Month: March 2025

chronic wound‐care competence in student nurses and podiatrists

The purpose of this study was to describe the level of chronic wound‐care competence among graduating student nurses and student podiatrists in comparison with that of professionals and to develop and test a new instrument (the C/WoundComp) that assesses both theoretical and practical competence in chronic wound care as well as attitudes towards wound care. The data (N = 135) were collected in 2019 from four groups (1): graduating student nurses (n = 44) (2); graduating student podiatrists (n = 28) (3); registered nurses (n = 54); and (4) podiatrists (n = 9). The data were analysed using statistical analysis. According to the results, the students’ total mean competence score was 62%. Their mean score for theoretical competence was 67%, and for practical competence, it was 52%. The students’ competence level was statistically significantly lower than that of the professionals (P < .0001), but the students showed a positive attitude towards chronic wound care. The instrument demonstrated preliminary validity and reliability, but this warrants further testing. This study provides new knowledge about student nurses’ and …. full article

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Summary:

This study aimed to develop and test a new assessment tool—called the C/WoundComp instrument—to evaluate both theoretical and practical competence in chronic wound care among student nurses and podiatrists. It also examined their attitudes toward chronic wound care.

Design & Participants: The study used a descriptive, comparative, and methodological approach with 135 participants:

• 44 graduating student nurses

• 28 graduating student podiatrists

• 54 registered nurses

• 9 practicing podiatrists

Key Findings:

• Students had an average competence score of 62% overall:

  • 67% in theoretical knowledge

  • 52% in practical skills

• Professionals scored significantly higher than students.

• Students showed positive attitudes toward chronic wound care despite limited competence.

• The C/WoundComp instrument showed initial reliability and validity for assessing wound-care competence.

Conclusion: Graduating students lack sufficient theoretical and practical knowledge in chronic wound care, highlighting the need to strengthen wound-care education. The C/WoundComp tool could help evaluate and improve competence in this critical area of healthcare.

The authors:

• Emilia Kielo-Viljamaa, PhD, RN: Dr. Kielo-Viljamaa is a Senior Lecturer at Novia University of Applied Sciences, Faculty of Health and Welfare, in Vaasa, Finland. She also serves as a Postdoctoral Researcher at the University of Turku’s Department of Nursing Science. Her research focuses on nursing education and wound care competence. ​ResearchGate

• Riitta Suhonen, PhD, RN: Dr. Suhonen is affiliated with the Department of Nursing Science at the University of Turku, Turku University Hospital, and the Welfare Division of the City of Turku in Finland. She has an extensive background in nursing science and education. ​PubMed

• Maarit Ahtiala: Associated with Turku University Hospital in Finland, contributing to research in nursing and healthcare. ​PubMed

• Terhi Kolari: Affiliated with the Department of Biostatistics at the University of Turku, focusing on statistical analysis in medical research. ​PubMed

• Jouko Katajisto: Part of the Department of Mathematics and Statistics at the University of Turku, specializing in statistical methodologies. ​PubMed

• Leena Salminen, PhD, RN: Connected with the Department of Nursing Science at the University of Turku, with research interests in nursing education and professional competence. ​PubMed+1ResearchGate+1

• Minna Stolt, PhD, RN: Also from the Department of Nursing Science at the University of Turku, Dr. Stolt’s research includes nursing education and wound care. ​PubMed

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Society of Tissue Viability Conference 2025
Solving skin and wound challenges together

30 April – 01 May 2025
LIFE Centre, Wapping Road, Bradford BD3 0EQ

Want to attend?
We are delighted to offer several FREE conference registrations (travel / accommodation bursaries are ‘sold out’) to attend our conference. Link below to find out more and apply now.

Call for abstracts
Are you doing some great work in research? Do you have a case study or product evaluation that you would like to present? Then consider submitting to #SoTV2025! The call for abstracts is now open! Find out more below. Closing 28 February, 2025. Submissions now closed. Thank you to everyone that has submitted – we will notify you of the results soon

Get in touch
If you have any questions, email hello@societyoftissueviability.org

A wound heals by progression through various stages of inflammation, granulation tissue synthesis, collagen deposition and maturation, and epithelization.¹ The majority of acute wounds follow this organized pattern to achieve structural and functional stability. However, some acute wounds with large raw areas progress into chronic wounds refractory to conventional treatments. The presence of bacteria in significant numbers is one important reason a wound may not proceed through the healing trajectory …. full article

Speaker:

A Multimethod Study

Diabetes-related lower extremity amputations (LEAs) are among the most devastating complications of diabetes, profoundly impacting physical, psychological, and social well-being. The Diabetes-Related Extremity Amputation Depression and Distress (DREADD) study examines the emotional and psychological consequences of amputation in diabetic individuals, employing a multimethod approach to capture the full spectrum of patient experiences.

