Thanks,

Debra

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Colette,

Hi, you ask a difficult question. I am currently living in Cambodia which is a third world country and I can tell you that there are most likely no statistics on wounds (besides maybe minor accident wounds) here b/c the health care system is not that organized. You may find statistics on TB or HIV but wound care is not a priority in places like this. Being that many places in the world are third world like here, you would need some very rough estimate. You may want to consider scaling down your search to places like Europe, North America, Japan, Korea, and Australia.

Good Luck,

Amy

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One starting place is the weblink below that gives
links to:

http://www.aawcone.com/aawcb/AAWCLINKS2.htm

I also recall that Prof. David Margolis at the Univ.
of Pennsylvania Medical School seemed to be in touch
with lots of statistics on wound issues.

Good luck,

Nathan H
Lafayette, CA
 

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I have had some experience with this on massive abdominal wounds that do not
heal well and on legs, having worked in Surgical Oncology and Major Plastics
and Burns. This device was not used often but was helpful in promoting
healing in wounds with excessive amounts of drainage; sometimes we just have
to try whatever resources may be available to us!

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i have used the vac pac quite a bit with patients both in the nursing home setting and at home. There are some stipulations to the vac dressing usage. ie; certain infections........osteomyelitis......they do reduce healing time significantly, and they have come out with portable units for easier ambulating and transferring.

Kim
LPN

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As a former patient with venous stasis ulcers, I can tell you that if we are talking about the same machine, then the wound vac is a God send. I have been getting ulcers on both of my ankles off and on for over 10 years. I have gone through every treatment from having the wound surgically debrieded to unna boots and every thing in-between. My wounds always had a hard time responding especially after it was discovered that I am allergic to many topical ointments because they contain parabens which is a preservative.
Last year, I had a wound that spread to about the size of a golf ball in diameter. My DR surgically cleaned out the wound due to a severe infection. I was put under general anesthesia. I was then put on the wound vac machine. Having had ulcers this large before, I knew I was looking at 6-9 months of healing that is often very painful. However, with the machine, this same wound healed in less than 3 months. Luckily for me, my insurance covered the machine at 100 %!
Hope this helped! Good Luck!

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Hi-

The V.A.C. stands for Vacuum Assisted Closure, and is available by KCI (San Antonio, TX). They have a wealth of information at www.kci1.com. They also
own the patent, so there is only one VAC. I did hear a rumor yesterday that another company has developed a similar device, and may be marketing it soon, however those claims are not validated.

It works on the basis of "negative pressure". Try "Acute and Chronic
Wounds, Second Edition" by Ruth Bryant for wound care information, along
with a pretty good description of the V.A.C.
Take care

JS

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We use Wound Wash Saline which is similar. It is much cheaper and doesn't have to be discarded after 24 hours like a liter bottle of saline.
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Why don't they think it should be used? There are no preservatives, the pressures are appropriate (as you mentioned), it can be held at any angle and
work, and you don't need a separate syringe to get the spray. I use it all the time in my OP clinic. I love it.

Renee

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I am a medical supplier and send this product to many of my PPS HHA Nurses and they love it. The can keeps the contents sterile while also providing a way to govern the amount dispensed.

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In reference to the Blairex product. The standard for irrigation of wound is 8PSI. The Blairex product doesn't provide an indication of PSI as it varies by the amount of fluid in the container each time it is used. Also the product is one person use. You could get the same effect by using the "gold standard" of syringe and needle with sterile saline at a cheaper cost. Hope that answers your question. Janet, RN, MSN, CS

[Note: I contacted the manufacturer. They recommend 1 can of Blairex be used on a single patient due to the possibility of cross contamination from back splash - Dr. Allan Freedline]

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Hi...I hope your mother is feeling better by now! It is imperative that she go to the doctor and have that wound treated by her physician. Some diabetics have their toenails cut by a podiatrist in order not to risk cutting themselves by doing it themselves. I have the same 'apron' of a belly since I had my child and I get the same rash. It is like a yeast infection. I treat mine with Lotrimin cream which can be bought over the counter now but I use it sparingly. However, I would consult her physician before using any topical salves because I don't know the condition of her skin or its breakdown. I hope my bit of advice helps. Take care and good luck!
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Hello! I'm sorry to hear about your mother. I am an ADON in a long-term care facility and deal with many wounds similar to what you have described. The information that you have given may indicate a yeast in the folds of her skin. She may need some nystatin cream or another antifungal medication and a clean towel or wash cloth tucked into the folds to keep the moisture from proliferating the infection. Does this area itch or have an odor? With the warm weather, yeast loves this type of environment. Wash all skin folds and dry twice a day. Apply clean towels with each washing and change as needed. Her physician can order an antifungal for her. Good luck!!
Cindy

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it is unfortunate that your mother has an open area in the skinfold but I have found that when the skin is red here it is ususally due to heat and perspiration and a fungal infection can quickly start if it is not kept very
clean and dry; also, the redness in her skinfolds can spread quickly; after the open area is healed I would wash and dry inbetween the skinfolds twice a
day and if it gets red with a raised rash use an antifungal ointment; the tenderness is quickly relieved and it heals quickly.

