1. Foundations
1. Principles for practice development to facilitate outcomes and productivity
Educational preparation of the wound specialist
National certification: Value and routes
Roles, functions, and responsibilities of a wound specialist
Prevalence/incidence studies
Marketing, justifying, and securing the wound specialist role: Benefits and outcomes
Summary
References
2. Billing, reimbursement, and setting up a clinic
Creating the business plan
Clinic management
Clinic structure
Clinic operations
Affordable care act and payment systems
Factors that influence provider reimbursement
Coding and billing for services and supplies
Summary
References
3. Anatomy and physiology of skin and soft tissue
Skin layers
Skin functions
Factors altering skin characteristics
Summary
References
4. Wound-healing physiology and factors that affect the repair process
Mechanism of wound healing
Wound-healing process
What makes a chronic wound chronic?
Mediators of wound healing
Extremes of repair: Scarless healing versus excessive scarring
Factors affecting the repair process
Summary
References
5. Types of skin damage and differential diagnosis
Assessment
Mechanical forces
Moisture-associated skin damage
Medical adhesive–related skin injury
Vascular damage
Infectious agents
Allergic factors
Radiation
Summary
References
6. Skin and wound inspection and assessment
Significance
Assessment
Reassessment and evaluation of healing
Summary
References
2. Pressure Ulcers
7. Pressure ulcers: Impact, etiology, and classification
Scope of the problem
Vulnerable patient populations
Terminology
Causative factors
Pathophysiologic changes
Classification of pressure ulcers
Summary
References
8. Developing and maintaining a pressure ulcer prevention program
Pupp justification
Components of a PUPP
Establishing a best-practice bundle
Creating infrastructure to sustain the pupp
Summary
References
9. Support surfaces
Interface tissue pressures: Past and present
Physical concepts and therapeutic functions
Components
Categories and features
Support surface selection criteria
Summary
References
3. Lower Extremity Wounds
10. Lower extremity assessment
General appearance of the limb
Functional–sensory status
Perfusion
Diagnostic testing
Summary
References
11. Arterial ulcers
Epidemiology
Etiology
Risk factors for lead
Pathology of arterial ulceration
Assessment
Noninvasive testing for lead
Invasive testing for lead
Management of the patient with arterial ulceration
Patient education
Summary
References
12. Venous ulcers
Epidemiology
Venous structure and function
Chronic venous disease
Assessment
Management
Compression therapy
Compression wraps
Compression garments
Intermittent pneumatic compression
Local wound care
Adjunct therapies
Surgical interventions
Follow-up and lifelong maintenance
Summary
References
13. Lymphedema
Epidemiology
Pathophysiology
Types of lymphedema
Stages of lymphedema
Lipedema
Diagnostic tests
Assessment
Prevention
Management
Complications
Summary
References
14. Neuropathic wounds: The diabetic wound
Epidemiology
Pathogenesis
Assessment
Management
Summary
References
15. Foot and nail care
Quality of life
Structure and function
Physical assessment
Prevention and routine management
Management of specific conditions
Summary
References
4. Wound Bed Preparation
16. Wound infection: Diagnosis and management
Continuum of microorganism bioburden
Management of bioburden
Evaluation
Summary
References
17. Wound debridement
Methods of debridement
Selection of debridement method
Summary
References
18. Principles of wound healing and topical management
Principles of wound management
Types of dressings
Components of a dressing change
Dressing selection
Documentation and reimbursement
Summary
References
5. Biophysical and Biologic Agents
19. Cellular- and/or tissue-based products for wounds
Indications for use
Classification of products
Bilayered CTPs
Future directions
Summary
References
20. Molecular and cellular regulators
Biologic roles of cytokines and growth factors
Adhesion molecules and adhesion receptors in inflammation
Cytokines
Growth factors
Major families of growth factors
Integrating growth factors into clinical practice
Summary
References
21. Negative pressure wound therapy
Mechanism of action
Indications and uses
Safety, contraindications, and precautions
Clinical application
Summary
References
22. Hyperbaric oxygenation
History
Physiologic effects
Indications
Contraindications
Protocols and clinical application
Topical oxygen is not HBO
Summary
References
23. Electrical stimulation
Effects of electrical stimulation
Indications and contraindications
Types of electrical stimulation
Payment coverage
Summary
References
24. Ultraviolet light and ultrasound
Ultraviolet light
Ultrasound
Summary
References
6. Critical Cofactors
25. Wound pain: Impact and assessment
Perceptions about pain
Consequences of wound pain
Pain physiology
Classifications
Assessment
Wound pain care models
Translation to practice
Summary
References
26. Managing wound pain
Nonpharmacologic pain control
Pharmacologic interventions
Summary
References
27. Nutritional assessment and support
Malnutrition
Screening and assessment
Nutrient needs for healing
Nutritional support
Summary
References
28. Perfusion and oxygenation
Effect of oxygen and perfusion in wound healing
Factors that alter perfusion and oxygenation
Interventions to improve perfusion and oxygen
Measuring the response
Summary
References
29. Eliminating noncompliance
Significance
Goal setting
Patient perceptions and the health belief model
Informed refusal
Summary
References
7. Acute and Traumatic Wounds
30. Uncommon wounds and manifestations of intrinsic disease
Infectious etiology
Spider bites
Pyoderma gangrenosum
Vasculitis and connective tissue disorders
Calciphylaxis
Martorell hypertensive ischemic leg ulcer
Epidermolysis bullosa
Extravasation
Immune reactions
Frostbite
Primary malignancy and malignant transformation wounds (Marjolin ulcer)
Blood dyscrasias
Summary
References
31. Traumatic wounds: Bullets, blasts, and vehicle crashes
Etiology of war wounds
Acute management of traumatic wounds
Subacute management of traumatic wounds
Summary
References
32. Burns
Epidemiology
Types of burn injury
Evaluation of burn injury
Pathophysiology of burn injury on the body
Phases of burn care
Outpatient burn management
Summary
References
33. Reconstructive surgery
History of surgery for wounds
Surgical decision making
Selection of wound closure method
Nonoperative conditions
Urgent operative conditions
Preoperative management
Operative management
Postoperative management
Summary
References
34. Surgical wounds and incision care
Surgical wound closure
Surgical wound assessment
Topical incision care
Summary
References
8. Special Patient Populations
35. Skin care needs of the obese patient
Defining obesity
Altered skin function
Unique needs
The surgical experience
Nutritional considerations
Quality improvement
Summary
References
36. Skin care needs of the neonatal and pediatric patient
Neonatal terminology and skin characteristics
Skin inspection and risk assessment
Pediatric conditions that affect the skin
Summary
References
37. Managing wounds in palliative care
Definition of terms
Palliative wound care
Nonmalignancy-related wounds
Malignancy-related wounds
Objectives in the care of the malignant cutaneous wound
Evaluation
Summary
References
38. Management of draining wounds and fistulas
Epidemiology and etiology
Terminology
Manifestations
Medical management
Nursing management
Summary
References
39. Percutaneous tube management
Gastrostomy and jejunostomy devices
Placement approaches
Feeding tube features
Low-profile gastrostomy device (button)
Nursing management of enteric tubes
Complications
Tube removal
Patient education
Miscellaneous drain tubes
Summary
References