The Psychological Toll of Amputation

Individuals who undergo amputations due to diabetes-related complications, such as diabetic foot ulcers and peripheral artery disease (PAD), often experience profound emotional distress. Depression, anxiety, and post-traumatic stress are common, exacerbated by a loss of mobility, independence, and altered self-identity. Many struggle with feelings of grief, shame, and social isolation, impacting their overall quality of life and mental health.

A Multimethod Approach

The DREADD study employs both qualitative and quantitative research methods to explore these psychological impacts. Surveys and standardized depression scales, such as the Patient Health Questionnaire-9 (PHQ-9), are used to measure depression severity, while structured interviews provide insights into personal struggles, coping mechanisms, and unmet psychological needs. Additionally, biometric data, including heart rate variability and cortisol levels, offer physiological indicators of chronic stress and emotional dysregulation.

Findings and Implications for Care

Preliminary findings suggest that nearly half of patients experience moderate to severe depression post-amputation, with many lacking adequate mental health support. Factors such as poor social support, financial strain, and preexisting mental health conditions contribute to worse outcomes. The study underscores the need for integrated care models that address both physical and psychological rehabilitation, including peer support groups, counseling services, and cognitive behavioral therapy (CBT) to improve patient adaptation and emotional resilience.

By highlighting the critical intersection between diabetes, amputation, and mental health, the DREADD study aims to reshape post-amputation care, advocating for holistic interventions that go beyond wound healing to address the profound psychological distress faced by affected individuals.

by Claire Kowalick, University of Texas Health Science Center at San Antonio

Texas has one of the highest rates of diabetes in the country, with more than 2.7 million Texans diagnosed with the condition. About one in six people in San Antonio have type 2 diabetes, and a third of residents are prediabetic, according to the American Diabetes Association.

Type 2 diabetes is a chronic condition in which the body cannot produce enough insulin or use insulin properly and, if left uncontrolled, can lead to high blood sugar, heart disease and kidney failure. It also predisposes people to foot ulcers, of which almost 50% become infected, subsequently leading to hospitalization and potentially amputation of part of the foot or a lower limb … full article

related:

Texas has one of the highest rates of diabetes in the country, with more than 2.7 million Texans diagnosed with the condition. This epidemic has significant implications for healthcare systems, particularly in the management of complications like diabetic foot ulcers (DFUs). In San Antonio, where approximately one in six residents has type 2 diabetes and a third of the population is prediabetic, the risk of developing DFUs is alarmingly high.

Diabetic foot ulcers result from a combination of neuropathy, poor circulation, and impaired immune response, all of which are common in individuals with long-standing diabetes. Without proper intervention, these ulcers can progress to severe infections, leading to hospitalizations, amputations, and increased mortality rates. Given the high prevalence of diabetes in Texas, hospitals and wound care centers face mounting challenges in treating and preventing these wounds effectively.

The economic burden of DFUs is also substantial. Studies indicate that treating a single DFU can cost tens of thousands of dollars, with the total cost of diabetic foot care in the U.S. exceeding billions annually. In areas like San Antonio, where diabetes rates are disproportionately high, local healthcare facilities must prioritize specialized wound care services, early detection, and preventive measures such as total contact casting (TCC) to offload pressure from wounds and enhance healing.

Community-wide initiatives are essential to combat this growing crisis. Increasing awareness about proper foot care, expanding access to podiatric and wound care specialists, and implementing preventive strategies—such as routine screenings for neuropathy and peripheral artery disease (PAD)—can significantly reduce the incidence and severity of DFUs. Additionally, addressing social determinants of health, such as limited access to quality healthcare, lower socioeconomic status, and dietary challenges, is crucial in mitigating the long-term consequences of diabetes-related foot complications.

