Acute and Chronic Wounds : Current Management Concepts

by Bryant & Nix

• ISBN13: 9780323030748
• ISBN10: 0323030742
• Edition: 3rd
• Format: Hardcover
• Copyright: 2006-04-01
• Publisher: Mosby

Summary

Using a multidisciplinary approach, this all-inclusive resource provides clinicians with a strong knowledge base for understanding the complete spectrum of wound care, including the structure of the skin, its functions, types of skin damage, physiology of wound healing, and general principles of wound management. Seven new chapters cover The Multidisciplinary Team Approach to Wound Management; Skin Care Needs of the Obese Patient; Foot and Nail Care; Facilitating Adaptation; Support Surfaces; Devices and Technology in Wound Care; and Reimbursement and Billing. Recent advances in disease etiology, diagnosis, and treatment are discussed in appropriate chapters and each chapter opens with a list of learning objectives and closes with review questions. Authored and contributed by respected experts in wound care management members of Wound, Ostomy and Continence Nurses Society (WOCN) and Wound Healing Society (WHS). Risk assessment scales are included to assist with determining a patients risk for developing a wound. Assessment tools are provided to assist the clinician with wound evaluation, care, and treatment. Patient compliance and guidance on how to identify and resolve issues of non-compliance are discussed in the new Facilitating Adaptation chapter. The multidisciplinary approach to wound care management is discussed in a single chapter and applied throughout the text to demonstrate how this approach works and why it is critical to successful patient outcomes. A wound care product formulary lists wound care products by category, usage guidelines (indications and precautions), and helpful hints is included to facilitate outcomes measurement and quality improvement. Algorithms demonstrate the critical steps for topical wound care management. Key information is highlighted in box or table format to enable the user to quickly focus on selected information. Clearly defined chapter objectives provide a focused guide to key elements within each chapter. A self-assessment exercise is included at the end of each chapter to provide a review of critical chapter concepts. Seven new chapters: The Multidisciplinary Team Approach to Wound Management; Skin Care Needs of the Obese Patient; Foot and Nail Care; Facilitating Adaptation; Support Surfaces; Devices and Technology in Wound Care; and Reimbursement and Billing. Revisions to every chapter reflect the most recent advances in disease etiology, diagnosis, and treatment. Updated content reflects the latest technologic advances and therapies to strengthen the clinicians knowledge base in available treatment options. Assessment tools to assist the clinician with evaluation, care, and treatment. Explanation of how to set up a practice and the principles of practice development.

