Wound Email - April 20, 2006

Wound Care Information Network

April 20, 2006

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Previous email questions & their replies are listed below. Remember, replies have not been validated for accuracy or truthfulness.

I've heard about a device called MIST. I'd like to hear from anyone who has had experience with it...good or bad. Thanks, Alfred	This is a modality that has had some new research published on it in the past year. If you check their website, they'll have abstracts and the citations to help you find the full articles. I was really skeptical before, but would consider it now with the new evidence available. Renee Cordrey, PT, PhD(c), MSPT, MPH, CWS ----- I did a trail with "Mist" and was not impressed Linda H. MS, CWOCN, CNP
I just attended a wound care class and learned that there is a pediatric Braden scale called Braden Q scale. Can you help me find a copy. Thank you Jan Bahnsen jbahnsen@magrduerhospital.com	www.mc.vanderbilt.edu/learning-center/publist.html ---- Go to www.bradenscale.com Ellen BA,LPN,CWS --- contact the wound ostomy and continence nurse society .. wocn for info on braden scale ---- Advance for Nurses (Florida edition). published it on March 6, 2006. The name of the article is Young Patients, Age-old Wounds. Cynthia A. Fleck was the author. Nancy B. RN, CWCN
Hello, Can you recommend a wound care magazine for RN’s/WCC’s? Thanks Annette Kietur	Lippincott publishing, has an excellent magazine on wound care. unsigned --- If you join the AAWC (www.AAWCone.org) you can receive Wounds and Ostomy/Wound Management as a benefit of membership. These are both excellent journals. For other journals and books, visit www.AdvancingThePractice.org. Renee Cordrey, PT, PhD(c), MSPT, MPH, CWS --- Go to www.hmpcommunications.com They have several good journals Ellen LPN,CWS --- wocn journal ostomy wound management wounds pdevine2@earthlink.net
Hi I was wondering if you know of Medicare's view of Physical Therapy intervention on a patient with a pressure wound without the use of modalities, debridement, or dressing changes but intervention consists mainly of (for ex.) positioning, contracture management, assessment and try out of wheelchair cushions, recommendation for labs work, recommendations for dietary, etc as interventions. Jonathan Yogore, PT	If you can provide a reason those skills are necessary to work on, and be able to demonstrate improvement, then mobility and positioning are definitely reimbursable. The other management issues (eg: making recommendations) is included in your plan of care and is not separately billable. Renee Cordrey, PT, PhD(c), MSPT, MPH, CWS
I am a healthy 31 year old female with known healing problems (hypergranulation/keloids) after surgical procedures or suturing. I have a sphincterotomy site that has been hypergranulating since Feb 2005, I have been to 2 colorectal surgeons--have tried time, nifedipine oint, anamet oint, and numerous silver nitrate treatments (every 4 weeks up to the present) Does anyone have any suggestions? Help! Kim	Treatment of keloids can sometimes be successful with IPL- Intense Pulse Light treatments- I worked at a Laser Center in St. Louis and treated a keloid from a jellyfish sting that was purple and raised. It took several treatments and increase in jewels to flatten the keloid and discolor the keloid. You may want to contact a local plastic surgeon or spa in your area that performs these procedures- you may have some luck. Dawn Whalen Laser certified, LPN. --- see a plastic surgeon that specializes in hypergranulation tissue pdevine2@earthlink.net
I am a student nurse in the middle of nursing school hoping to specialize one day in wound care. Over the course of our clinical rotations I have developed a fascination for wound care and its methods, not to mention a great feeling of accomplishment at the end of any day in which wound care was involved. I have researched certification information and it seems I will have to work for awhile before getting that. In the meantime I would like to improve my skills in this field and have been looking for a good book for self study. I was hoping your group might recommend one or two for me to start with. Thanks and regards, Erik Heard	I would recommend Prescription for Nutritional Healing by James Balch. Learn as much about nutrition and the various vitamins, minerals, etc. as you can as I believe this is the basis for not only the healing of pressure sores but the prevention also. As great as it feels to heal a wound, it feels even better to teach a patient how to not have a recurrence. This is not usually an area that is covered in depth