As Texas continues to grapple with rising diabetes rates, proactive intervention and innovative wound care solutions will be key in preventing DFUs and improving patient outcomes.

Background. Martorell hypertensive ischemic leg ulcer (HYTILU) is a chronic, hard-to-heal wound linked to hypertension. This study explores nanofat grafting as a regenerative alternative to traditional skin grafting for improved healing and patient outcomes. Objective. To explore the efficacy of nanofat grafting in the management of HYTILU and compare it with skin grafting. Materials and Methods. This was a retrospective single-center pilot study involving 23 patients with HYTILU treated with adipose-derived stromal cells (adipose-derived stromal cells/nanofat). The primary outcomes were ulcer healing rate, pain reduction, and improvements in quality of life, as measured by SCAR-Q (a scar quality of life questionnaire) and the Vancouver Scar Scale, over a period of 6 months posttreatment. Results. This study revealed a significant decrease in ulcer size from an initial mean of 39.69 cm² to complete healing, with an average healing time of 4.65 months. The mean visual analog scale pain scores significantly decreased from an initial score of 5.87 to 0.39 at 3 months …. read more

Kathleen D. Schaum, MS

Medicare coverage for distinct types of wounds/ulcers has received attention for many years. Because the theme of this issue of Advances in Skin & Wound Care is pressure injuries (PIs), this article reviews whether Medicare covers certain technologies and procedures for PIs.

DEBRIDEMENT

Most Medicare Administrative Contractors (MACs) have a Local Coverage Determination (LCD) and Local Coverage Article (LCA) that address the coverage guidelines for debridement of all types of wounds/ulcers, including PIs. Some MACs have a separate debridement LCD/LCA, whereas others include debridement coverage guidelines within their LCD/LCA related to wound care. Readers should check their MAC’s LCDs, which do not limit debridement to distinct wound types. However, their LCDs/LCAs have similar coverage guidelines that include, but are not limited to, documentation of:

• History and physical examination with an initial wound description, location, measurements, and response to prior treatment (if applicable).
• Identification of wound location, size, depth, and stage (supported by a drawing or photograph of the wound).
• Clinical documentation of diagnosis or symptoms to justify services.
• Current progress notes including measurable signs of healing as well as causes of delayed wound healing or modifications to the treatment plan.
• Documentation of the wound’s characteristics (e.g., dimensions, necrotic tissue presence, tissue removed, degree of epithelialization) before and after debridement.
• Operative note or procedure note for debridement services, including descriptions of tissue debrided, wound measurements, and pre-/post-debridement wound assessments.
• Plan of care containing treatment goals and physician follow-up.read full article

Kathleen D. Schaum, MS, is a healthcare reimbursement expert specializing in wound care, durable medical equipment (DME), and Medicare coverage policies. She is the president and founder of Kathleen D. Schaum & Associates, a consulting firm focused on payment strategies for healthcare providers and manufacturers. Schaum is a frequent author and speaker on reimbursement-related topics in wound care and medical technology.

Johns Hopkins University has announced plans to eliminate over 2,200 jobs following the Trump administration’s decision to cut $800 million in grants previously allocated by the U.S. Agency for International Development (USAID). This reduction represents the largest layoff in the university’s history, affecting 247 positions within the United States and 1,975 positions across 44 countries.

The job cuts will impact several key divisions of the university, including the Bloomberg School of Public Health, the School of Medicine, and the affiliated nonprofit organization Jhpiego, which focuses on international health initiatives. The university expressed deep concern over the funding termination, stating that it forces them to wind down critical work both domestically and internationally.

This development is part of a broader trend affecting higher education institutions across the United States. Several universities, including Harvard, the Massachusetts Institute of Technology, and the University of California, San Diego, have implemented hiring freezes and other cost-saving measures in response to federal funding uncertainties. These financial strains threaten the academic and research integrity of these institutions and pose risks to job growth in higher education.

The reduction in USAID funding is expected to have significant implications for global health initiatives, particularly those targeting infectious diseases and women’s health in low-income countries. Johns Hopkins University and other research institutions anticipate further financial challenges and have initiated legal actions against the proposed budget reductions.

As the largest private employer in Maryland and Baltimore, Johns Hopkins University’s decision to cut over 2,000 jobs underscores the real-world impact of federal funding policies on employment and public health research.