The First 100 Days: A Survival Guide for New Professional Caregivers

As noted in the U.S. Library of Medicine at the National Institutes of Health, the amniotic membrane used in the HealPrecisely treatment regimen can be a valid source for wound healing.  The Study, published in 2016, followed two groups of patients with chronic leg ulcers.  Group I was the control group and included 11 patients treated using conventional wound dressings that were changed daily for eight weeks.  Group II consisted of 14 patients treated by placing an amniotic allograft over the ulcer, which was held in place with a secondary dressing.  The allografts and dressings were changed daily.  After 60 days of treatment, Group I showed no reduction in the size of their ulcers and had no relief for their pain.  Group II, on the other hand, complete healing occurred within 14 to 60 days for all 14 patients in the study.  Eleven of the 14 patients reported improvement in their pain level as well.An article released by the International Wound Journal in 2020 compiled data from 257 articles, including articles on patient research using amniotic allografts.  Patients were suffering from Diabetes mellitus, one of most serious, chronic, non-communicable diseases worldwide, and is currently the seventh leading cause of death worldwide.  They found that the proportion of wound healing using human amniotic membranes was significantly higher than those who received conventional wound dressings alone.  Those receiving the kind of care HealPrecisely offers had a 95 percent improvement in just six weeks.Europe PMC released a literature review entitled Amniotic Membrane Adjuncts and Clinical Applications in Wound Healing in 2018.  Following data from studies conducted between 2013 and 2017, they concluded that amniotic allografts were beneficial in the setting of difficult-to-heal fistulas and effective in treating diabetic and venous ulcers when combined with standard therapy.We know this treatment has the power to change lives, said Jennifer Rivard, HealPreciselys COO.  Weve seen amazing outcomes from patients who had little or no hope to be wound-free.  This therapy is truly life-changing.To read these studies and others, visit our research page.

Wounds are a natural part of life, typically healing on their own with proper care and attention. However, some wounds defy the bodys natural healing processes, persisting despite treatment efforts. A non-healing wound, also known as a chronic wound, poses significant challenges to both patients and healthcare providers. In this article, well explore the tell-tale signs of non-healing wounds, delve into their causes, and discuss innovative treatments and diagnostics aimed at addressing this issue. What Is a Non-healing Wound?A non-healing wound is a wound that fails to progress through the normal stages of healing within a reasonable time frame. According to Yale University, that reasonable time frame is between four to six weeks. While acute wounds typically show signs of improvement within a few weeks, chronic wounds may remain stagnant or worsen over time. Examples of chronic wounds include diabetic foot ulcers, pressure ulcers, venous ulcers, and arterial ulcers. These wounds can result from several factors, including diabetes, poor circulation, immobility, and trauma. Causes of Non-Healing WoundsFollowing are some of the most common conditions that can lead to the development of non-healing wounds.Poor Blood CirculationAdequate blood flow is essential for delivering oxygen and nutrients to the wound site and removing waste products. Conditions such as peripheral artery disease (PAD) and venous insufficiency can impair blood circulation, hindering the bodys ability to heal wounds.Woman testing her blood sugar level at home.DiabetesDiabetes can lead to peripheral neuropathy (nerve damage) and peripheral vascular disease (blood vessel damage), increasing the risk of foot ulcers and impairing wound healing. Elevated blood sugar levels can also interfere with the bodys inflammatory response to immune function, further complicating the healing process.PressureProlonged pressure on the skin can cause tissue damage and lead to the formation of pressure ulcers, commonly known as bedsores. Individuals who are bedridden or confined to a wheelchair are particularly susceptible to pressure ulcers, which can be challenging to heal due to constant pressure on the affected area.InfectionWounds that become infected are less likely to heal properly, as bacteria can impede the bodys natural healing processes. Chronic wounds are especially prone to infection, as the compromised tissue provides an ideal environment for bacterial growth. Infections can lead to delayed wound healing, increased pain, and systemic complications if left untreated.Underlying Health ConditionsCertain underlying health conditions, such as autoimmune disorders, cancer, and malnutrition, can impair the bodys ability to heal wounds. These conditions often weaken the immune system, disrupt normal physiological processes, and interfere with tissue repair mechanisms, thus prolonging the healing process. What Are the Stages of a Healing Wound?Before we look at the signs of a non-healing wound, lets look at the stages all wounds go