Wound Healing Case Study

Skin tears are traumatic wounds, which usually occur on the extremities of the elderly. Not to mention the amount of deaths that occur when skin breakdown doesn’t get treated. The article, “Preventing in –facility Pressure Ulcers, “ states that, “60,000 U.S. patients will die from complications related to hospital-acquired Pus”. (Preventing, 2013). When you think about all the different diseases and illness that can kill someone, pressure ulcer don’t normally come to mind. If we have less skin breakdown with the elderly, we can keep our facilities safer, less life-threatening problems, and have a more successful career as a nurse. There are many ways that you can treat pressure ulcers or skin breakdown in general, but people need to realize what patients are at more risk to develop skin integrity, the ways to prevent skin breakdown from the beginning, and how to treat skin tears when they appear before they can say that they know what skin integrity is. This concept paper will provide the key points on what to know about skin integrity. Who is more at risk, how to prevent them from occurring, and what to do if it does happen.

I can relate to one of the points in your discussion. I work in a small community hospital in the Wound Healing Clinic. We are an outpatient addition to the hospital. We have one nurse who has the primary responsibility of the acute admissions wound care. Last year we were bought by a large health systems. Recently, we were informed that we, the Wound Center, are held responsible if a patient has a hospital acquired pressure ulcer (HAPU). As part of this new directive we were also informed that prevalence rounds were to be done weekly. This is what you described your facility does once a month. These changes place responsibility for care which our staff does not even provide, moreover the changes were never discussed with our clinical coordinator.

Integra is a synthetic wound dressing frequently used to treat burn wounds (Figure 5). It is a bilayer composed of bovine tendon collagen glycosaminoglycan (chondroitin-6-sulphate) cross-linked to it, onto which a silicone (synthetic polysiloxane polymer) membrane is sealed to the upper surface to act as a protective temporary epidermis. The silicone layer is applied as a liquid monomer; curing occurs on the surface of the collagen at room temperature. It serves to control moisture loss from the wound. Water flux across this silicone membrane is the same as that across normal epidermis. The collagen-GAG matrix contains pores ranging from 70 to 200 µm that are invaded by host fibroblasts upon application to an excised wound bed. The pore size was carefully designed by adjusting the collagen-GAG mixture. In GAG-free collagen, the resulting structure was more closed than in collagen-GAG matrices. Smaller pores can delay, or even prevent, biointegration, whereas larger pores would provide an insufficient attachment area for invading host cells. Freeze-drying procedures followed by slow sublimation are used to control pore size too. The degradation rate of 30 days of the collagen-GAG sponge is controlled by glutaraldehyde-induced cross-links. The polypeptide collagen is used for its low levels of antigenicity (it has minimal rejection potential) and because it exerts a hemostatic effect on vascular wounds. Collagen is already found in skin. It is degraded by collagenase deposited

Patients at Long Term Care Facilities are generally debilitated and elderly people who have incontinence problems. Incontinence makes treating pressure ulcers very difficult because it alters tissue tolerance and reapplying products becomes very costly. Usually negative pressure wound therapy (NPWT) is used to treat pressure ulcers but it is also very costly and does not match with some wound locations. Collagen plays a vital role in the wound healing process by creating a framework for the adhesion, movement, and production of new cells. This study determined the effects and uses of Type 1 formulated collagen on granulation tissue formation and reepithreelialization in chronic pressure ulcers.

My new role as an adult/gerontology nurse practitioner (AGNP), will be part of team that provides care for Long-term acute care LTAC, Skilled Nursing Facilities (SNF), or Rehabilitation hospital. After gaining considerable experience, my focus in future will be working in home healthcare and primary care clinics. My scenario will involve an organization that provides innovative, collaborative, health care team for one hundred bed LTAC Hospital. Working as an LTAC registered nurse, I noted that, despite the variety of diagnosis, majority of patients’ presents to LTAC hospital have wounds that require complex wound care management. The wounds can range from pressure ulcers to non-healing illness/injury wounds such as diabetic foot ulcer, venous leg ulcers, and post-surgical wounds among others. For this assignment, my scenario will focus on the role of Nurse Practitioner (NP) on skin care and wound managements.

DOI: 1/14/2016. Patient is a 47 year old male senior information technology field services who sustained injury when his vehicle went off road. He had a transmetatarsal amputation of left foot with failed flap, status post further surgical excision debridement twice a week removing necrotic tissue.

The first couple of paragraphs include an explanation of what is considered a complex wound and the current available treatments. It is beneficial that the authors include an explanation of what the problem is so that the reader can have a better understanding of why this issue is of concern. The paragraphs then transition towards the types of treatments available for the problem and a description of why the current treatments are not sufficient for restorative care.

I observed the documentation process from week -2 in my clinical setting and through reading the related documents I gained theoretical knowledge of documentation . I week -4 I did the the return demonstration of documentation with my instructor successfully and started the documentation process in clinical and developed my communication skill . I think my learning plan helped me to achieve this goal . When I started this semester I wanted to learn about the wound care . To achieve this goal I observed the techniques of wound care in week -10 demonstrated by my instructor and reviewed the related resources of wound care . In week -11 I was successful in return demonstration of wound care and evaluated by my instructor . The plan I made

Aim: This paper considers the effectiveness of different methods of closure materials after surgery looking primarily at complications such as infection rates and dehiscence of wounds. Secondary outcomes measured include cosmetic scar evaluation, patient satisfaction, and cost, ease of use and speed of application.

Today, despite precise surgical techniques to cut out dying tissue, artificial skin and other high-tech treatments, hard-to-heal wounds remain a huge problem. Diabetic foot ulcers alone strike about 600,000 people annually and lead to thousands of

Stechmiller, J. K. (2010). Understanding the Role of Nutrition and Wound Healing. Nutrition in Clinical Practice, 25(1), 61-68. doi:10.1177/0884533609358997

This report will discuss the risk of impaired wound healing, amongst patients in the community. Patients may be at risk due to increased age, malnutrition and underlying medical conditions (Timmons, 2003, White, 2008). However, this report concerns with patients’ knowledge deficit about the importance of nutrition, which may be the risk factor (Casey, 1998, Dealey, 2005, Timmons, 2003). In this respect, a management package in the form of a leaflet aimed at these patients has been prepared, (see appendix), which may improve patients’ knowledge. The report will evaluate how the risk could be minimised by using this leaflet.

Wound management is one of the cornerstones for nursing care however, effective wound care extends far beyond the application of the wound itself. Nurses may be required to assess, plan, implement, and evaluate wound care; therefore, order to fill these roles it’s critical to have an understanding of the several different areas of wound care such as, integumentary system, classification of wounds, wound procedures, and documentation. Knowledge in each of these areas will allow nurses to make well informed decisions about wound care, and as a result play an active part in wound healing.

In this paper we will present critical analysis on the different views on nursing the wound dressing focusing primarily on the possible infections ranging from technique to use of silver to the overall impact made by these choices.

Hyperbaric Oxygen Therapy (HBOT): Systemic hyperbaric oxygen therapy (HBOT) involving breathing 100% oxygen while under 2.4 atmospheres of pressure induces both increases basal PO2 typically lower than 40 mmHg, to ≥100 mmHg, at least 3 times the basic value, and induces collagen production and fibroblast proliferation, which are associated with a 13% increase in wound healing vs. controls [175, 176], and for diabetic ulcers it induces a 4.6-fold decrease in the ulcer size in 70% of the patients at an average of 2.5 months [110] and doubling of the rate of ulcers healing, reducing the need for amputation, and increases the number of wounds that are found to be completely healed on long-term follow-up.[177-179] Thus, HBOT enhances the healing