Impact of Dehydration on Wound Healing

What is the role of water?
Water plays a vital role in our overall health and may be the most important nutrient of life. Roughly two-thirds of our body is comprised of water. Since the body is not capable of storing water, daily replacement of lost fluids is needed for cellular functions such as delivering nutrients and oxygen to the cells, removing waste products and toxins, lubricating joints, protecting the central nervous system, retaining acid base balance and maintaining adequate tissue temperature. (3) Sufficient oral intake of water is vital to these functions.  

What is one of the most common, unrecognized obstacles impacting successful wound healing?
If you answered dehydration you would be correct. More than 1/3 of America’s seniors do not consume enough water. (8) The human body can survive for weeks without food but will only exist a few days without water.   Simply, dehydration occurs when more water (fluid volume) is lost than is replaced. (6)   Dehydrated skin is known to be more fragile, less elastic and susceptible to wound occurrence. (2)

How are seniors affected?
Water intake in the senior population can be impacted by decreased sensation of thirst, fear of incontinence,   diminishing cognitive skills,   or physical limitations that inhibit their ability to pour and drink water, even when placed nearby.  Also, disease processes, medications, heavily draining wounds, illness involving fever, vomiting or diarrhea or decreased kidney function can negatively impact hydration in the this population. (5) Additionally, highly specialized air fluidized therapy beds used for persons with serious wounds or surgical repairs may increase the evaporation of body fluids requiring additional fluid intake. (7)  Drops in fluid volume of 1-2 % can trigger fatigue, while drops of 10% or more may severely impact all areas of health. (7)   The ability to heal wounds suffers because of decreased oxygenation, cellular communication, or electrolyte functions that negatively impact the ability of the wound to progress through the stages of wound healing. (1)

How can we help?
We can’t ignore the impact of diminished thirst in the aging population. Thirst is the mechanism to tell us our body is in need of fluid. (6) Unfortunately, the body can be 1 or 2 percent dehydrated before the thirst mechanism becomes active. The average water requirement for an adult is about 1,500 ml daily or eight 8 ounce glasses. More accurately, fluid needs should be based on weight; adults should consume 30 ml/kg of fluids per day. (2) Keep in mind that some fluids hydrate better than others, for example, those containing caffeine may have a diuretic effect. (7)  Some simple hydration tips include:

  • Keep drinks accessible
  • Provide straws or easy to remove capped lids
  • Offer assistance frequently when needed
  • Encourage consumption of water packed foods, such as jello, soup, fruit
  • Note personal preferences, ice or no ice, types of liquids, and flavors to encourage intake
  • Offer meals at preferred eating times
  • Encourage fruits and vegetables;   they are an important food source for hydration.

When using air fluidized beds, mitigate the risk of dehydration by consulting with the bed provider for training and support.

Optimize topical wound care
Keep dry wound beds hydrated with products that provide additional moisture, such as DermaRite’s DermaSyn products. DermaSyn Gel, DermaSyn Ag and DermaGauze are excellent options for meeting the needs of dry wound beds. DermaSyn and DermaSyn Gauze are water based gel formulas, enriched with vitamin E to donate moisture to a dry or minimally draining wound bed. DermaSyn Ag contains ionic silver to minimize microorganism growth. DermaSyn products promote an optimal moist wound environment, facilitate autolytic debridement and support new tissue development. Visit our website at www.dermarite.com to learn more about DermaRite products.

References

  1. Today’s wound care: a review.. (n.d.) >The Free Library. (2014). Retrieved Feb 23 2016 from http://www.thefreelibrary.com/Today%27s+wound+care%3a+a+review.-a019446345
  2. Wotton, Karen; Crannitch, Karina et al., Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemporary Nurse : a Journal for the Australian Nursing Profession, December 1, 2008
  3. Water: The essential nutrient. Retrieved Feb 23, 2016 from http://swine.missouri.edu/nutrition/water.htm
  4. Dorner B., Creative nutrition: Solutions for failure-to-thrive patients. Aging Well
    3 No. 4 P. 8
  5. Borreli, L., Lack of drinking water, Retrieved Feb 22, 2016 from http://www.medicaldaily.com/pulse/lack-drinking-water-deteriorates-human-body-adverse-effects-dehydration-329640
  6. Batmanghelidi F., Optimal hydration. (2011) Retrieved Feb 23, 2016 from http://www.realfoodwholehealth.com/2011/04/optimal-hydration/
  7. The role of nutrition in tissue viability. (2007) Retrieved Feb.23, 2016 from http://www.woundsinternational.com/media/issues/217/files/content_182.pdf
  8. Older Americans do not drink enough water. (2002) Retrieved Feb. 22, 2016 from http://www.cnpp.usda.gov/sites/default/files/nutrition_insights_uploads/Insight27.pdf

