AAWC Wound Care Pearls
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March 20, 2017
A(1c) Major Fake Out……….
Did you know HbA1c may not provide a relevant assay for glycemic control in patients with end stage renal disease (ESRD)? HbA1c can be lower in ESRD patients due to reduced numbers of red blood cells. These patients should submit logs or meters to clinicians for an accurate picture of glycemic control!
Adams, M. (2009). Is HbA1c a reliable test in patients with diabetes and renal disease? Podiatry Today, 22(8). Retrieved from http://www.podiatrytoday.com/is-hba1c-a-reliable-test-in-patients-with-diabetes-and-renal-disease
Baboolal, K., & Sharif, A. (2010). Diagnostic application of the A1C assay in renal disease. Journal of American Society of Nephrology, 21(1), 383-385.
Emily Greenstein, RN, BSN, CWON
Feb 22, 2017
Nursing time is the major driver of wound care cost; not the cost of the dressing!1
Quality dressings resulted in decreases of >50% in dressing change frequency and 75% overall cost of care, with 100% faster healing!2 Saving nursing time is the key.
1. Vowden K, Vowden P, Posnett J. The resource costs of wound care in Bradford and Airedale primary care trust in the UK. J Wound Care. 2009. 18: 93-94.
2. Hurd T, Zuiliani N, Posnett J. Evaluation of the impact of restructuring wound management practices in a community care provider in Niagrara, Canada. Int Wound J. 2008. Jun 5(2): 296-304.
Jenny Hurlow, GNP-BC, CWOCN
Jan 18, 2017
Malnourished diabetic foot ulcer (DFU) patients may be at higher risk for amputation. A study reported use of the validated Mini Nutritional Assessment (MNA) on 478 DFU subjects. Seventy and a half percent of subjects were identified as having compromised nutritional status and at risk of lower extremity amputation.
Gau B, Chen H, Hung S, et al. The impact of nutritional status on treatment outcomes of patients with limb-threatening diabetic foot ulcers. J Diabetes Complicat. 2016;30(1):138-142.
Latricia Love Allen DPM, MPH, FACFOAM
Dec 21, 2016
Close that incision and keep it closed! Did you know that the use of incisional negative pressure has been shown to reduce surgical dehiscence rates secondary to infection?
Sensarzadeh NN, et al. Closed incision negative-pressure therapy is associated with decreased surgical-site infections: a meta-analysis. Plastic Reconstruction Surgery, 2015, Sep;136(3):592-602.
Terina DeVore, PT, DPT, WCC, CWS
Nov 22, 2016
Follow the DIME model for wound bed preparation and effective healing. Debridement of nonviable tissue, control of Inflammation or Infection, Moisture balance and Edge effect.
Woo, K., Ayello, E.A., Sibbald, R.G.(2007).The Edge Effect: Current Therapeutic Options to Advance the Wound Edge. Advances in Skin and Wound Care, 20(2), 99-117.
Susan Julian, DNP, RN, CNS, CWS
Oct 7, 2016
Did you know that elevated HbA1C (blood glucose) levels can impede wound healing?
Thus, it is important for clinicians, regardless of their discipline, who are treating wounds in diabetic patients to know what the patient’s A1C level is to appropriately set healing expectations and goals. Research shows that diabetic patients with higher A1C levels have reduced wound healing progression than those patients with lower A1C levels, regardless of treatment strategies.
Christman et al. Hemoglobin A1c is a Predictor of Healing Rate In Diabetic Wounds. J Invest Dermatol. 2011 October ; 131(10): 2121–2127.
Quiona Stephens-Russell, PhD