through on their way to being healed.There are four stages of wound healing  Hemostasis, inflammatory, proliferation, and maturation. Here are the signs that will help you recognize whether a wound is healing normally:Bleeding or ScabbingTypically, wounds like burns and pressure ulcers do not bleed. If its a cut, scrape, gash, or puncture wound, it goes through three stages bleeding, clotting, and scabbing. This is called haemostasis, which begins within seconds of the wound occurring.A healthy response to cuts and scrapes is that the wound will bleed and begin to clot within a few minutes. After the blood begins to dry, there will be scabbing. But if the wound is bleeding after a significant period or you cant stop the bleeding, stitches may be required to close the wound. If there is no scabbing after a while, you need to seek treatment from a wound care expert.Swelling After the scab formation, the bodys immune system starts healing the wound in the form of swelling, or tendering. The inflammation or swelling is a sign that the bodys immune system is working properly and repairing your wound. You may notice drainage from the wound. It may have a reddish or pinkish appearance, enabling sufficient blood flow, oxygen, and nutrients to the affected area. This usually occurs within 0 to 4 days of when the patient receives the wound. Growth of New Tissues In 2 to 24 days from the wounds appearance, proliferation occurs. When the swelling is stopped, the tissues will begin forming over the wound. That can last a couple of weeks in case of minor wounds. This is when the body repairs broken blood vessels and replaces damaged tissues. In the healing process, the skin pulls the wound edges inward, and it will get smaller.Scar indicate the final stages of wound healing.Scarring Scaring typically happens within 24 days to 1 year from the wound occurring. This is the last stage of wound healing. This can last anywhere from a few weeks to a whole lifetime. There will be a scar in the place of the initial scab. If the injury is minor, the scar will slowly fade away. You may also experience itching during this stage. If the wound is significant and is in a visible location, some seek plastic surgery to repair scar tissue.5 Signs of a Non-Healing WoundNow that we know what a properly healing wound looks like, here are the five main warning signs that a wound isnt healing.Sign #1: Thick Discharge of Yellow or Green Pus. Excessive pus or drainage from a wound can indicate infection, particularly if the discharge is thick and yellow or green in color. Pus is a sign that the body is fighting off bacteria present in the wound, and its presence may delay the healing process if not addressed promptly. Sign #2: Redness or Warmth Around the WoundPersistent redness or warmth in the skin surrounding the wound can indicate inflammation and infection. Inflammatory mediators released by the body in response to infection can cause the skin to appear red and feel warm to the touch. This inflammatory response may impede wound healing and require targeted intervention.Sign #3: Unpleasant OdorA foul or malodorous smell emanating from the wound is often indicative of bacterial infection and tissue necrosis. The breakdown of tissue by bacteria produces volatile organic compounds (VOCs) that contribute to the characteristic and unpleasant odor of infected wounds. Addressing the underlying infection is essential. Sign #4: SwellingSwelling, or edema, around the wound site can impede blood flow and hinder the delivery of oxygen and nutrients to the tissues. Chronic inflammation and impaired lymphatic drainage contribute to fluid accumulation in the affected area, further exacerbating the swelling. Managing edema is crucial for optimizing wound healing outcomes and preventing complications.Sign #5: Darkening of the Skin Around the WoundDarkening or discoloration of the skin surrounding the wound, known as periwound maceration, can occur due to prolonged moisture exposure and impaired tissue oxygenation. Macerated skin is more susceptible to breakdown and infection. Proper wound dressing selection and moisture management are essential for preventing periwound maceration and promoting healing. In addition to these signs, systemic symptoms such as fever, chills, and malaise may indicate a severe infection or systemic inflammatory response requiring urgent medical attention. Factors Affecting Wound HealingFactors affecting wound healing can be extrinsic or intrinsic. Wound care teams must address all of these factors to see success in healing chronic wounds.Extrinsic Local FactorsWound management and moisture balance (e.g. wound dehydration or maceration)Stable temperature (approximately 37oC)Neutral or acidic pHPresence of infectionWound locationMechanical stress, pressure, or frictionPresence of foreign bodiesGood nutrition plays an important role in healing chronic wounds.Intrinsic Systemic FactorsNutritionUnderlying or chronic diseaseLimited mobilityImpaired perfusionMedications (including immunotherapy, chemotherapy, radiation, or NSAIDs)Mental health (including stress, anxiety, or depression)Patient understanding and complianceAge of patientBest Wound Care PracticesImproving the healing rate and patient outcomes for non-healing wounds