Deep Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

Posted in Articles, Clinical Insights Newsletter

DermaRite Releases New Interactive Catalog App

DermaRite Releases New Interactive Catalog App Designed To Help Caregivers Navigate The Ever-Expanding Wound Dressing Landscape

March 2, 2016 – DermaRite recently released its Interactive Wound Dressing Selection Guide, a unique interactive catalog app that allows users to input a series of wound characteristics that generates a list of DermaRite dressings appropriate for that presentation. Available for iPhone, iPad, and Android, the guide is great for on-the-job reference or simply to learn more about DermaRite’s wound dressings.

Prompted by the ongoing expansion of DermaRite’s wound dressings catalog, the app was designed to help caregivers narrow down their options. “Most wounds can be treated with any one of multiple dressing choices that we provide,” points out Dr. Holly Korzendorfer PT, PhD, CWS, FACCWS, DermaRite’s VP of Clinical Business Development. “The Dressing Selection Guide helps users by displaying a list of appropriate options in order to accommodate individual and institutional preferences.”

The app was developed to ensure that as many wound care scenarios as possible were addressed. “Our app will help caregivers navigate our growing wound dressings catalog, and in turn support them to provide better care for persons with wounds,” says Dr. Korzendorfer.

Designed as an educational resource tool, the app is part of Healing In D.E.P.T.H.™ , DermaRite’s holistic skin and wound care program for facilities. Created to address the primary areas of skin and wound care, each of the program’s four steps supports the next, giving caregivers the tools they need to support healing from without and within.

To download the app for iPhone or iPad, visit iTunes at https://geo.itunes.apple.com/us/app/dermarite/id1056301580?mt=8. For Android, visit the Google Play store at https://play.google.com/store/apps/details?id=com.dermarite.dermarite. To learn more about DermaRite and the Healing In D.E.P.T.H. program, please visit their website at DermaRite.com.

Posted in Press Release

DermaRite: Introducing ComfortFoam™ Border Lite Thin Silicone Foam Dressing

January 28, 2016. DermaRite®, manufacturers of cost-effective advanced wound care, skin care and nutritional supplements for health and senior care facilities, is proud to introduce their ComfortFoam™ Border Lite dressings.

A slimmer, more conformable addition to their best-selling ComfortFoam line of silicone foam dressings, ComfortFoam Border Lite is an absorbent, self-adherent silicone foam island dressing consisting of a soft silicone contact surface, a thin flexible polyurethane foam pad and a vapor-permeable, moisture-proof outer film. ComfortFoam Border Lite’s gentle silicone adhesive sticks to surrounding skin but not to the wound bed, minimizing pain and the risk of damage to the periwound area.

“ComfortFoam Border Lite expands our silicone product line to address wounds with lower levels of drainage, offering greater choice to better meet the needs of those with fragile skin” indicates Dr. Holly Korzendorfer, PT, PhD, CWS, FACCWS, DermaRite’s Vice President of Clinical Business Development.

ComfortFoam Border Lite is showerproof and can be worn for several days depending on wound condition and exudate levels. It is ideal for a wide variety of low-to-medium exudating partial and full thickness wounds, including pressure ulcers, diabetic ulcers, arterial ulcers, venous ulcers, and traumatic wounds.

“As part of our Healing in D.E.P.T.H. program, we are committed to providing caregivers complete, holistic solutions to skin and wound care”, says Udi Mantel, DermaRite’s Director of Marketing. “Expanding the ComfortFoam line in response to customer feedback is just one way that we ensure our customers have the tools they need to heal from without and within.”

For more information about ComfortFoam Border Lite and DermaRite’s extensive line of high quality, affordable skin, wound care and nutritional products, please contact DermaRite at 1-800-337-6296 or visit their website at www.dermarite.com.

Posted in Press Release

Obesity and Wound Healing

Obesity is a national health concern impacting over 35% of our adult population above the age of 60.1 Obesity can be directly related to heart disease, stroke, type 2 diabetes and some cancers, but did you know that obesity also affects our ability to heal wounds?3

Several things occur as we gain weight. First, the demands on the circulatory system are stressed due to the increased amount of adipose (fat) tissue. The vascular system becomes overwhelmed and can’t supply the required oxygen and nutrients,   resulting in chronic inflammation.4  Decreased tissue oxygenation also negatively affects the ability of fibroblasts to produce collagen, a vital component for healing and wound tensile strength. 5

Secondly, the production of an important protein (adiponectin) decreases as girth increases, negatively influencing two vital components of wound healing. Adiponectin aids in stimulating angiogenesis (new blood vessel formation) as well as promoting the proliferation and migration of keratinocytes to close wounds. 5

Finally, we cannot assume that an obese person is well nourished and must have consideration for the fact that high calorie diets may be very deficient in nutrients. It is well known that an adequate supply of vitamins, minerals and protein are necessary for wound healing. 2 A proper assessment of the obese individual’s dietary requirements may reveal the need for protein supplements.

