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Related Concept Videos

Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Chronic Kidney Disease IV: Nursing Management01:18

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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Venous Thrombosis IV: Nursing Management01:30

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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Phases of Wound Repair01:28

Phases of Wound Repair

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Following injury, the integrity of the injured tissues must be reestablished. For example, in skin tissue, wound repair involves coordination among resident skin cells, blood mononuclear cells, extracellular matrix, growth factors, and cytokines to complete the healing cascade.
Formation of Blood Clot
In case of deep injuries, trauma to blood vessels results in blood loss. In the meantime, phospholipids released from the ruptured endothelial cellular membrane are converted into arachidonic...
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Protocol to Create Chronic Wounds in Diabetic Mice
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Chronic Wounds: Evaluation and Management.

Steven Bowers1, Eginia Franco1

  • 1St. Luke's University Health Network, Bethlehem, PA, USA.

American Family Physician
|February 1, 2020
PubMed
Summary

Chronic wounds, often mismanaged, require adherence to guidelines. Effective treatment involves the TIME principle (Tissue debridement, Infection control, Moisture balance, Edges of wound) tailored to specific lower extremity ulcer types.

Area of Science:

  • Wound healing and management
  • Vascular surgery
  • Dermatology

Background:

  • Chronic wounds fail to progress through normal healing stages, leading to significant morbidity and cost.
  • Common types include lower extremity ulcers: arterial, diabetic, pressure, and venous.
  • Inaccurate treatment of chronic wounds is prevalent, necessitating evidence-based guidelines.

Purpose of the Study:

  • To outline diagnostic and treatment strategies for chronic lower extremity wounds.
  • To emphasize the importance of vascular assessment and the TIME principle in wound care.
  • To provide specific management approaches for arterial, diabetic, venous, and pressure ulcers.

Main Methods:

  • Physical examination for initial diagnosis.
  • Vascular assessment including wound characteristics, pedal pulses, and ankle-brachial index for nonhealing ulcers.

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  • Biopsy for atypical wounds.
  • Application of the TIME principle (Tissue debridement, Infection control, Moisture balance, Edges of wound).

    • Main Results:

    • Diagnosis can often be guided by physical examination.
    • Vascular assessment is crucial for all nonhealing lower extremity ulcers.
    • The TIME principle forms the foundation of wound management.
    • Specific treatments vary by ulcer type: vascular intervention for arterial, compression for venous, offloading for diabetic and pressure ulcers.

    Conclusions:

    • Implementing wound prevention and treatment guidelines is essential for managing chronic wounds.
    • A systematic approach combining general principles (TIME) with ulcer-specific treatments improves outcomes.
    • Prompt vascular referral and appropriate offloading are critical for specific ulcer types.