Wound Care Information Network

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Nov 15, 2010

 

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Survey Results

We asked clinicians who sit on product selection committees to tell us about the committee and how wound care products are viewed. Overall, the committee members said:

  • Committee meetings typically occur monthly or once a quarter

  • Many departments are represented

  • On a scale of 1 - 5, with 1 being 'virtually impossible' and 5 being 'really easy', participants said that it's relatively easy to get a new wound care product admitted (3.8 was the avg score)

  • In terms of what's important to the committee, evidence of wound healing, wound improvement and quality of life benefits scored the highest.

The messages in this table are New. Please e-mail your answers by using the links to the right of each question.

I have an open wound about 3/4 in. deep and 3 in. long as the result of 2 surgeries to address peritenonitis brought on by a ruptured appendix. The wound had been cleaned about twice daily and repacked with gauze lightly wetted with saline solution. A week ago two penrose? drains were removed. A day later a small amount of light green mucous like staining began to appear on the section of bandage touching the bottom of the wound. The mucous has no odor. Our family physician examined the wound assessed the wound and said it was healing quite satisfactorily. He said if it increased in amount we might look further into it. Aside from sign of infection what might this mucous be caused by?
Thomas
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tnicas@infomagic.net

 

I was wondering if you have any suggestions as to any products on the market at this time that would compare to the enzymatic debriders that have been removed from the market. or suggestions as to what can be used to cleanse out wounds of necrotic, dead or otherwise non viable tissue from a wound bed that doesnt warrant mechanical debridement.

Eddie

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Can you help me understand how to bill for a nurses visit in an office setting? The RN sees the patient for approximately 30 minutes measuring, cleaning, notating, and educating the patient. Patient never sees the doctor. We use the 99211 but the reimbursement on some of the insurances is very minimal. Do you have any suggestions on a better CPT code to use?

We would also like to know the best way to bill the supply codes?

Thank you - Ruth
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I would like to get training in wound care. Any where near Statesville, NC?

unsigned

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My mother has been in remission over 10 yrs. from her bout with colon cancer. She is now 75 and has Alzheimer's. While going through radiation treatments her oncologist suggested she have a colostomy due to the foreseeable complications of the radiation treatments to her intestines. She now suffers daily from the inability to clean herself properly and her insistence in trying to wipe herself with a cotton towel instead of wipes. She has gone through hyperbaric treatments and uses all sorts of prescribed ointments and suppositories with no relief. Most of her problems are self-inflicted as a result of the Alzheimer's but I'm looking for other options besides a colostomy bag at this point. If you have any suggestions they would be greatly appreciated. I live in Baytown, Tx. and my parents live in Brownsville, Tx. Thank you.
Joe
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Can sequential compression therapy be initiated while MRSA is located on dorsal aspect of foot? …is it ok to just eliminate compression to that particular foot and have the compression start above the ankle?

Peter
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I have a 79 year old man this is diabetic and has an open wound that was cause by cellulisus. He is now being treated with Selvercel Hydro-Alginate. I was wondering is there are side effect from this dressing? If so what are they.

Thanks,
Diane
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Can any one give me information regarding a product by the name of Risamine ointment by rising pharm?

I'm comparing it to calmoseptine.

Terri (ANP, CWOCN)

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

I'm a 53 old male,left leg amputated 7 inch's below knee aprox33 years ago--motorcycle acc---revision in 2002-Dr.Yen-des Moines,Ia--have another pressure sore approx.,(you can about put your little finger in it up to the end of nail) that's how deep it is. Question being ,can a sore like this heal by-it's self over time or not? Please advise. Marshall - Murray,Ia Mr. Marshall,
It depends on several things.
1. if infection is present. (purulent discharge, odor, redness or warmth.
2. What does the wound bed look like. (is yellow loose slough present, necrotic tissue ect. You need a clean wound bed for wounds to heal. You may want to consider a negative pressure wound therapy.
M Puglia BS, RN, CWON

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Good morning

I think this kind of wound can be treated there is a lot of products can help depend on the wound it self if its infected can use any product with silver if cavity with exudate or with out

The question did not describe the wound status but at end if the patient is compliant with the management his wound can be treated I don’t know also if the patient is diabetic or not thanks

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In my experience, the sore will not heal by itself most especially since it is a pressure ulcer from your prosthesis.