requires a comprehensive approach to wound care. Here are some of the best practices to consider.DebridementDebridement is the process of removing necrotic tissue, foreign material, and biofilms from the wound bed to promote healing. Sharp debridement, mechanical debridement, enzymatic debridement, and surgical debridement are among the techniques used to facilitate wound healing. Debridement helps create a clean wound environment conducive to tissue repair and reduces the risk of infection. IV antibiotics can help treat bacterial infections in non-healing wounds.AntibioticsAntibiotics may be prescribed to treat bacterial infections associated with non-healing wounds. Topical antibiotics, oral antibiotics, or intravenous antibiotics may be used depending upon the severity of the infection and the patients overall health status. However, antibiotic stewardship is essential to prevent the development of antibiotic resistance and minimize adverse effects.Advanced Wound Care Procedures and Diagnostic ToolsAdvanced wound care procedures such as amnion allografts, near-infrared spectroscopy, low-frequency ultrasound, and fluorescence imaging offer innovative solutions for promoting wound healing and monitoring treatment progress. These technologies enable clinicians to assess wound characteristics, optimize tissue oxygenation, and target interventions effectively.The most advanced wound care tools and treatments available include Negative Pressure Wound Therapy (NPWT). Also known as vacuum assisted closure, the provider applies controlled negative pressure to the wound using a specialized dressing and vacuum system. This is particularly useful for large, deep, or complex wounds.Biological and cellular therapies like autologous skin grafts, allografts, xenografts, bioengineered skin substitutes, and growth factors work to provide a scaffold for cellular activities. Some of the most advanced diagnostic tools available in wound care today include the Mimosa multispectral near-infrared spectroscopy for low-frequency ultrasound which promotes healing through dilating blood vessels and speeds healing. Another innovative tool is MolecuLight, a device that provides highly accurate real-time information on harmful bacteria that are often present in wounds. XSONX is a vibrating mechanical debridement tool (VMDT) which uses low sonic level frequency vibrations to scrub and debride wounds often with less pain and better results.Nurse applies a bandage to help ensure a moist environment for the wound.Proper Wound DressingChoosing the appropriate wound dressing is crucial for maintaining a moist wound environment, managing exudate, and protecting the wound from contamination. A wide range of wound dressings is available, including hydrocolloids, foams, hydrogels, and alginates, each offering unique benefits depending on the wound type and nature of the wound. Regular assessment and reassessment of the wound and dressing are essential to ensure optimal healing outcomes. Compression therapy is ideal for managing venous leg ulcers or edema-related wounds. It involves the application of graduated compress through compression bandages, compression stockings, or compression wraps to improve venous return, reduce swelling, and encourage healing. Surgical InterventionsIn some cases, skilled wound care surgeons conduct wound debridement, closure with sutures or staples, skin grafts or flaps, or the removal of non-viable tissue. Heal Precisely can treat even the most stubborn wounds in the comfort of a patients home or care facility.Mobile Wound CareClinics like HealPrecisely have mobile care clinics that can be bring treatments directly to the patient. A perfect option for people with mobility challenges, mobile care clinics are staffed by a wound care team, the latest in diagnostic tools, and able to allow our clinicians to deliver a superior care experience wherever our patients need us.Consultation With a Wound Care SpecialistFor complex, non-healing wounds that do not respond to conventional treatments, consultation with a wound care specialist or multidisciplinary team can help resolve even the hardest-to-heal wounds. Wound care specialists have expertise in managing challenging wounds and can recommend advanced treatment modalities tailored to the individual patients needs.Non-Healing Wounds Represent a Significant Health Challenge, but They Can Be Healed With the Right Tools and ExpertiseBy understanding the signs of non-healing wounds, addressing underlying causes, and implementing best wound care practices, healthcare providers can improve patient outcomes and enhance the quality of life for individuals suffering from chronic wounds.Through ongoing research and innovation, the field of wound care continues to evolve, offering hope for those grappling with this complex and debilitating condition. At HealPrecisely, we are pioneers in making breakthrough therapies and diagnostic tools available to our patients faster than other wound care clinics. Thats why we have healing rates of 98.05%, which is 6% higher than the national average, according to EHR Healthnet.If you, someone youre treating, or someone youre caring for has a chronic wound that wont heal, we can help. To learn more, visit www.HealPrecisely.com. 

