What is the difference between undermining and tunneling of a wound? This wound care demonstration will help you understand the concepts of undermining and tunneling in wounds. Wound Care Demonstrations: by Dianne Murray Rudolph, APRN, GNP-BC, CWOCN, UTHSCSA Related Videos: Part 1: The Science of Wound Healing https://youtu.be/Ypo7Ql8twWY Part 2: What is Wound Healing - https://youtu.be/1x0ml0GPtdQ How to Perform a Diabetic Foot Exam - https://youtu.be/tRdKOIi6hYU Leg Wrap / Compression - https://youtu.be/ReaLJfu7WS0 We value your opinion - please let us know what you think of this video: http://www.mmlearn.org/survey
Views: 12249 mmlearn.org
More information at http://www.vohrawoundcare.com/education Vohra Wound Physicians: Healing Wounds, Saving Lives Understand Wound Care: Wound Measurement Demonstration Summary- This is a demonstration of a wound care physician exhibiting the correct measurement of a wound. Japa Volchok, DO explains how to accurately and consistently measure wounds. Volchok discusses the importance of proper measurement and documentation in the wound healing process. This demonstration is performed by a trained wound care physician for educational purposes only and should not be tried at home. Understand Wound Care: Wound Measurement Demonstration Commentary: Japa Volchok, DO In this demonstration we will be exhibiting the correct measurement of a wound. For wound measurement you will want to have a disposable paper or similar measuring device as well as a cotton-tipped applicator. The measuring device is either a paper or plastic disposable measuring tape. It is generally marked in centimeter markings with sub-markings in millimeters. A cotton-tipped applicator is useful for measuring depth and checking for any undermining. This model demonstrates a wound. By convention, the superior aspect of the wound would also usually coincide with the head. The inferior aspect would be the foot. We measure length from a head to foot direction. Width is measured from left to right or right to left. Depth is measured at the maximum location of depth in the wound. The left to right or right to left convention does not matter in terms of the documentation. It is important however, that length and width are correctly measured and documented. As the convention from head to feet for length and left to right for width are important in being able to reproduce measurements between measurers. In this particular instance, we would start off by measuring the wound in the length dimension. Where there is the maximum length of this wound of approximately 5.7 centimeters. The width would then be measured at its maximum point of width which is 2.5 centimeters. The depth we then would determine by probing the wound with our cotton-tipped applicator using the cotton end. We would probe all areas of the wound to determine where the most depth was located. It appears to be approximately in the middle of the wound. We would then slide our finger down the cotton-tipped applicator to where it is flush with the intact skin. Pinch the applicator at that point and withdraw from the wound. This can then be laid over your measuring device and the depth determined. In this particular instance, it appears to be 1.8 or 1.9 centimeters. Once the length, width and depth of the wound have been measured, it is important to then record any evidence of undermining and what the dimensions of that undermining are. In determining undermining, gently probe the wound with your cotton-tipped applicator circumferentially around the wound. You can see that over on this side of the wound we are starting to see some undermining. It appears at this location, the cotton-tipped applicator slips deeper under the wound then it does at any other point. This would be the maximum area of undermining. As you can see, by convention, the superior aspect of the wound or the head aspect of the wound would be 12 o'clock. If we then progress clockwise around a clock face, the area of maximum undermining is approximately 10 o'clock. Similar to how we measured the depth of the wound, you would want to slide your finger down the cotton-tipped applicator. Pinch it with your nail. Then, bring it up to your measuring device. In this particular instance, it appears that the undermining is approximately 1.7 centimeters. As you will recall from the last image, the undermining is located at 10 o'clock. This will be recorded as 1.7 centimeters of undermining at 10 o'clock. For more information visit http://www.woundphysicians.com or http://www.understandwoundcare.com
