Journal of the American College of Certified Wound Specialists RSS feed: Current Issue. The Journal of the American College of Certified Wound Specialists is a multidisciplinary, peer-reviewed educational resource for wound care professionals espousing the principles of evidence-based medicine. http://www.jaccws.org/?rss=yesElsevier Inc.en © 2011 Published by Elsevier Inc. Journal of the American College of Certified Wound Specialists1876-498332June 2011 © 2011 Published by Elsevier Inc. healthpermissions@elsevier.comhttp://www.jaccws.org/article/PIIS1876498311001159/abstract?rss=yesDear Fellows of the College: We continue to make great strides in the educational and public policy efforts of the College. In July, we held the second wound care course in Bogota, Colombia, and continued to establish the College of Certified Wound Care Specialists as a premier educational venue in Latin America. In August, we held our first Caribbean Encounter on Wound Care in Ponce, Puerto Rico. We had more than 175 attendees and excellent reviews of the course. As a result of this endeavor, we have been invited to give the wound care course in Santo Domingo in November 2011. In October, we will be highlighting our first wound care conference in conjunction with Kindred Hospital, to be held in Dayton, Ohio, on October 7. We will have outstanding faculty from all over the United States lecturing at the conference.Letter from the ChairAimée D. Garcia10.1016/j.jcws.2011.10.001Journal of the American College of Certified Wound Specialists 3, 2 (2011)2011-06-01Journal of the American College of Certified Wound Specialists2011-06-0132S1876-4983(11)X0005-XEditorial2525http://www.jaccws.org/article/PIIS1876498311001111/abstract?rss=yesAbstract: Wound bed preparation is an organized approach to create an optimal environment for wound healing by the use of the most cost-effective therapeutic options. It has become an essential part of wound management and seeks to use the latest findings from molecular and cellular research to maximize the benefits of today’s advanced wound care products. The international advisory panel on wound bed preparation met in 2002 to develop a systemic approach to wound management. These principles of this approach are referred to by the mnemonic TIME, which stands for the management of nonviable or deficient tissue (T), infection or inflammation (I), prolonged moisture imbalance (M), and nonadvancing or undermined epidermal edge (E). One critical element of pathophysiology, understanding of the hypoxic nature of the wound and correction of hypoxia as a critical element of wound bed preparation, is not covered. This article proposes to add correction of hypoxia to the TIME principle (TIMEO2 principle) based on the evidence. The evidence that will support the reason and the need for modification of the wound bed preparation protocol is discussed.Correction of Hypoxia, a Critical Element for Wound Bed Preparation Guidelines: TIMEO2 Principle of Wound Bed PreparationJayesh B. Shah10.1016/j.jcws.2011.09.001Journal of the American College of Certified Wound Specialists 3, 2 (2011)2011-06-01Journal of the American College of Certified Wound Specialists2011-06-0132S1876-4983(11)X0005-XReview Article2632http://www.jaccws.org/article/PIIS1876498311001147/abstract?rss=yesAbstract: Chronic venous disorders are common in the Western world. The current treatment of venous leg ulcers is unsatisfactory despite the availability of well-documented standards of care. Patients today are interested in alternative approaches to modern medicine. We have developed a wound-healing powder containing natural ingredients with absorptive, aromatic, antiseptic, and anti-inflammatory synergistic properties. This report describes 3 cases that were successfully treated with the powder, demonstrating the potential of herbal remedies in the clinical treatment of venous leg ulcers.Novel Wound Healing Powder Formulation for the Treatment of Venous Leg UlcersAngela V. Ghatnekar, Tuan Elstrom, Gautam S. Ghatnekar, Teresa Kelechi10.1016/j.jcws.2011.09.004Journal of the American College of Certified Wound Specialists 3, 2 (2011)2011-06-01Journal of the American College of Certified Wound Specialists2011-06-0132S1876-4983(11)X0005-XCase Study3341http://www.jaccws.org/article/PIIS1876498311001123/abstract?rss=yesAbstract: Clostridium tertium has historically been regarded as nonpathogenic, and its implication as the primary microbe in infectious etiologies remains unclear. Although there have been several reports of C tertium isolated from blood, tissue, and other specimens, largely this population has consisted of patients with neutropenia, hematologic malignancies, or gastrointestinal disorders. Here we describe a case of a 39-year-old nonimmunocompromised man with a history of type 1 diabetes mellitus and intravenous drug use who presented to our institution with a necrotizing soft tissue infection involving his right upper extremity. The infection had developed after the patient had injected methamphetamines. At surgery, tissue was obtained for Gram stain and culture, yielding C tertium, after an initial misidentification as Lactobacillus species. After undergoing extensive surgical debridement and treatment with an appropriate antibiotic regimen, the patient was able to be discharged home with retained function of his extremity. Although not common, infections involving C tertium can produce severe, potentially life- and limb-threatening disease processes, which may require aggressive therapy even in the nonimmunocompromised patient.Clostridium Tertium Isolated From a Necrotizing Soft Tissue Infection in a Diabetic but Otherwise Nonimmunocompromised PatientElizabeth A. Steensma, Christian W. Ertl, Leandra H. Burke10.1016/j.jcws.2011.09.002Journal of the American College of Certified Wound Specialists 3, 2 (2011)2011-06-01Journal of the American College of Certified Wound Specialists2011-06-0132S1876-4983(11)X0005-XCase Report4244http://www.jaccws.org/article/PIIS1876498311001160/abstract?rss=yesThe wound care provider is often faced with challenges that extend beyond wound treatment. In any chronic wound treatment scenario, often dressing choice and wound bed preparation are the focus. Habitually, blinders are donned with disregard to the surrounding skin structures. It is important to consider all factors contiguous with the healing of a wound, as well as being cognizant of the patient’s surrounding skin integrity. Care of the periwound skin is mandated in successful treatment of any patient with a chronic wound. Regardless of the cause of wounds and potential secondary skin breakdown, diabetes, poor circulation, or other immunologic compromising states, treatment must always include an extensive evaluation of the patient’s general health. Placing the wound and skin condition in relation to the patient’s overall health helps the clinician to determine the best course toward reaching the ultimate goal of cure, closure, and or palliation. Early intervention reinforces the identification of the risk factors for developing ulcers and skin complications. Noting abnormal skin conditions immediately will hasten one’s success.Consider Skin Hygiene and Care Beyond the WoundDonald E. Mrdjenovich, Cynthia A. Fleck10.1016/j.jcws.2011.10.002Journal of the American College of Certified Wound Specialists 3, 2 (2011)2011-06-01Journal of the American College of Certified Wound Specialists2011-06-0132S1876-4983(11)X0005-XColumn4547http://www.jaccws.org/article/PIIS1876498311001135/abstract?rss=yesAbstract: Dr Jayesh Shah authors this quarterly column, consisting of 5 questions with explanations, to help you practice for your exam.Ace Your Certification ExamJayesh Shah10.1016/j.jcws.2011.09.003Journal of the American College of Certified Wound Specialists 3, 2 (2011)2011-06-01Journal of the American College of Certified Wound Specialists2011-06-0132S1876-4983(11)X0005-XColumn4849