RECALLING THE GOOD NEWS.

Nexus Specialty Hospital Featured Program: Wound Care

While advances in wound care have improved management of all types of wounds, Nexus Specialty Hospital has developed a program where they have recorded increased success with complicated and non-healing wounds. Known for their specialized wound care program, the team at Nexus Specialty Hospital focuses specific attention and resources to close wounds faster and without infection or need for future debridement (removal of dead or infected tissue or foreign material).

“Depending on a patient’s length of stay, they may be with us for a week or up to a month,” explained Mary Vallery, RN, WCC, OMS, Wound Care Supervisor at Nexus Specialty Hospital. “We have to work at an aggressive pace because we know these patients won’t be with us long. It’s our goal to get the wound clean, so that when they discharge, patients can have successful closure.”

Interdisciplinary Wound Care Team
The team at Nexus Specialty Hospital works with patients holistically under the guidance of a Board Certified wound care specialist. Additional members of the interdisciplinary team are wound care certified nurses, an ostomy certified nurse, and registered dietician. The program incorporates rehabilitation, bowel and bladder management, and medical management, as well as consults for additional specialist including podiatry, plastic surgery, and infectious disease.

“Our wound care department has taken care of even the most complicated cases,” explained Vallery. “Nothing discourages us because we find wound care as an exciting challenge. We love to problem solve and creatively find what will work best for each individual patient. We have innovative techniques and tools. We build our dressings differently than other facilities making it easier for the patient to maneuver.”

Treating All Kinds of Wounds
The team at Nexus Specialty Hospital treats all types of chronic and complex wounds, including those that are infected or have developed calciphylaxis. Wound care treatment is tailored to each patient, and depending on the location and type of wound, one or multiple of the following treatments and/or services are provided:

  • Negative Pressure Wound Therapy (NPWT) is a standard best practice for wounds. Additionally, the hospital is one of the only facilities that offers NPWT with Veraflo, a system that instills antiseptic cleansers into the wounds to promotes autolytic debridement of the wound. This is an important therapy for patients with infected wounds or non-surgical candidates since the process regularly cleans the wound every three hours without changing the dressing.
  • For smaller wounds, the team performs bedside debridements. Using local anesthesia or conscious sedation, non-surgical patients are able to have their wounds completed cleaned out without the risk of going under or being intubated.
  • For flap candidates, the team ensures that patients are getting adequate oxygenation to the area of closure, proper nutrition which can include the use of a feeding tube, and appropriate methods of bowel regulation that could include ostomy, rectal tube, or bowel program. Patients are educated on proper offloading to promote success, and graduated sitting protocols are followed upon discharge. The hospital’s flap success rate ranges from 75-85%.
  • The wound care physician, nutritionist, and ostomy nurse work side by side to promote appropriate avenues towards healing and closure, or chronic management of fistulas, and are experienced with enterocutaneous, enteroatmospheric, urinary, and rectal fistulas. The hospital also offer an ostomy support group on the 2nd Friday of the month.
  • Lower extremity wounds receive extensive work up to ensure blood flow to the affected area is adequate for healing. If needed, the team sends for outpatient angiogram and stent placement prior to aggressive wound healing to achieve the best possible outcome for patients.
  • End stage renal disease (ESRD) and peritoneal dialysis accelerate the development of calciphylaxis. There is no literature providing recommended treatment for this condition as it is considered a terminal illness, but the Nexus team recognizes the need for comfort, pain management, and aggressive prevention of infection in these wounds including surgical debridements.

Additional treatments include pulsatile lavage therapy, maggot therapy, skin substitutes, full thickness skin grafts, advanced wound dressings, and compression dressings. Specialty beds, like low air loss mattresses, dolphin beds, and sand beds, are also offered according to needs.

New Outpatient Clinic Supports Wound Care
Recently, the hospital also started an outpatient clinic, providing continuity of care for wound care patients. Because the staff collaborates with other healthcare facilities in the area, outpatient follow up care is scheduled before discharge. Nexus Specialty Hospital is also seen as a source of education for other healthcare professionals.

“Wound care is so gratifying,” said Vallery. “It’s the part of nursing you can actually see improvement in your patient. We can see it happening and families can too. It’s amazing how from one day to the next, the wound can be looking much better.”

Nexus Specialty Hospital Nanofiber Surgical Matrix Study
Nexus Specialty Hospital is participating in a study to evaluate the role and efficacy of nanofiber surgical matrix in flap reconstruction of chronic pressure ulcers. The wound care team is collecting data on patients being treated with Restrata® Wound Matrix, developed by Acera Surgical, a soft-tissue repair company.

So far from phase one of the study, the team is seeing great results. The completely artificial graft is being recognized by the body as its own tissue, and therefore, the body granulates the tissue and doesn’t reject it. In fact, the nanofiber surgical matrix promotes angiogenesis (where new blood vessels form) 50% faster than other widely used products.

“We’re seeing a lot of success with this study,” explained Vallery. “We’re looking forward to what results we can report from phase two. Ultimately, this is proving to be a good option for patients with complicated wounds.”

Click to learn more and to review data from phase one of the study.

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