Views: 169185 Vohra Wound Care
In this video from The Online Suture Course, you will learn how to undermine a laceration. Undermining reduces tension in the overlying skin, enhancing the end cosmetic outcome. The Online Suture Course brings up-to-date wound closure approaches, as well as comprehensive treatment of the wounded patient, to NPs, PAs, and physicians ready to enhance their level of care, marketability, patient outcomes, and medicolegal defense. For the full course, visit https://onlinesuturecourse.com. The full course offers: - 9.5 CME hours - 11 closure methods - 10 exciting case studies - 11 hands-on practice modules - Closure basics including line and needle selection - When and when not to close - The A.C.E. F.A.S.T. Closure Method - Anesthesia - Cleansing - Examination - Foreign Bodies - Antibiotic appropriateness - When to seek surgical consultation - Tetanus guidelines - Proper knot tying - Multi-layer suturing - Head and neck lacerations - Torso lacerations - Extremity lacerations - C-spine management and imaging related to head and neck lacerations - Dog ear deformity - Undermining - Pediatric lacerations - Scalp lacerations - Eyelid lacerations - Ear lacerations - Lip lacerations - Open fractures - Nailbed lacerations - Flap lacerations - Buccal lacerations - Tongue lacerations - Joint capsule lacerations - Animal bites - Lacerations in the anticoagulated patient - Managing poorly healing lacerations - Appropriate follow-up care - Medicolegal tips and nuggets
Views: 331 Online Suture Course
This video utilizes an anatomical model to demonstrate techniques for general care and treatment options for the four stages and unstageable pressure sores and tunneling wounds. NOTE: Pressure Ulcer stages have since been updated. See our SCI Infosheet on Prevention of Pressure Ulcers for the updated stages. ©2008 The University of Alabama at Birmingham Spinal Cord Injury Model System (UAB-SCIMS)
Views: 198007 UAB-SCIMS
The third hole packing video was filmed 8-19-13. my Wife & i are unsure if the Dr. Resident needed to cut that third hole because we believe the drainage from the main surgery hole tunneled & accumulated in my hip area. That third hole is getting smaller in size but the home health nurse says it is mostly 1 cm underneath the skin but it is getting deeper, 2 cm, in one direction. Toward the main surgery hole. She says that the main surgery hole is mostly 4 to 5 cm underneath the skin but there is one direction where the tunnel is 8 cm deep. She said the main surgery hole & the third hole tunnels almost run parallel to each other. She said the main surgery hole & the third surgery hole are about 10 centimeters from each other. i believe the holes heal faster internally if my bottom feels comfortably numb instead of the normal burning sensation. I'm paraplegic(20+ years in a wheelchair) with Website http://wheelchairstyl.com, https://sites.google.com/site/wheelchairstyle/home, http://wheelchairstyl.com, http://wheelchairstyle & https://twitter.com/#!/Wheelchairstyl . Many of the things i do are either done wrong or incorrectly. Doing things the incorrect way is probably what made me paraplegic in the first place. Even though they are probably not correct, i hope my video gives you an idea you might possibly be able to do safely & correctly yourself. Follow these videos at your own risk :)
Views: 927 d72466fly
Guidelines for Pulsed Lavage with Suction: Wear appropriate personal protective equipment (PPE) Use in a private room with walls and doors Cover access sites, drains, and other open areas Clean ALL horizontal surfaces thoroughly after each procedure. Keep splash shield in total contact with wound and periwound the entire time so you get a complete suction. Sometimes it is necessary to put a finger over one of the open fenestrations, but never cover both at once. It will not destroy the granulation tissue with pressure between 4-15 psi per AHCPR guidelines. You can retract the pulsed lavage splash shield to access wound tract. Guide the tool with your finger. It is important to keep tunnel open so you do not close off or cause an abscess. Concentrate on necrotic tissue. Shown: PLWS with Flexible Tip for tunneling wounds Examples shown on Neuropathic ulcer on foot - Slide lavage tool in and out. Check patient comfort and pain level. Shown using the max PSI to finish cleaning foot ulcer. Learn More: https://woundeducators.com/pulsed-lavage/ Available Wound Care Certification Courses: https://woundeducators.com/wound-care-certification-courses/
