Wound emergencies: The importance of assessment, documentation, and early treatment using a wound electronic medical record

Michael S. Golinko, Sunday Clark, Robert Rennert, Anna Flattau, Andrew J.M. Boulton, Harold Brem

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Chronic wounds such as diabetic foot ulcers, venous ulcers, and pressure ulcers are a major source of morbidity and mortality. To describe wound characteristics associated with a wound emergency, the Wound Electronic Medical Records (WEMR) of 200 consecutive admissions (139 patients, average number of admissions 1.4) to a dedicated inpatient wound healing unit over a period of 5 months were retrospectively reviewed. Patient mean age was 62 ± 16 years, 59% were men, 27% had a foot ulcer and diabetes mellitus, and 29% had venous ulcers. Presenting signs and symptoms included wound pain, cellulitis, nonpurulent drainage, and undermining, but few presented with classic local clinical signs of infection. Treatment consisted of sharp debridement with deep tissue culture and pathology from the wound base and/or systemic antibiotics. Twenty-percent (20%) of patients had pathology-confirmed and 38% had pathology- or radiology-confirmed osteomyelitis on admission, supporting that new or increasing wound pain, cellulitis, and/or nonpurulent drainage or presence of significant undermining may be indicative of an invasive infection and that patients presenting with these signs and symptoms require an immediate treatment plan and consideration of hospital admission. Use of an objective documentation system such as the WEMR may help alert clinicians to subtle wound changes that require aggressive treatment; thereby, avoiding emergency room visits and hospital admissions. Future research is needed utilizing the WEMR across multiple medical centers to further define criteria for a chronic wound emergency.

Original languageEnglish (US)
Pages (from-to)54-61
Number of pages8
JournalOstomy Wound Management
Volume55
Issue number5
StatePublished - Dec 1 2009

Keywords

  • Case series
  • Chronic wounds
  • Diagnosis
  • Electronic records
  • Osteomyelitis

ASJC Scopus subject areas

  • Internal Medicine
  • Nursing(all)
  • Gastroenterology

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    Golinko, M. S., Clark, S., Rennert, R., Flattau, A., Boulton, A. J. M., & Brem, H. (2009). Wound emergencies: The importance of assessment, documentation, and early treatment using a wound electronic medical record. Ostomy Wound Management, 55(5), 54-61.