Letters to the Editor

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Question 

Do you have any information about the Silverhawk procedure?

Melinda Kaplan, WOCN, CWS

Vahalla, NY

Editor: The Silverhawk procedure uses a new style of catheter that houses a directional rotating blade for the treatment of atherosclerotic plaque within peripheral arteries. The traditional treatment to increase lumen size is by compression whereas this technique allows the rotating blades to shave the arterial plaque in different aspects of the lumen. A visual description and video can be found at http://youtube.com/watch?v=umCd3BMRIK0.

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Question 

I work at a long-term care facility and use Accuzyme for our enzymatic debridement. Is it true that we are no longer going to have reimbursement for this product?

Sandra Yordash, RN, CWS

New York, NY

Editor: The federal Centers for Medicare & Medicaid Services has stated that as of January 1, 2008, all products without a Food and Drug Administration approval application were removed from the 2008 Formulary Reference File. So products with papain/urea will be limited in their eligibility for reimbursement coverage under Medicare Part D. This does not hold true at this time for the enzyme collagenase (Santyl).

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Question 

We were told by our hospital administration that negative pressure wound therapy (NPWT) is a “time-out” procedure. Is this true?

Amanda Sievert, PT, CWS

Tampa, FL

Editor: A time-out procedure is applicable for all operative or invasive procedures or procedures that put patients at minimal risk. The time-out procedure is the final verification process before starting a procedure to assure that you have the right patient, correct site, correct procedure, correct position, and any available special equipment prior to treatment. NPWT is not considered an invasive procedure. Certain aspects of the time-out process, such as the use and documentation of the two patient identifiers (patient name or birth date, or medical record number), can be used during NPWT, prior to treatment. Our facility has also documented the number of pieces of foam or gauze that were used and to where NPWT was applied. Remember, a good rule of thumb is to document everything because if it was not documented, it was not done.

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Question 

What is the difference between the American Academy of Wound Management (AAWM) and the American College of Certified Wound Specialists (ACCWS)?

Samatha Vermas, PT

Newark, DE

Editor: The AAWM is a national multidisciplinary board whose main purpose is to provide a national examination that certifies health care professionals in wound management.

The ACCWS is composed of health care professionals who have obtained the designation of certified wound specialist (CWS) from the AAWM. The college provides education and informational resources to health care professionals and the public, as well as avenues of research to enhance the care that we provide to our clients.

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Question 

How would you manage wounds for a patient undergoing treatment with Hydrea?

Jason Oldman, RN

Sedona, AZ

Editor: You must remember that hydroxyurea (Hydrea) is an antineoplastic drug that is not cancer cell specific. It typically will have an effect on rapidly replicating cells, such as cancer cells, but may also be cytotoxic to cells involved in wound repair. If the treatment of the wound is the primary concern for the health care team, then stopping the use of hydroxyurea needs to be considered.