Views: 972 WoundEducators.com
CellerateRX Advantages Hydrolyzed collagen •The body does not have to break it down, delivering the benefits of collagen to the wound immediately •Minimizes potential of scarring •The ONLY hydrolyzed collagen on the market Biocompatible •May be used in conjunction with other therapies, treatment modalities, and any secondary dressing Biodegradable •Does not need to be removed from the wound bed with subsequent dressing applications Ease of application •Increases patient compliance and outcomes; ideal for home health care patients •Range of use from first dressing to closure •Put it on-cover it up-leave it alone.......Simple dressing application Powder and gel •Ideal for tunneled/undermining wounds and skin tears and flaps •No waste of product No special storage requirements •Protect from freezing •Sterile
Views: 4544 WMGTech
There was an abcess on the front of my leg caused by an infection from the open wound on the back of my heel. They took me to surgery, cleaned out the wound, cut open the abscess and drained it and packed it. It has to be unpacked and repacked two times a day. The wound was deep all the way to the bone. It hurts like hell when it is repacked. I have an extremely high pain tolerance. Higher than the average person. So when I am making noises about the pain, believe me it hurt like hell. I had been in a very bad motorcycle accident. They tried to save my leg. I spent 20 months in the hospital and had 57 surgeries to put the leg back together and save it, so my leg was already in a lot of pain. By the time this was all over I ended up having 73 surgeries on this leg. What you don't see is that on the other side of my ankle there was another one of these that was even worse than this one. At this particular point over the last 32 days I had 19 IVs placed in my arm because the antibiotics kept destroying the veins. I had 96 Heparin shots in my stomach so my stomach was all bruised and in extreme pain. I had endured 1007 days of extreme pain by this point. I was emotionally and physically spent by time I took this video. That should answer the smart ass comment about why the noises were made. They completely removed my stomach muscles on the left side to use to rebuild my foot. That is what you are seeing in that area next to the wound. I had posted this video originally so that my friends could see what I was dealing with. I'm glad others have found it helpful and educational. As to the trolls, I don't have time for or interest in your nonsense. Get a life.
Views: 195545 Dal Texas
Pressure sore or bed sore appear on areas due to continuous pressure of soft tissue over bony prominences which deprived of blood supply to that area resulting ulcer. Most common areas are over sacrum, hip, heel, elbows, knee, ankle, back of cranium. Factors affecting formation of pressure sore are- old age, diabetes, infection, paralysis, humidity, spinal cord injury, prolonged wheelchair use, terminally ill patients, neglected cases. Bed sores can cause iatrogenic death. Primary treatment is continuous or frequent change of posture of patient to reduce pressure over the affected area , allowing increase blood flow to the affected area,maintainance of proper hygiene of the area. Stages of pressure sore or bed sore- Stage I -most superficial. Appear as nonblanchable redness that does not subside after pressure gets relieved. Stage II -- damage to epidermis and extend up to dermis. Appear as blister or abrasion. Stage III-full thickness skin is involved; sometimes extend up to subcutaneous tissue. As blood supply is less the ulcer gets undermined. Stage IV -- ulcer extends up to muscle, tendon or even bone. Causative factors are -- pressure, shear force, friction. Excess moisture, increase cutaneous temperature. Preventive care- Avoid continuous pressure over any area by frequent (2 hourly) change in position. Use of water bed, air mattress which distribute the pressure evenly. Keeping the pressure area clean dry with proper nursing care avoids formation of bed sore. Treatment- debridement- removal of necrotic tissue .It may be autolytic, chemical or surgical debridement to remove necrosed tissue. Infection control with appropriate antibiotics, both systematic and local with proper dressing of wound. Nutritional support to help the wound heal faster. In stage III or IV -- flap cover may be required to close the wound.