Pressure ulcers, commonly known as bedsores, are a significant health concern, particularly for individuals who are immobile or bedridden. Understanding the 4 stages of pressure ulcers can help in early identification and treatment, thereby reducing the risk of severe complications. In this comprehensive guide, we will:Explain how pressure ulcers formExplain who is most at riskDetail the 4 stages of bedsores Discuss treatment options and advancements in wound care for treating the 4 stages of pressure ulcersWhat Are Pressure Ulcers and How Do They Form?Pressure ulcers are injuries to the skin and underlying tissue primarily caused by prolonged pressure on the skin. They often develop on skin that covers bony areas of the body, such as heels, ankles, hips, and the tailbone. The constant pressure against the skin reduces blood flow to the area, which can lead to tissue damage and necrosis. Pressure ulcers can also form due to shear and friction. Shear occurs when two surfaces move in opposite directions, such as when a bed-bound person slides down in bed. Friction happens when the skin is dragged across a surface, like bedding or clothing. Both shear and friction can damage the skin and underlying tissue, contributing to the development of pressure ulcers. Who Is Most Susceptible To Pressure Ulcers? Certain groups of people are more susceptible to developing pressure ulcers, including: Individuals with limited mobility: Those who are bedridden, use a wheelchair, or have difficulty changing positions. Elderly people: Aging skin is more fragile and less elastic, making it more prone to damage.Patients with certain medical conditions: Conditions that affect blood flow, such as diabetes and vascular disease, increase the risk of bedsores.Malnourished individuals: Poor nutrition can impair skin health and healing.People with spinal cord injuries: Lack of sensation and mobility increases the risk of pressure ulcers. What Are the 4 Stages of Pressure Ulcers?Understanding the 4 stages of bedsores is crucial for early intervention and effective treatment. Stage 1: Non-Blanchable Erythema of Intact SkinIn stage 1, the skin is intact but shows signs of redness (erythema) that does not blanch (turn white) when pressured. This stage indicates the beginning of tissue damage. Symptoms may include pain, warmth, or a firmer or softer area compared to surrounding tissue. The skin may also appear differently in darker skin tones, showing discoloration instead of redness. Stage 2: Partial-Thickness Skin Loss With Exposed DermisStage 2 pressure ulcers involve partial-thickness skin loss with exposed dermis. The ulcer is a shallow open wound with a pink or red wound bed, or it may appear as an intact or ruptured blister. The damage extends through the epidermis and into dermis, but does not affect deeper tissues. This stage may be painful and more susceptible to infection. Stage 3: Full-Thickness Skin LossAt stage 3, the damage extends through the dermis into the subcutaneous (fatty) tissue. The wound may have a crater-like appearance and can include undermining and tunneling, where the wound extends under the surrounding intact skin. The risk of infection increases, and the wound may produce exudate (fluid) and slough (yellow or white tissue). Stage 4: Full-Thickness Skin and Tissue LossStage 4 pressure ulcers are the most severe, involving both skin and underlying tissue loss. The damage extends into the muscle, tendon, ligament, or even bone. These deep wounds may have a large amount of necrotic tissue (eschar) and extensive undermining or tunneling. Stage 4 bedsores are extremely painful and carry a high risk of serious infection, including osteomyelitis (bone infection) and sepsis (blood poisoning). How Are Pressure Ulcers Treated?Effective treatment of pressure ulcers depends on the stage and severity of the wound. Here are general guidelines for treating each stage:Treatment of Stages 1 and 2:Relieve pressure: Use specialized mattresses (also called offloading or pressure redistribution mattresses), cushions, or pads to reduce