References:

  1. Adult obesity facts. CDC, 2015. http://www.cdc.gov/obesity/data/adult.html
  2. DHHS, AIM for a Healthy Weight, page 5. Available online:
    http://www.nhlbi.nih.gov/health/public/heart/obesity/aim_hwt.pdf[PDF-2.17MB]
  3. Holcomb, Valerie B & Keck, Victoria A & Barrett, J Carl & Hong, Jina & Libutti, Steven K & Nunez, Nomeli P. (n.d.). Obesity impairs wound healing in ovariectomized female mice. In vivo (Athens, Greece), 23. Retrieved from http://www.biomedsearch.com/nih/Obesity-impairs-wound-healing-in/19567384.html
  4. Obesity and Inflammation,   https://www.ncsf.org/enew/articles/articles-obesityandinflammation.aspx
  5. Pierpont YN, Phoung Dinh T, Salas R, et al. (2014). Obesity and surgical wound healing: A current review. ISRN Obesity. 2014. doi:10.1155/2014/638936.

Deep Dive

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Posted in Articles, Clinical Insights Newsletter

UTI Prevention – Minimizing Antibiotic Overuse

Recently,   the CDC released the Core Elements for Antibiotic Stewardship for Nursing Homes to provide guidance to Long Term Care (LTC) facilities related to antibiotic prescribing practices. The CDC guidelines are designed to reduce antibiotic overuse and decrease the alarming rise in antibiotic resistant infections. (2) Antibiotics provide an astonishing value to healthcare, however, over prescribing these drugs threatens the longevity of their effectiveness due to the ability of bacteria to develop defense mechanisms and resistance to antibiotics.  Newly emerging antibiotic therapies are not being developed fast enough to keep up with the growing resistance capabilities of bacteria. (7) Our practices need to change to protect current therapeutic drugs and still meet the healthcare needs of our residents.

Urinary tract infections (UTIs) are a serious concern in the LTC setting, and are ultimately responsible for frequent repetitive antibiotic use in the elderly. UTIs account for approximately 30 % of all infections and up to 50% of antibiotic use in the elderly residing in LTC facilities. (3,5)   Complications from UTI’s can include bacteremia, cystitis, pyelonephritis, falls and septic shock. It is important to remember that UTI’s can mimic symptoms of Alzheimer’s disease and senile dementia. An estimated 1 in 10 nursing home residents has a UTI and nearly half of these residents will not exhibit typical signs and symptoms of infection, such as fever. (5,9) Falls have been shown to increase over 30-60% in residents with moderate to severe urinary tract infections. (8)

How can UTI’s be prevented? Several preventative measures can help minimize the risk of developing a UTI. These include adequate hydration, emptying the bladder when the need to urinate occurs, excellent perineal cleanliness and of course supplementing the diet with cranberries and D-Mannose (1,4). Incorporating a cranberry and D-Mannose supplement works naturally to interfere with bacterial adherence to the bladder walls, where infection of the mucosal surface can occur. E-Coli entering the bladder is the most common cause of   UTIs. (4)

DermaRite’s UTI Heal is an excellent supplement to promote urinary health in your residents. UTI Heal contains Cranberry, D-Mannose, Inulin (FOS) and Erythritol. Taken in a great tasting 1 ounce serving, the cranberry and D-Mannose in UTI Heal promote an environment that inhibits the proliferation of infection causing bacteria in the bladder. Additionally, Inulin promotes digestive health by stimulating beneficial bacterial growth and reducing harmful bacteria that can lead to infections.

As with all of DermaRite’s nutritional supplements, UTI Heal is sugar-free, gluten-free, and lactose-free to meet the dietary requirements of your residents.