Table of Contents

Principles for Practice Development	1	(22)
Ruth A. Bryant
Denise P. Nix
Qualifications of a Wound Care Specialist	1	(2)
Roles, Functions, and Responsibilities of a Wound Care Specialist	3	(14)
Benefits and Outcomes	17	(6)
The Multidisciplinary Team Approach to Wound Management	23	(16)
Finn Gottrup
Denise P. Nix
Ruth A. Bryant
Magnitude of the Wound Problem	23	(1)
Terminology	24	(1)
Building a Case for a Multidisciplinary Team Approach	25	(2)
Wound Management Models	27	(4)
Establishing a Multidisciplinary Wound Management Program	31	(8)
Anatomy and Physiology of Skin and Soft Tissue	39	(17)
Annette B. Wysocki
Skin Layers	39	(5)
Skin Functions	44	(4)
Factors Altering Skin Characteristics	48	(8)
Wound-Healing Physiology	56	(26)
Dorothy B. Doughty
Bonnie Sparks-DeFriese
Physiology of Wound Healing	56	(1)
Definitions and Classifications	57	(1)
Wound-Healing Process	58	(8)
Characteristics of Full-Thickness Wounds Healing by Secondary Intention	66	(3)
What Makes a Chronic Wound Chronic?	69	(2)
Mediators of Wound Healing	71	(1)
Interplay of Mediators	72	(1)
Extremes of Repair: Scarless Healing versus Excessive Scarring	73	(2)
Factors Affecting the Repair Process	75	(7)
Molecular Regulation of Wound Healing	82	(18)
Gregory Schultz
Biologic Roles of Cytokines and Growth Factors in Wound Healing	82	(3)
General Properties of Growth Factors and Their Receptors	85	(2)
Major Families of Growth Factors	87	(6)
Distinguishing Cytokines from Growth Factors	93	(1)
Potential Limitations of Growth Factor Technology	94	(2)
Wound Bed Preparation	96	(4)
Skin Pathology and Types of Damage	100	(30)
Ruth A. Bryant
Richard A.F. Clark
Assessment	100	(1)
Mechanical Damage	100	(7)
Chemical Factors	107	(3)
Vascular Damage	110	(1)
Infectious Factors	110	(5)
Arthropod	115	(2)
Allergic Factors	117	(1)
Inflammatory Conditions Leading to Atypical Ulcerations	118	(2)
Intrinsic Skin Diseases Associated with Ulceration	120	(10)
Patient Assessment and Evaluation of Healing	130	(19)
Denise P. Nix
Significance	130	(1)
Monitoring, Observation, and Inspection	131	(1)
Assessment	131	(13)
Frequency of Wound Assessment	144	(1)
Evaluation of Healing and Documentation Tools	144	(5)
Nutritional Assessment and Support	149	(12)
Nancy A. Stotts
Malnutrition	149	(4)
Nutritional Assessment	153	(5)
Nutritional Support	158	(3)
Wound Infection: Diagnosis and Management	161	(15)
Nancy A. Stotts
Infection as a Significant Problem	161	(1)
Bioburden as a Concept	162	(1)
Microbial States of a Wound (Infection Continuum)	162	(1)
Factors That Effect the Microbial State of a Chronic Wound	163	(2)
Acute Wound Infection	165	(1)
Diagnosis of Infection	166	(4)
Treatment of Wound Infection	170	(3)
Psychological Support and Education	173	(3)
Wound Debridement	176	(17)
Janet M. Ramundo
Methods of Debridement	177	(11)
Selection of Debridement Method	188	(1)
Assessment of the Debridement Process	189	(4)
Acute Surgical and Traumatic Wounds	193	(12)
JoAnne D. Whitney
Factors in the Repair of the Acute Wound	193	(4)
Interventions that Support Acute Wound Healing	197	(2)
Assessment of Healing in the Acute Wound	199	(1)
Incisional Care	200	(2)
Patient Education	202	(3)
Mechanical Forces: Pressure, Shear, and Friction	205	(30)
Barbara Pieper
Economic Effects	206	(1)
Scope of the Problem	206	(1)
Terminology	207	(2)
Causative Factors	209	(1)
Intensity of Pressure	209	(1)
Duration of Pressure	210	(1)
Tissue Tolerance	211	(3)
Pathophysiologic Changes	214	(3)
Pressure Ulcer Prevention Program	217	(11)
Management of Pressure Ulcers	228	(1)
Pressure Ulcer Healing	229	(1)
Quality of Life and Psychosocial Needs	229	(1)
Quality Improvement	229	(1)
Legal Concerns	230	(5)
Support Surfaces	235	(14)
Denise P. Nix
Support Surface Features	236	(1)
Categories of Support Surfaces	237	(7)
Product Selection	244	(2)
Safety	246	(1)
Renting versus Owning	246	(1)
Evaluation of Effectiveness	247	(2)
Skin Care Needs of the Obese Patient	249	(9)
Susan Gallagher Camden
Defining Obesity	249	(1)
Changing Demographics	250	(1)
Stereotypes About Obesity	250	(1)
