Comments for WOUND BLOG by Matthew Livingston RN

Comment on About Woundblog by Matthew Livingston R.N. C.W.S.

Matthew Livingston R.N. C.W.S. — Fri, 10 Feb 2012 18:16:06 +0000

Hey Kathleen,

Thanks for your kind words. I have a lot of experience with pulse lavage in deep full thickness wounds (mostly in the early 2000s). I believe that pulse lavage has lost favor related to the high risk for spreading microorganisms via water droplets that inevitably spray back out of the wound. Two other developments have lead to the reduction in pulse lavage use including VAC (NPWT) and Mist therapies. That being said pulse lavage does have a place in the care of patient’s if the wound is grossly contaminated (say status post traumatic injury to flush debris).

I would review the goals that you expect to achieve when treating the patient with pulse lavage. Typically, pulse lavage helps to reduce slough and prep the wound bed for granulation. Depending on your goals I think there are better solutions. To reduce or loosen slough in high draining wounds I recommend DrawTex (SteadMed). If you fear contamination (and in a hospital setting) I would recommend VAC instill with Microcyn as the irrigant. If the patient is at an ECF, Home Care, or being seen at a wound clinic I would consider going with our classic antimicrobial silver (We use a ton of Silvadene) , but opt for an silver alginate if the patient can’t get the dressing changed daily.

As for the Polymem, I really haven’t used the product so I will have to withhold comment.

Thanks again for the question,

Matthew

Comment on About Woundblog by Kathleen

Kathleen — Fri, 10 Feb 2012 15:31:44 +0000

WHAT a great blog!
Matt, I currently use your blog as a resource and plan to purchase your book. Congrats on your good work, and I look forward to future posts.
Question for you: Have you had any experiences with pulse lavage therapy as a treatment for wounds? In particular, stage III and IV wounds. If so, what are your thoughts on the therapy? Also, what do you think about the new product, “polymem.” I don’t know too much about it, other than, it is a cleansing dressing that supposedly debrides wounds and helps feed new cells. I have also been told that the product helps to reduce pain by inhibiting sodium receptors. The Physician I work for is showing an interest in purchasing the polymem product. I’ve heard good things, but was wondering, if you have used the polymem dressing, and if so, what you think about it?
Thank you for your resource,
KS

Comment on Five Ways to Build the Ideal Wound Clinic by Sue Hull, RN, MSN, CWOCN

Sue Hull, RN, MSN, CWOCN — Tue, 07 Feb 2012 20:21:47 +0000

And, don’t forget, you need a concrete process for assuring your patients can get the supplies they need to continue their plan of care between clinic appointments. What I see happening is 1) the patient doesn’t get their supplies, often because the supplier wants to be paid up front, leaving it up to the patient to submit claims. 2) the patient gets the wrong supplies, either because they misunderstood, OR the supplier used substitutions, because they don’t know about wound care (eg. Hydrofera Blue and Optifoam are both categorized as foams, but they are NOT interchangeable.)

Comment on Five Ways to Build the Ideal Wound Clinic by Marie Hope

Marie Hope — Wed, 09 Nov 2011 21:14:15 +0000

Thank you for this post. I work at a Hyperbaric out-patient clinic. Our physician on staff is fairly knowledgable about wounds but I wanted to reach out to some of the wound care nurses and doctors at the hospitals in Marin County. None of the local wound care facilities have hyperbaric chambers and I feel like if we partner with them we could really improve patient outcomes. Any ideas on how to reach these doctors and nurses would be great! Thank you!

Comment on Venous Wounds and VAC Therapy by rian

rian — Tue, 01 Nov 2011 01:28:14 +0000

This is really helpful and very educational.

Comment on Support the World Alliance for Wound and Lymphedema care by Adilson

Adilson — Thu, 27 Oct 2011 23:04:12 +0000

Here in Brazil we have no great sites about this subject. It is a pity as this theme has a enormous searchs here.

Comment on About Woundblog by cmchoto

cmchoto — Thu, 27 Oct 2011 04:56:17 +0000

I am very happy to see such a well organized website and also to know it has been created by a nurse. Like you I also like to work with wounds and find this field fascinating. I encountered this site by accident, in one of my usual Internet explorations, which I am glad I did as it will not be the last time I visit. Thank you for all your information and congratulations in your work, I look forward to read your book.
CC

Comment on Teaching New Wound Clinicians by CobeyJ

CobeyJ — Sun, 23 Oct 2011 14:31:19 +0000

Very relevant to me right now and the industry overall as the public need for wound care grows. I have an uninitiated nurse on my staff right now and I found that categorizing wound characteristics and pathophysiology with products and their mechanisms of action to be the most effective. That might sound like a tall order, but it’s really not.

Comment on Diabetic Wound Best Practice Evidence by Marie Hope

Marie Hope — Mon, 17 Oct 2011 20:48:02 +0000

Thank you for including Hyperbaric Oxygen therapy in your article. I have seen 100% improvement in all of our wound patients that come into our clinic. Hyperbarics should be in every wound clinic and hospital.

Comment on Venous Wound Basics by Drea

Drea — Thu, 01 Sep 2011 03:16:26 +0000

This is an absolute great article. I am a lymphedema therapist treating wounds under compression and needed more guidance. This is great!