Views: 56304 sankaqm5
More information at http://www.vohrawoundcare.com/education Vohra Wound Physicians: Healing Wounds, Saving Lives MDS 3.0 Wound Staging: This is a demonstration of a wound care physician explaining the proper staging of wounds using the MDS 3.0 staging convention. Japa Volchok, DO discusses the indications for each wound stage and explains why proper staging is important in documenting wounds. This demonstration is performed by a trained wound care physician for educational purposes only and should not be tried at home. Today we will be discussing the correct staging of a pressure ulcer as it pertains to MDS 3.0. MDS 3.0 is a staging convention used for the resident assessment. In the staging under MDS 3.0, there are some differences when compared to the older MDS 2.0 staging system and the more commonly known National Pressure Ulcer Advisory Panel staging. The MDS 3.0 staging convention uses four stages and an additional stage for an unstageable wound. MDS 3.0 does not allow for reverse or back-staging of wounds. The first stage is a stage one. This is an area of localized redness or erythema that is non-blanchable in intact skin. A Stage 2 pressure ulcer presents as a shallow ulcer with an area of open epidermis. There is no evidence of slough. A Stage 2 may also present as an intact or a ruptured blister. The blister may contain serum fluid-filled or a bloody fluid-filled blister. These are both staged as a Stage 2. If the underlying tissue with a blister shows evidence of deep tissue injury, or there is significant surrounding deep tissue injury, this should be staged as an unstageable secondary to deep tissue injury or DTI. A Stage 3 pressure ulcer involves full thickness tissue loss including the epidermis and the dermis. It extends into the subcutaneous tissue but does not extend below the depth of the subcutaneous tissue. It may include tunneling or undermining as well as slough or necrotic tissue. A Stage 4 pressure ulcer involves full thickness tissue loss involving the epidermis, the dermis, the subcutaneous tissue and includes exposed muscle, fascia, bone or other underlying structures such as tendon. There may be undermining and tunneling. In addition, there may be areas of necrosis or eschar present in the wound bed. Depending on the anatomic location on the body, the depth of the wound can vary dramatically. The subcutaneous tissue over an area such as the ankle and the lateral malleolus or on the hands can be fairly thin. An area such as the heel or the back can have significant subcutaneous tissue before you reach the level of muscle or fascia. The actual depth of the wound does not dictate the stage. Rather, the anatomic structures that are involved such as muscle, tendon or bone are what determines the stage of the wound. If the bed of this wound was obscured by necrotic tissue it would be staged as an unstageable. However, it is clear that there are muscle fibers present in the base of the wound as well as bone. This would then be categorized as a Stage 4 pressure ulcer. The final category of staging under MDS 3.0 includes unstageable. There are several reasons that a wound may be unstageable. If there is suspected deep tissue injury, the wound should be staged as unstageable. This is because deep tissue injury often progresses to a much deeper extent than has originally appeared on the surface of the wound. Other signs of DTI include color change, bogginess or tenderness. Other reasons for staging a wound as unstageable include necrosis that covers the full extent of the wound or eschar that prevents visualization of the entire depth of the wound and identification of the anatomic structures. Additionally, under MDS 3.0, there is a category unstageable secondary to a non-removable device. This would be appropriate for staging a wound that has been present under a cast that could not be removed or some other type of medical device that would not be normally removed. This does not include wounds that are covered by negative pressure. Unless the negative pressure device has explicitly been ordered not to be removed except by the licensed physician that ordered the device. Under MDS 3.0, only pressure ulcers are staged with this convention. Pressure ulcers of a Stage 3 or 4 are measured and recorded in the MDS 3.0 resident assessment. In addition, diabetic foot ulcers are recorded under a separate category and are not staged using the aforementioned staging structure.
Views: 126768 Vohra Wound Care
@DrArthurMiami applying the PICO negative pressure wound therapy device . Watch DrArthur from @MarquisPlasticSurgery apply the newest technology in wound VAC technology for wounds after skin grafts for patients that are ambulatory and Leaving the hospital
Views: 65453 Arthur DesrosiersMD
On March 14, 2011 they changed my wound VAC dressing for the first time. I now go through this three times a week, but with drugs nowhere near as potent as this first time. This first time I was on morphine AND Dilaudid. The second time, the wound care nurse didn't wait long enough for the morphine to kick in, and I had no dilaudid. So, I felt the full force of the pain! Today, will mark my 3rd changing and the first changing at home. I will let everyone know how it goes! ** Update ** I have posted an update showing what to expect after your wound closes up and has "healed". https://youtu.be/o1je-1CrEg8
Views: 492449 Joel Bryant
0910 Seymour II™ Wound Care Model is the most comprehensive and realistic model of its kind. Molded from a 74-year-old patient and displaying the following conditions: Stage I, Stage II, Stage III with undermining, tunneling, subcutaneous fat and slough, deep Stage IV with exposed bone, undermining, tunneling, subcutaneous fat, eschar and slough. Also shown are a suspected DTI, unstagable, and a 5 1/2” dehisced wound. The unique flexible life-like material permits the placement of dressings for use with negative pressure wound therapy devices without leaving an adhesive residue. Wound cleansing, classification and staging as well as the measurement of wounds can be demonstrated. A great tool for competency testing!