with the patients at most wound care centers. You could develop some teaching sheets, etc. and make the most of your time with your patients while you are doing treatments. Yvonne Asay LPN --- Erik- Welcome to the wonderful world of wound care. Please consider joining the AAWC, www.aawcone.org. I think you'd find it of interest, and the benefits include two wound journal subscriptions. Also, check out www.AdvancingThePractice.org for other resources. Renee Cordrey, PT, PhD(c), MSPT, MPH, CWS --- Start with some journals ... wocn journal wound ostomy management wounds there are several levels at which you can obtain a certification wound ostomy and continent nurses society requires bachelors' however there are other wound certifications for health care clinicians that do not require a bachelors' Pat Devine cwocn --- I would certainly recommend the book titled: Wound Care Essentials; Principles and Practice offered by Lippincott and Williams, authored by Barinkowski and Ayello. I have found it to have everything I need and it is the book that our Regional Director of Physical Therapy and Rehab uses. I lead the Wound and Skin team at the rehab facility here in Colorado. Diane Sewell LPN --- I really like Wound Care Essentials by Baronoski and Ayello. That was my bible for my recertification exam. Wound Care Made Incredibly Easy (published by Lippincot, Williams and Wilkins) is also pretty good. Nancy B. RN CWCN
I am providing wound care on a diabetic patient’s 2nd toe, at the very tip of the toe. Capillary refill is < 3 seconds. The nail is being treated for fungus. The ulcer at the tip is round, shallow & pink in the center. It keeps trying to close, like a purse string, but the podiatrist keeps cutting it back, wanting it to fill in from the center to the outside. I use wound wash on the ulcer followed by Duoderm gel and a sponge toe cover. Any hints on alternative treatments to promote healing to prevent surgical removal of the tip of the toe? Jennifer RN, MSN, MBA	This patient has PVD of diabetic nature - the podiatrist is trying to convert the chronic wound to an acute wound to "jump start " wound healing. Review the patient' diet and make sure that he / she is complying with blood sugar management. Keep the lower extremities warm to enhance blood flow............... Pat Devine CWOCN --- I have had very good luck using the same treatment that you are using except I use the paste instead of gel and a very light dressing. C. Hall RN --- Hi Jennifer, I sure do. I am a diabetic of 43 years. I had stage lV diabetic ulcers, poor circulation and doctors were going to amputate my feet. I found out about maggot therapy by accident and how well it works. The maggots healed up my feet in a few months and my doctors had tried for two years at a cost of $40,000. to no avail. Maggots eat just the dead infected tissue, excrete enzymes to promote healing, and kill all the bacteria. Though used widely in the 30's it fell out of use when antibiotics came into the picture. Now that antibiotics are being overly used and are not always the answer--maggots are making a big comeback. They are now FDA approved and can be obtained with a prescription from a doctor. I highly recommend and would use again as a first resort, not as a last. Please check out the info on the BTERFoundation website on how they work and how to order. Please be your patient's best advocate for this and learn. Good luck! Thanks, Pam Mitchell Patient Advocate --- Investigate the use of a product from Shaklee Products called Nutriferon. Go to www.shaklee.net/yvonne for more info. It was developed by the man that developed interferon many years ago as a natural product without the side effects of interferon but with the same effectiveness. My mom inadvertently was healed of a fungal infection of her toenail using this product. She had tried all conventional methods without success. She was taking this as a part of her daily supplements and realized within a two weeks of starting it that the fungal infection was gone and has not returned. It is the only alternative method I've ever found that will accomplish what you are asking for. Yvonne Asay LPN
Hi, I Hit my arm on a paper shedder a couple months ago. Had a very bad wound and cut my arm, and it was bleeding, the wound was very bad had a cream and applied gauze to area.Much better now just where I cut it cleared up, just a light redness around it, is there any kind of cream I can use to get rid of it. I do not have sugar, nurse said it takes a long time to heal. Thank you for your help! Dale E-mail address Dkhpebbles203@aol.com	sorry, no replies

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