to document a reddened area on the buttocks, peri-rectal area or perineal area. Is this a pressure ulcer or is the underlying etiology totally different?

Ask the treatment expert ... about 'micro movements' in bed

Ask the treatment expert ... about 'micro movements' in bed

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I recently read an article addressing the movement of patients while in bed. It was conducted in the United Kingdom and contains valuable information.

Ask the treatment expert ... about friction and pressure ulcers

Ask the treatment expert ... about friction and pressure ulcers

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What role does friction play in pressure ulcers?

Ask the treatment expert ... how to manage painful wounds

Ask the treatment expert ... how to manage painful wounds

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We continue this month on how to manage painful wounds.

Ask the treatment expert ... about the relationship of pain and wounds

Ask the treatment expert ... about the relationship of pain and wounds

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How can we best identify pain associated with wounds?

Ask the treatment expert: What are some of the documentation things nurses often miss?

Ask the treatment expert: What are some of the documentation things nurses often miss?

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A useful resource, "Wound Care Made Incredibly Visual," offers an acronym that may be helpful in highlighting information that should be included when documenting about wounds: WOUNDD PICTURE

Ask the treatment expert: What is the best way to treat a yeast infection?

Ask the treatment expert: What is the best way to treat a yeast infection?

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This is a question that often surfaces, so it may be useful to review the definition, causes, recognition and treatment of "yeast infections."

Ask the treatment expert: How should we calculate pressure ulcer prevalence?

Ask the treatment expert: How should we calculate pressure ulcer prevalence?

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Prevalence is defined as a cross-sectional count of the number of cases at a specific point in time, or the number of people with pressures ulcers who exist in a patient population at a given point in time.

Do you recommend Negative Pressure Wound Therapies?

Do you recommend Negative Pressure Wound Therapies?

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If you do not currently use Negative Pressure Wound Therapy (NPWT) you may want to investigate and consider this excellent option.

Ask the treatment expert: What effect does xerosis have on pruritus?

Ask the treatment expert: What effect does xerosis have on pruritus?

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Xerosis, dry skin, can cause the skin to become scaly and crack, which increases the skin's exposure to bacteria. Many factors contribute to dry skin.

Ask the treatment expert: Are allergies to wound care products common?

Ask the treatment expert: Are allergies to wound care products common?

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Years ago, this question wouldn't have even made our radar screen. However, now it seems a standard consideration since allergies have become increasingly prevalent.

Ask the treatment expert: What should I watch out for when treating darkly pigmented skin?

Ask the treatment expert: What should I watch out for when treating darkly pigmented skin?

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Caregivers must be taught how to closely examine darkly pigmented skin in order to determine tissue damage. A purplish/blue discoloration may be seen.

Ask the treatment expert: Should treatment nurses be certified?

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I am definitely a proponent of education for treatment nurses. Continuing education is significantly important to all of us in long-term care, but especially for those directly involved in wound care.

What's the best way to prevent skin tears?

What's the best way to prevent skin tears?

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A skin tear is a traumatic wound resulting from separation of the epidermis (top layer) from the dermis (underlying layer). The aging process causes older adults to be at high risk for skin tears.

Ask the treatment expert: When are clean and sterile dressing techniques indicated?

Ask the treatment expert: When are clean and sterile dressing techniques indicated?

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This question is often asked. Wound care specialists debate among themselves as to when to use sterile technique and when to use clean technique.

Ask the treatment expert: What should I know about ischemic and diabetic ulcers?

Ask the treatment expert: What should I know about ischemic and diabetic ulcers?

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Some of the risk factors that may contribute to development of these ulcers include atherosclerosis, hypertension, diabetes mellitus, smoking and dyslipidemia.

Ask the treatment expert: What are the key points of caring for venous stasis wounds?

Ask the treatment expert: What are the key points of caring for venous stasis wounds?

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Risk factors that may contribute to development of venous stasis ulcers include history of leg swelling, varicose veins, history of blood clots, deep vein thrombosis, obesity, sedentary lifestyle, prolonged sitting or standing, increasing age and associated immobility, multiple pregnancies, congestive heart failure and smoking.

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