Views: 2729 VATA
How To Apply a Negative Pressure Wound Vac Gauze Dressing
Views: 901 Advacare Systems
http://kci.orlive.com//videos/v-a-c-ulta-negative-pressure-wound-therapy-system1 The V.A.C.Ulta™ Therapy System is the evolution of V.A.C. Therapy. It's one unit providing two therapies: V.A.C.® Negative Pressure Wound Therapy; and V.A.C. VeraFlo Therapy, which is the automated, controlled delivery and removal of topical wound solutions in the wound bed.
Views: 15710 BroadcastMed Network
V.A.C. VERAFLO™ Therapy combines the benefits of V.A.C.® Therapy with automated topical wound solution distribution and removal. The V.A.C. VERAFLO CLEANSE™ Dressing is a tubular shaped dressing that allows clinicians flexibility in addressing wounds with complex geometries. Watch the V.A.C. VERAFLO ™and V.A.C. VERAFLO CLEANSE™ Dressing Application Video for tips for applying the V.A.C. VERAFLO™ Therapy Dressings. For questions about V.A.C.® Therapy in the U.S. please contact your local Acelity representative or call 1-800-275-4524. NOTE: Specific indications, contraindications, warnings, precautions and safety information exist for Acelity products and therapies. Please visit http://www.acelity.com/healthcare-professionals/instructions-for-use for complete safety information and product instructions for use prior to application. This video is intended for healthcare providers. Patients should consult with their healthcare providers regarding their specific medical conditions, treatments, information in this video, and risks and benefits of Acelity products. This video is not a substitute for professional medical advice, diagnosis, or treatment. Not all Acelity products are available in all countries. Copyright 2017 KCI Licensing, Inc. All rights reserved. All trademarks designated herein are proprietary to KCI Licensing, Inc., its affiliates and/or licensors. PRA001028-R0-US, EN (07/17)
Views: 2630 Acelity
what i did today.. VAC (Vacuum assisted closure) dressing on buttocks VAC (सहायता वैक्यूम बंद) नितंबों पर ड्रेसिंग લાંબી રજા (વેક્યુમ મદદ બંધ) નિતંબ પર ડ્રેસિંગ सुट्टी (व्हॅक्यूम मदत बंद) ढुंगण वर जमिनीच्या पृष्ठभागावर खत घालणे https://www.youtube.com/channel/UCsgnedlJ_USwQbQLCfRYGUA
Views: 720 What I did today..
DeRoyal offers all the necessary foam dressings needed for Negative Pressure Wound Therapy today. Our standard Black Foam dressings are customizable to any wound size and wound type, while out Thin Foam dressings are available for shallower wounds. Our White Foam dressings are also available for wounds with exposed bones, tendons, vessels, and tunneling/undermining.
Views: 995 DeRoyal
http://www.topclosure.com/ The TopClosure™ 3S System- Skin Stretching and Secusure wound closure, is a simple yet creative and effective manner of applying diverse and complex skin wounds such as post traumatic, surgical, acute and chronic skin wounds, which not respond to conventional wound care. Prior to a surgical procedure, the TopClosure™ 3S system is used non-invasively to temporarily stretch skin tissues where direct skin closure is anticipated to take place under excessive tension. Following surgery, the TopClosure™ 3S system is applied to secure wound closure and relieve tension from wound edges. The TopClosure™ 3S System can also be attached to the skin invasively during surgery as a replacement for tension sutures and to approximate wound edges when the edges are under significant tension, preventing primary closure. The use of this unique new system is easy, safe and leads to excellent results. Surgeons will find this application to be extremely helpful when managing complex wounds. 3S System product line consists of three size options: 4mm, 6mm, 8mm. TopClosure™ 3S System- Simple solutions for complex problems.
Views: 31007 IVTMedicalLtd
PART 2: Chronic wounds, or wounds that do not heal in an orderly fashion, require treatment to assist in speeding the healing process. Poor blood circulation being the primary culprit, chronic wounds are often seen in patients with diabetes as well as in those who have sores resulting from a longer duration in bed. Negative Pressure Wound Therapy, or NPWT works in a number of ways to promote the healing of chronic wounds. However, in the past, this type of therapy has been reported as being a painful process. Prospera provides patients with all of the benefits of NPWT without the discomfort.
Views: 265 Anna Gable