Tag: wound infection

Using technology to reduce waste and improve surgical care

Every day, millions of patients undergo procedures in ambulatory surgery centers (ASCs), and a very small percentage of them have complications during and after the procedure. Fortunately, new technologies promise to address problems that have challenged patients and their surgical teams.New analytical tools using artificial intelligence and machine learning, coupled with data streams from patients, can be used to better understand patient risk sand develop treatment strategies to reduce complications and improve outcomes.These new tools promise to reduce waste (defined as care that does not add to the patient’s health).For example, a patient who develops a wound infection post-operatively that requires re-operation and hospital admission may benefit from those interventions, but if the patient had gotten treatment earlier for the wound infection,hospitalization and re-operation could have been avoided altogether. Waste is common in our healthcare system today, but things are already starting to change.

 

How can new technologies reduce waste and improve outcomes for patients treated in ASCs? These tools can help predict risk of complications, better manage surgical procedures, and post-operative recovery.Physicians and teams managing surgical patients face several difficult issues: when is it safe to take my patient to surgery? What are the identifiable risks of surgery for this patient and what can be done to minimize those risks? How can the surgery be made as safe as possible? What does this patient need to heal successfully after surgery and what can be done to minimize surgical complications that require treatment? Better answers to these questions lead to better outcomes for patients and reduce wasteful expenditures … read more

Complications in Chronic Wound Healing and

Associated Interventions

 

Overview of Chronic Wounds
Chronic non-healing wounds affect millions of patients each year and contribute significantly to their morbidity and mortality. These wounds have a substantial impact because of their economic burden and the significant effect on the reduction in quality of life, as well as the increased risk of death for those patients affected by them. A 2014 study of Medicare data showed that chronic non-healing wounds and associated complications affect nearly 15% or 8.2 million Medicare beneficiaries. The study also estimated the cost to treat these wounds at between $28.1 billion and $31.7 billion annually. The highest costs were associated with infected or reopened surgical wounds, and outpatient care had the highest site-of-service costs. In addition to being older, most of these patients have obesity and diabetes. Underlying causes often include diabetic foot ulcers, venous leg ulcers, arterial insufficiency, and pressure ulcers. The list of complications contributing not only to chronicity but also to further deterioration is quite lengthy.

 

Specific Wound Healing Complications and Interventions
The prevalence of chronic wounds and their complications has not been well documented in the literature. However underappreciated they may be, the complications associated with chronic wounds increase the cost—both financial and personal—to the individuals with these wounds.Although not an all-inclusive list, some of the more common complications include infection, tissue necrosis and gangrene, periwound dermatitis, periwound edema, osteomyelitis, hematomas, and dehiscence. Our purpose is to discuss the presentation of each and potential interventions … read more

Clinical Challenges in Diagnosing Infected Wounds

Given the impact of infection on delayed wound healing, determining the presence of colonization and infection is imperative to achieving healed outcomes. Chronic wounds are always contaminated, and timely implementation of management and treatment interventions is a key component of the plan of care.

 

Diagnosis of infection can be a very challenging task to say the least, and it is further complicated by the presence of biofilms for which no diagnostic tool is currently available. If not addressed in a timely manner, these local infections can become systemic, leading to sepsis, multiple organ failure, and death. The first steps are a complete and thorough history and a physical examination of the whole patient, not just the patient’s wound, while taking into account both primary and secondary findings to understand the host response.

 

Having a thorough understanding of the principles of chronic wound care and of the current diagnostic modalities available is essential to the improvement of clinical outcomes and cost reduction related to the complication of wound infection. Our focus is on the challenges to diagnosing wound infection, including accurately determining risk factors, differentiating colonization from infection, and understanding the gold standard for diagnosing wound infection … read more

Clinical Challenges in Diagnosing Infected Wounds

Given the impact of infection on delayed wound healing, determining the presence of colonization and infection is imperative to achieving healed outcomes. Chronic wounds are always contaminated, and timely implementation of management and treatment interventions is a key component of the plan of care.

 

Diagnosis of infection can be a very challenging task to say the least, and it is further complicated by the presence of biofilms for which no diagnostic tool is currently available. If not addressed in a timely manner, these local infections can become systemic, leading to sepsis, multiple organ failure, and death. The first steps are a complete and thorough history and a physical examination of the whole patient, not just the patient’s wound, while taking into account both primary and secondary findings to understand the host response.

 

Having a thorough understanding of the principles of chronic wound care and … read more

The Role of Hypochlorous Acid in Managing Wounds

Reduction in Antibiotic Usage

 

by Martha Kelso, RN, HBOT

Numerous brands of hypochlorous acid have emerged in the last few years and have been marketed as “ideal” products for use in wound cleansing. These statements, of course, should draw speculation because it is rare for a single product to be used on all wounds, all clients, in all care settings, all the time, thus making it “ideal.” Let’s explore the role of hypochlorous acid in wound management and wound healing and see how it assists with reduction in antibiotic usage.

