Woodland Villa RPN inspired by wound care program
Tuesday, August 23, 2005 -- Craig Anderson
Watching an advanced Stage 4 wound heal successfully and sharing therapeutic knowledge through the course of the healing, says Debra Hannan, a Woodland Villa RPN trained in Theresa Hurd wound care techniques, reminds her why she chose to work in the nursing home field.

“Where can you go where you can get more back than you ever put in?” she asks, adding that as a little girl it was her dream to care for the elderly.

Wound care is a more recent interest for Debra, spawned following an injury her husband incurred 2 years ago that required surgery and follow-up wound care. While she is quick to note that for some frontline workers wound care – often involving debriding necrotic tissue and negotiating odorous slough – is “hard to tolerate,” she became further intrigued by the treatment process after completing the Theresa Hurd program.

“I like to clean, and debride, and see things heal and progress,” she says. “It’s really rewarding for me to see that.”

“And I like to share the information with my staff, and I encourage them to be a part of it if they feel comfortable with it.”

Debra has instituted a bi-weekly wound care treatment session, and using the latest dressings and gels has seen significant advancements in wound treatment in the last year.

Recently, a resident with an occluded, necrotic stage 4 heel ulcer – which was significantly deep and odorous, says Debra – was treated with a combination of Intrasite gel (which moistens the slough) and sharp debridement, a process where devitalized matter is pulled or surgically cut from the wound.

Reducing the chances for a recurrence of the resident’s wound – Debra feels it is crucial to remember that even with a full recovery, tissue and skin only heal to 80 percent of their former state, making future preventative methods an absolute necessity – involved changing the residents sleeping habits.

The wound was caused due to poor sleeping positioning on a stiff mattress, so a specifically soft mattress where the heel could rest over the edge was brought in. The healing process, which took three months, underscored the specific challenges that healing wounds in the elderly presents.

“This is a population that is already compromised,” says Debra, “and despite a well-healed wound there is a diminished strength in the tissue. And then if you factor in diabetes and circulatory issues it can be quite a challenge.”

Lifestyle alterations are mandatory for properly treating wounds, she says. Increasing protein intake and ensuring an overall healthy diet are part of proper, comprehensive wound care. Woodland is currently employing a protein boosting beverage – 2.0 Resource – in their wound therapy, and work closely with the dietician when treating residents with serious wounds.

Lately, treatment for a number of stage X wounds (an advanced wound which could turn out to be a 3 or 4, but obfuscated by necrotic tissue) has Debra singing the praises of the therapeutic products offered by Smith and Nephew, (see http://www.smith-nephew.com/what/wound.jsp) the sole dressing and gel supplier for OMNI homes.

“We’re very fortunate to have these products available,” she says, adding that certain gels and dressings impregnated with gels are speeding up the healing process quite considerably.