pressure on affected areas.Clean and moisturize: Keep the skin clean and well-moisturized. Use mild soap and water or saline solution for cleansing.Dressings: Apply appropriate dressings to protect the wound and promote healing. Hydrocolloid or foam dressings are commonly used. Monitor and assess: Regularly inspect the skin for signs of improvement or worsening.Treatment of Stages 3 and 4:Its especially important to seek treatment by a qualified team of wound care health professionals when pressure ulcers reach stages 3 and 4. They may employ the following treatment therapies, or a combination of several:Debridement: Remove necrotic tissue to promote healing. This can be done through surgical, enzymatic, or autolytic (a moist environment using the bodys own enzymes) methods.Advanced dressings: Use advanced wound dressings such as alginates or hydrogels to manage exudate and encourage healing. Infection control: Administer antibiotics if there is an infection. Maintain strict hygiene to prevent contamination. Nutrition: Ensure adequate nutrition, including protein, vitamins, and minerals to support wound healing.Surgery: In severe cases, surgical intervention may be necessary to remove damaged tissue from the wound. What Are the Latest Advancements in Wound Care for Stage 4 Pressure Ulcers?Recent advancements in wound care have significantly improved the management and treatment of stage 4 pressure ulcers. Some of the latest innovations include:Negative Pressure Wound Therapy (NWPT)NPWT involves applying a vacuum dressing to the wound, which reduces pressure, removes exudate, and promotes tissue granulation. This method has shown effectiveness in accelerating the healing process and reducing infection risk. Growth Factors and Bioengineered Skin SubstitutesGrowth factors such as platelet-derived growth factor (PDGF) and fibroblast growth factor (FGF) can stimulate cell growth and tissue repair. Bioengineered skin substitutes, made from natural or synthetic materials, provide a scaffold for new tissue growth and help close the wound. Biological Skin Graft TherapyBiological grafts, such as amnion grafts, are able to jump-start healing in even the most challenging chronic wounds. These types of grafts have incredible natural healing properties.Advanced DressingsInnovative dressings, such as antimicrobial dressings with silver or honey, help reduce bacterial load and promote a healthy wound environment. Foam dressings with silicone adhesive borders provide better adherence and minimize skin damage during dressing changes. Electrical Stimulation Electrical Stimulation uses low-level electrical currents to stimulate cell growth and enhance blood flow to the wound. This therapy has shown potential in promoting faster healing of chronic wounds. Specialized Understanding of Pressure Ulcers Is Critical for Early Identification and Effective Treatment.At HealPrecisely, we employ many of these therapies and more to achieve some of the highest healing rates in the wound care industry.* These include amnion grafts, 3D grafts, and Cellular, Acellular and Matrix-Like Products (CAMPs). We also use the most advanced diagnostic tools in wound care today, such as the Near Infra-Red Spectroscopy (NIRS), which evaluates tissue oxygen saturation in the wound and fluorescence imaging, which provides real-time information on the bacterial load in the wound.Heal Precisely can treat even the most stubborn wounds in the comfort of a patients home or care facility.Perhaps the best innovation we bring to wound care is our Mobile Care Clinic, which brings the latest wound care advancements directly to the patients bedside, whether thats at home or in an assisted living facility. *Comparison of 1096 clinics/341,742 wound events. Wound Expert EHR by NEThealth. In direct comparison with these clinics, HealPrecisely healed 98.05% of patients, with the national average at 82.47% a difference of 5.58%. The national average days to healing is 62, with HealPrecisely healing in an average of 30 days a difference of 32 days, a 52% quicker healing rate.