 

In its true native natural state, hypochlorous acid is a biocide produced naturally by the human body through the process of phagocytosis during the oxidative burst pathway. Because hypochlorous acid is an oxidant, it leaves nothing behind for bacteria and viruses to create resistance to and therefore does not contribute to the superbug (multidrug-resistant organisms) dilemma. Manufacturers have found a way to create hypochlorous acid outside the human body and bottle it for commercial use. These products are non-cytotoxic when concentrations (parts per million) and pH levels are acceptable for human use … read more

 

Understanding Debridement: An Important Part of Wound Healing

During wound healing, the affected area can become overrun with necrotic – or dead – tissue. This can be harmful to the body’s ability to recover and develop new skin, so debridement may be necessary to remove that dead material. In this way, debridement is essential for preparing the wound bed to promote speedy and efficient healing.

 

Why is debridement important?
Debridement promotes the wound healing process in a variety of ways. Not only does dead skin inhibit the development of healthy new tissue, but it makes the affected area more susceptible to infection. It can also hide the signs of infection, as dead tissue can increase odor and exudate, making it easier for bacteria and other harmful foreign invaders to spread.

 

How does debridement work?
Sometimes, debridement occurs naturally on its own thanks to the body’s own ability to shed off dead tissue. However, more often, it requires a medical procedure. There are two different categories of debridement: active and autolytic. Autolytic debridement involves application of hydrocolloids and hydrogels to enhance moisture in the affected area in order to degrade it so the body will naturally deslough the dead tissue. Active debridement involves the manual removal of necrotic material, and it comes in several types of procedures, such as … read more

The International Wound Infection Institute (IWII) is an organisation of
volunteer interdisciplinary health professionals dedicated to advancing
and improving practice relating to prevention and control of wound
infection. This includes acute wounds (surgical, traumatic and burns)
and chronic wounds of all types, although principally chronic wounds of
venous, arterial, diabetic and pressure aetiologies.

 

Wound infection is a common complication of wounds. It leads to delays in wound
healing and increases the risk of loss of limb and life. Implementation of effective
strategies to prevent, diagnose and manage, is important in reducing mortality and
morbidity rates associated with wound infection.

 

This second edition of Wound Infection in Clinical Practice is an update of the first edition
published in 2008 by the World Union of Wound Healing Societies (WUWHS). The
original document was authored by leading experts in wound management and endorsed
by the WUWHS. The intent of this edition is to provide a practical, updated resource that
is easy-to-use and understand.

read more (pdf)

TIME to face the challenge of wound infection

Complex wounds, Events, Infection | Schulke
TIME to face the challenge of wound infection.
This microsite follows on from the plenary session,
chaired by Kath Vowden at the Wounds UK conference, Harrogate 2016.

Click here to view the microsite

Topical Nystatin Treatment for Candida Infection

Abstract

Introduction. Wound infection is an important cause of nonhealing wounds and graft rejection. Objective. A series of 5 patients (4 females, 1 male; median age, 50; age range, 1.5–83 years) with nosocomial Candida infection of burns and chronic wounds that were reconstructed with split-thickness skin grafts is presented.

 

Materials and Methods. This case series was carried out between February 2011 and June 2014. Based on tissue cultures, wounds were treated with 100 000 units/mL of nystatin and 25 mg in 500 cc normal saline of mafenide acetate, which resulted in regression of wound infection symptoms and improvement of skin graft take. Conclusions. The authors propose this simple, nontoxic, and economic topical treatment for wounds and skin grafts with positive Candida cultures.

 

Infection is a common local factor that impedes wound healing. Hence, a topical antimicrobial dressing is frequently used to control bacterial proliferation.1 Since the introduction of effective topical antibacterial therapy, fungal infections have become more prevalent, especially in burn patients … read more

SIGNS OF WOUND INFECTION THAT EVERYONE SHOULD KNOW

Wound infection is such a common condition and presents so often that every wound care professional will recognize the major signs and symptoms almost instantly. However, the consequences of diagnosing wound infection late, or missing the signs of wound infection completely, are such that it is worth spending a few moments every now and again to remind ourselves of all the signs of wound infection.

 

As we are taught during training, the principal signs of wound infection are rubor, calor, tumor, functio laesa, drainage, and a decline in wound status. Rubor in an infected wound describes a poorly defined erythemal border with a disproportionate amount of erythema, while calor describes a magnified localized increase in temperature with warmth extending further away from the site and a possible systemic increase in body temperature … read more

 

When and how to culture a chronic wound

Chronic wound infections are a significant healthcare burden, contributing to increased morbidity and mortality, prolonged hospitalization, limb loss, and higher medical costs. What’s more, they pose a potential sepsis risk for patients. For wound care providers, the goal is to eliminate the infection before these consequences arise.

 

Most chronic wounds are colonized by polymicrobial aerobic-anaerobic microflora. However, practitioners continue to debate whether wound cultures are relevant. Typically, chronic wounds aren’t cultured unless the patient has signs and symptoms of infection, which vary depending on whether the wound is acute or chronic … read more