2021 Guideline for Management of Patients With Lower-Extremity Wounds Due to Diabetes Mellitus and/or Neuropathic Disease: An Executive Summary.

This article provides an executive summary of the Wound, Ostomy, and Continence Nurses Society's (WOCN) "2021 Guideline for Management of Patients With Lower-Extremity wounds Due to Diabetes Mellitus and/or Neuropathic Disease." This executive summary presents an overview of the systematic process used to update and develop the guideline and recommendations from the guideline for screening and diagnosis, assessment, and management and education of patients with lower-extremity wounds due to diabetes mellitus and/or neuropathic disease. In addition, the executive summary provides suggestions for implementing recommendations from the guideline. The guideline is a resource for WOC nurse specialists and other nurses and health care professionals who work with adults who have/or are at risk for lower-extremity wounds due to diabetes mellitus/neuropathic disease. The complete guideline includes the evidence and references supporting the recommendations, and it is available in print and electronically from the Wound, Ostomy, and Continence Nurses Society, 1120 Rt 73, Suite 200, Mount Laurel, New Jersey, 08054; Web site: www.wocn.org.

2019 Guideline for Management of Wounds in Patients With Lower-Extremity Venous Disease (LEVD): An Executive Summary.

This article provides an executive summary of the 2019 Guideline for Management of Wounds in Patients with Lower-Extremity Venous Disease (LEVD) published by the Wound, Ostomy and Continence Nurses Society (WOCN). The executive summary presents an overview of the systematic process used to update and develop the guideline. It also lists the specific recommendations from the guideline for assessment, prevention, and management of LEVD and venous leg ulcers (VLUs). In addition, the guideline includes a new section regarding implementation of clinical practice guidelines. The LEVD guideline is a resource for WOC nurse specialists and other nurses, physicians, therapists, and health care professionals who work with adults who have or who are at risk for VLU.

Home-prepared saline: a safe, cost-effective alternative for wound cleansing in home care.

OBJECTIVE: The purpose of this study was to determine (1) the rate of contamination for a normal saline solution prepared with distilled water and salt when stored at room temperature and (2) when stored under refrigerated conditions; and (3) to compare the rate of contamination for solutions prepared and stored under controlled conditions with those prepared and stored in patients' homes. DESIGN: This quasi-experimental study examined the bacterial content of saline made with distilled water and stored at room temperature and that of saline stored in a refrigerator. SETTING: A large urban home health agency was the setting for the study. METHODS: Eight teaspoons of table salt were added to 1-gallon jugs of distilled water purchased from a grocery store to produce a normal saline solution. Two gallons of the prepared solution were stored at room temperature (80 degrees F) and 2 were stored in a refrigerator (48 degrees F). Cultures were taken from each of the 4 bottles of prepared solution immediately following preparation and at weekly intervals until bacterial growth occurred, or 4 weeks after preparation. RESULTS: All tested solutions were negative for bacterial growth at baseline. Cultures of the solution stored at room temperature were positive for bacterial growth 2 weeks after preparation, whereas those stored under refrigerated conditions remained free of bacterial contamination 4 weeks after preparation. Two "patient-prepared" solutions were tested at 3 weeks, and both were negative for bacteria at that time. Three patient-prepared solutions were tested at 4 weeks, of which 2 showed no bacterial growth in 48 hours, whereas 1 revealed 600 cfu/mL of Pseudomonas species. CONCLUSIONS: The results of this small study suggest that saline solutions produced by adding table salt to distilled water will remain bacteria-free for 1 month if refrigerated. Additional studies are needed to confirm these findings.