You need to have it thoroughly cleaned (debrided) by the wound care physician in order for the wound to start to heal. Usually, the doc will prescribe silver dressings to be changed every 3 to 4 days. This is done by the wound care nurse. The silver really helps the healing process. Meanwhile, during the healing, the pressure on the wound must be removed. Even after the wound heals, it is subject to breaking much more quickly than that of the surrounding skin.

PLEASE see a wound clinic......
Frances J. Jessup, RN, BSN

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It seems you may still have circulation issues in the stump area. First you need to make sure that area is not being pressurized in any way. You didn't say whether you are using a prosthesis. If yes then you need to stop immediately and have it refitted. If not, you need to check out your positions when sleeping or sitting in a chair to see if the area with the open wound is being pressurized. You also need to check you blood sugar levels frequently throughout the day and be careful withy your diet and insulin regimen. Finally you need to consult a vascular surgeon to check the circulation of the remaining leg.

There is also the Diapulse wound treatment system, which might be available in your area. You will have to go to diapulse.com or call 516-466-3030 for more information. I pray that you will heal completely.

Regards,

Tom Sharon, RN, MPH

I am having issues with a few codes for medicare. What codes can I use for wound debridements in nusing homes by nurses. Amy
 
Sorry, no replies
5 1/2 years ago I had Necrotizing Faciitis on my abdomen. I am diabetic. I have never fully healed. I have three ulcers on my lower addomen. Any advice? Risha
 
Risha
Are your blood sugars managed? Have you had Hyperbaric Oxygen Therapy?
How is your nutritional status? These are some reasons wounds do not heal.
MPuglia BS, RN, CWON

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You didn’t state your gender, age and whether you are insulin dependent. In any case, you need to check your blood sugar and keep it within the accepted range that your doctor advised you. Usually it’s between 90 and 120. If you are having trouble regulating your blood sugar, that would have a significant impact in retarding your healing process. Also do not wear tight clothing around your waist. When you are wearing pants, you should wear suspenders rather than a belt to keep them up.

Tom Sharon, RN, MPH

I have a open wound that I have had off and on for 5 years. I've 5 surgeries, all included grafting but none have never worked. I'm 63 yrs. old. I've had numerous surgeries and high blood pressure, diabetes,low thyroid,high cholesterol, all are kept controlled my medicines. I am 63 yrs old,black woman and I have medicare and medicad. If you can't help, please send me some literature on Wound Care and names of places that have a wound care program. I should mention the last 3 grafts were done by a plastic surgeon and I'm feeling that he does not know anything else to do. Dolores It sounds like you have had a lot of different experiences with trying to manage this wound. It might be worth exploring clinics that approach wound care from a multi-disciplinary perspective. A wound like yous, complicated by other health problems, have to have very optimal conditions in order to effectively heal, and then stay healed. A clinic with a physical therapist, a nutritionist, and medicine profession can look at the wound from every angle to help you create the best healing environment possible. Many times, going to a professional without only one set of tools or expertise can limit their ability to come up with sound rational treatments. This is just a thought; I hope it helps.

S. Christman

From Australia...

A specialists has advised me to get a ZipZoc stocking for my legs. I have been to several chemists but they don't have them. I am a pensioner and have a medical card if that helps. I live in Shorham Victoria. Can I purchase these through yourselves please.
Thanking you Pamela Lee.

Independence Australia should have this product
www.independenceaustralia.com


Julie Miller, Podiatrist

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Hi
For Australia ZipZoc is made by Smith and Nephew who can be Contacted in Victoria; suggest contacting them and ask for the Wound Care Specialist for your particular area...

Tel: 61 3 8540 6777 61 3 8540 6777

Jill - Research Fellow

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Dear Pamela:

The zipzoc is the same as a pressure stocking? Not sure. But, If this is correct.......a physical therapist can ascertain which pressure stocking is needed. Either a physician can order stockings (more likely)...and then the druggist/ or company who specialize in pressure stockings will go by the physical therapist's suggestions and fit you for the correct stockings.

These stockings must be hand washed...taken off at night, and then BEFORE getting out of the bed in the morning, put back on. Helps a lot to have someone get them from the drying rack and hand them to you.

Best wishes,

Frances J. Jessup, RN, BSN
 

 


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