References

  1. US National Library of Medicine: Cranberry. Retrieved October 21, 2015. https://www.nlm.nih.gov/medlineplus/druginfo/natural/958.html
  2. Centers for Disease Control and Prevention. The Core Elements of Antibiotic Stewardship for Nursing Homes. Retrieved October 21, 2015. http://www.cdc.gov/longtermcare/prevention/antibiotic-stewardship.html
  3. Centers for Disease Control and Prevention. Urinary Tract Infection (UTI) Event for Long-term Care Faciliites. Retrieved October 22, 2015. http://www.cdc.gov/nhsn/PDFs/LTC/LTCF-UTI-protocol_FINAL_8-24-2012.pdf
  4. Recurrent Urinary Tract Infections in Adult Women: a Plot study With Ora D-Mannose. Retrieved Oct. 23, 2015. https://www.clinicaltrials.gov/ct2/show/NCT01808755
  5. Buhr, G. & Genao, L. (2013). Urinary Tract Infections in Older Adults Residing in Long-Term Care Facilities. Retrieved October 22, 2015. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573848/
  6. Drugs Today 2007, 43(1): 47 ISSN 1699-3993 Copyright 2007 Prous Science
    CCC: 1699-3993 DOI: 10.1358/dot.2007.43.1.1032055
  7. Lieberman, P., & Wootan, M. (1988). Protecting the Crown Jewels of Medicine. Retrieved October 20, 2015. http://cspinet.org/reports/abiotic.htm
  8. Rhoads J1, Clayman A, Nelson S. The relationship of urinary tract infections and falls in a nursing home. Director. 2007 Winter;15(1):22-6.Retrieved 10/26/15 http://www.ncbi.nlm.nih.gov/pubmed/19348053
  9. Sollitto M. Urinary tract infections in the elderly. Retrieved 10/26/15: https://www.agingcare.com/Articles/urinary-tract-infections-elderly-146026.htm

Deep Dive

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Posted in Articles, Clinical Insights Newsletter

Introducing Healing In D.E.P.T.H

DermaRite®, manufacturers of cost effective advanced wound care, skin care and nutritional supplements for health and senior-care facilities, is proud to introduce their Healing In D.E.P.T.H. program.

In conjunction with the release of their new line of liquid nutritional supplements, aimed at supporting patients’ own healing abilities, the Healing In D.E.P.T.H. program was developed to assist caregivers by offering them a clear program of wound prevention and treatment utilizing the many tools and products that are available to them.

The result of cutting-edge research and close collaboration with Board Certified physicians and wound care specialists, “our liquid supplements propelled us to develop a program with a deeper, more holistic approach to patient care that engages the many layers of tools that are available to caregivers in a simple, easily understood plan of care,” says Udi Mantel, Director of Marketing at DermaRite.

The Program is designed to address four primary areas of patient skin and wound care, each step supporting the prior area, and providing caregivers with the tools and services needed to assure optimal care:

DermaRite’s
Educate – DermaRite offers a variety of clinical tools and educational programs, including online learning via DermaRite Academy.
Prevent – A broad range of soaps, sanitizers, moisturizers and skin protectants are available to keep skin healthy and clean, preventing issues related to broken skin and infection.
Treat – Take advantage of DermaRite’s comprehensive selection of advanced skin and wound care products, available in a wide range of sizes. Now includes a new line of compression dressings.
Heal – The NEW line of liquid supplements supports and assists patients’ own healing abilities by stabilizing and boosting their bodies’ own defenses, avoiding further deterioration.
Program

Servicing Healthcare and Senior Care facilities for over 20 years, “we are very excited to add yet another dimension to the DermaRite’s offering. DermaRite has grown to become the one stop solution to practically all of a facility’s skin care, wound care, and nutritional supplement needs. Our vast advanced wound care line, offered in dozens of different sizes and shapes, may very well give DermaRite the most expansive advanced wound care offering in the industry.

True to our reputation, we do this all at the highest quality, and with an approach to be the most cost effective brand there is” indicates Naftali Minzer, CEO of DermaRite. With cutting edge research, a holistic approach to skin and wound care, and unparalleled customer service, DermaRite is certainly the best option to Healing In D.E.P.T.H.

For more information about the high quality, cost-effective lines of advanced wound care, skin care and nutritional supplements from DermaRite, please visit www.dermarite.com or call (800) 337-6296.

Posted in Press Release

DermaRite Moves into New, State-of-the-Art Headquarters

DermaRite Industries, LLC. recently moved into a new state-of-the-art manufacturing and warehousing facility. With over 3.7 million cubic feet of space, the facility is designed to provide customers with more high quality products, faster and more efficiently than ever before. The new set-up allows DermaRite to move more nimbly as it expands into new product lines, and enables them to move more of the packaging in-house, further ensuring the highest level of quality control and oversight. The facility also houses corporate office space and labs for research & development.

Posted in Press Release