Common Skin Complications in the Obese Population	250	(3)
The Surgical Experience	253	(2)
Quality Improvement	255	(3)
Lower-Extremity Ulcers of Vascular Etiology	258	(49)
Dorothy B. Doughty
Rhonda Holbrook
Terminology	259	(1)
Assessment of the Lower Extremity	259	(6)
Diagnostic Tests for the Lower Extremity	265	(3)
Arterial Ulcers	268	(9)
Venous Ulcers	277	(21)
Lymphedema	298	(9)
Neuropathic Wounds: The Diabetic Wound	307	(30)
Vickie R. Driver
Mary Anne Landowski
J.L. Madsen
Epidemiology	307	(1)
Economic Burden	308	(1)
Pathogenesis	308	(4)
Assessment	312	(13)
Management	325	(7)
Education	332	(5)
Foot and Nail Care	337	(24)
Tara L. Beuscher
Quality of Life	337	(1)
Structure and Function	338	(1)
Pathology	339	(5)
Assessment	344	(4)
Interventions	348	(13)
Massive Tissue Loss: Burns	361	(30)
Jill Evans
Epidemiology	361	(1)
Pathophysiology	362	(1)
Types of Burn Injury	362	(3)
Inhalation Injury	365	(1)
Phases of Healing and the Burn Process	366	(1)
Evaluation of the Burn Injury	367	(2)
Initial Interventions	369	(1)
Emergent Phase	370	(4)
Acute/Wound Care Phase	374	(6)
Infectious Complications	380	(2)
Psychological Consequences of Burn Injury	382	(1)
Discharge Planning	383	(1)
Rehabilitation Phase	384	(2)
Outpatient Burn Management	386	(5)
Principles of Wound Management	391	(36)
Bonnie Sue Rolstad
Liza G. Ovington
Principles of Wound Management	392	(2)
Objectives to Achieve a Physiologic Wound Environment	394	(1)
Wound Care Dressing Performance Parameters	395	(2)
Wound Care Dressing Categories	397	(18)
Selecting the Wound Care Dressing	415	(4)
Wound Care Procedures	419	(2)
Standardization and Decision Making Tools	421	(1)
Evaluating Outcomes	422	(5)
Devices and Technology in Wound Care	427	(34)
Rita A. Frantz
Craig L. Broussard
Susan Mendez-Eastman
Renee Cordrey
Hyperbaric Oxygenation	427	(7)
Negative-Pressure Wound Therapy	434	(7)
Electrical Stimulation	441	(8)
Ultraviolet Light	449	(2)
Ultrasound	451	(10)
The Role of Surgery in Wound Healing	461	(10)
Joyce M. Black
Steven B. Black
History of Surgery for Wounds	461	(1)
Debridement	461	(1)
Surgical Decision Making	461	(4)
Nonoperative Conditions	465	(1)
Urgent Operative Conditions	465	(1)
Preoperative Management	466	(1)
Operative Management	467	(2)
Postoperative Management	469	(2)
Oncology-Related Skin Damage	471	(19)
Margaret T. Goldberg
Margaret McGinn-Byer
Extravasation	471	(6)
Fungating Wounds	477	(4)
Irradiation Tissue Damage	481	(5)
Primary Malignant and Malignant Transformation Wounds	486	(4)
Management of Drain Sites and Fistulas	490	(27)
Ruth A. Bryant
Bonnie Sue Rolstad
Epidemiology and Etiology	490	(1)
Terminology	491	(2)
Manifestations	493	(1)
Medical Management	493	(4)
Nursing Management	497	(20)
Management of Gastrointestinal Feeding Tubes	517	(22)
Ruth A. Bryant
Gastrostomy and Jejunostomy Devices	517	(1)
Placement Approaches	518	(10)
Feeding Tube Features	528	(1)
Low-Profile Gastrostomy Device (Button)	529	(1)
Nursing Management of Enteric Tubes	530	(3)
Complications	533	(2)
Tube Removal	535	(1)
Patient Education	535	(4)
Managing Wound Pain	539	(27)
Diane L. Krasner
Dag Shapshak
Harriet W. Hopf
Definition of Pain	540	(1)
Perceptions About Pain	541	(1)
Consequences of Wound Pain	542	(2)
Pain Physiology	544	(1)
Assessment of Pain	545	(5)
Nonpharmacologic Pain Control	550	(3)
Pharmacologic Interventions	553	(6)
Wound Pain Models	559	(7)
Facilitating Adaptation	566	(13)
Denise P. Nix
Ben Peirce
Significance	566	(1)
Barriers to Adaptation	567	(3)
Patient Learning	570	(9)
Billing, Coding, and Reimbursement	579	(67)
Ruth A. Bryant
Ben Peirce
Kathleen D. Schaum
Historical Perspective	579	(1)
Medicare	580	(1)
Medicaid	581	(1)
History of Medicare Payment Systems	581	(3)
Coding Systems	584	(4)
Billing for Wound Care Products and Equipment	588	(1)
Billing for Wound Care Services	588	(1)
Coordination of Care and Coverage Across Care Settings	589	(4)
Appendixes
A. Self-Assessment Answers	593	(9)
B. Policies, Procedures, and Decision Making Tools	602	(8)
C. Documentation Tools	610	(25)
D. Patient Education	635	(6)
E. Coding and Reimbursement	641	(5)
Glossary	646