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Carlena,

Tears in the skin in the abdominal fold is common in persons who are obese and even more common in diabetic women. Here are some preventative tips that can help keep this from happenig again. Since that area is dark and moist which is the optimal enviornment for bacterial and fungal grow you need to tackle that first. Lanaseptic ointment is fabulous for resolving skin irritations and you don't have to have a prescription for it. Next go to your local department store and get you a pack of about a dozen all cotten cloth diapers. Yeah you read it right, our mothers had one of the best anti moisture super absorbent solutions on the market. You take the diaper and fold it length wise and lay in the abdominal fold and change every 2 hours til rash and irritation is resolved and then for prevention, use routinely or when the weather is the hottest and she is more likely to persipire. This also works real well under heavy breasts where irritation and frequent yeasty beasties creep up. Good luck.........Jan

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Dear Carlena:

You have the right idea about protecting the open area in the fold of your mother apron abdomen. This area as well as any fold of excess skin and under the breasts is also quite prone to developing a fungal infection. Nystatin powder works great but it can sometimes roll up into globs when mixed with perspiration. I have found that mixing the Nystatin with Zinc Oxide into a gritty cream and applying liberally to all folds will help prevent further problems nad assist in healing. There is also a cream called Critic Aid out there that works very well also.

Good luck:
Becky M.  RN,BSN,CWS

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I recommend both Ostomy Wound Management and Wounds.
Both are published by HMP communications. You can
also subscribe to Advances in Skin and Wound Care.
All offer CEUs in various issues. As you have
probably seen, the JWOCN currently does not offer CEUs (I've complained about this). You can also join a
local WOCN chapter if one is available and attend
meetings that may offer CEUs. The various product
companies also offer programs that offer CEUs (you can contact Johnson & Johnson, Smith & Nephew, Convatec, etc).

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Regarding Carol,
I am suggesting a Symposium....SAWC...Symposium on Advanced Wound Care. It is usuallly in May or June. It will keep you up to date too.
JODY

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Well there are a few factors that might be taken into account for this patient:

Assuming that the wound is clean and has a granular tissue bed, you can use a scrotal support after dressing this wound with something like xenaderm or
tegaderm wih alginate and triple antibiotic.

Is he in his sexual reproductive years or beyond, it seems drastic but castration is an extreme option if the later is the case.

G.R.
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Sounds like you should screen him for MRSA in the wound, perhaps arrange some further imaging of the area like a CT or MRI scan to rule out a sinus and get some advice on changing the eqipment like the hoist and seating he's using

Good Luck

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Hi April,
It appears that shear is a cofactor in this particular instance, and is in a tough spot to treat. I wouldn't recommend Dakin's (unless 0.025% or less
and for a two-week trial basis only if the wound appears infected). The hydocolloid "Duoderm" may have a tendency to roll and bunch up. Try having
therapy create or purchase a wedge to assist in pressure management and prevent sliding. Also, consider a cream based zinc-oxide (only if the wound
is superficial), and apply throughout the day. Once healed, perhaps a transparent film dressing wound prevent friction to the area to keep it from re-opening.
Take care-
John S.

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For superficial open red area to the scrotum I would use some Critic Aid Paste it keeps the open area coated better then a regular moisture barrier type cream..It has worked wonderful for my residents. Hope this info helps.
unsigned

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Dakens is cytotokic to new cell growth and kills all new cells indiscriminately.

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Tell him to heal it by staying off it. I've had sores in the ischial area on ad off for 6 years I'm an extremely active 56yr old quad and these sores have substantially affected my ability to work, get out, interact with my kids, etc. He sounds young and stubborn, just as I was. Now, I have committed to healing the latest wound I have, I am on a wound vac and am staying off it 20 - 24 hrs/day. I don't like it but experience is a good teacher. Best of luck to you and your patient.

Navi

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There is a type of pressure relieving boot which is great, as the heel doesn't
touch anything, but if she fidgets or has an ankle contracture, it could be
more harmful than helpful. In the bed, the boots could work, with the same
cautions. Also, there's a product called the heelzup, which is a cushion with
side bolsters to keep her heels elevated. http://intensivetherapeutics.homestead.com/index.html

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Hi,

One of the most simple devices to get pressure off a heel is a Multi-podus boot, or something like it (Ali-Med company sells a generic for less, also check Sammons-Preston company). These boots can be worn in bed, and some have a sole that can be attached for walking. However, dont use them to walk much!! Medicare will not cover the cost.

Vicki, MSPT, CWS

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The pressure sore is most likely not from when your mom is sitting up in the chair but from the time she is spending in bed.Instead of spending alot of
money try using pillows to float your moms feet off the bed when laying down.They should be just high enough so that you can slid your hand under
her feet.Also, keep soft slippers on when up in W/C and be sure positioning is good so that heels are not pressing against W/C pedals when sitting
up.Hope this helps.
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Spray the heels with Granulex to increase circulation and toughen the skin. Also you may use Moon Boots when she is in bed. They are a thick soft quilted boot that prevent pressure

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an off loading shoe,,from any diabetic or orthopedic supply company

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Actually, Sonia, please visit the American Academy of Wound Management website. AAWM is an organization that certifies healthcare professionals as Certified Wound Specialists (CWS). They have an intensive national boards exam given about twice a year. Go to AAWM.org for more info. There are OT's that have earned their CWS designation.

Evelyn

Also looking for something called MIRE.

Thanks
Frank

Robin

it's much quicker to use the staples there's no other reason

Ed

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Hello,

As far as the CWS certification from the American Academy of Wound Management goes, you can find out the different levels of certification on their website at aawm.org.

Vicki, MSPT, CWS

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There are several different organizations that certify you as a "wound specialist". But yes, most if not all are geared towards health care professionals. There is one exception I can think of. The AAWM (American Academy of Wound Management) did certify someone who has a PhD in chemistry. Why? Because she has been instrumental in developing many wound dressings and ointments. Although she is not a nurse, MD or therapist, she has a lot of experience in this field, plus in order to get certified, you must pass a national boards exam. visit AAWM.org for more info.


Evelyn C.  MPT, CWS