Ep7 - Wound aetiology vs mechanism of injury

We have touched on wound aetiology previously, however in this episode we dive deeper into how wound types interface with mechanism of injury and dilemas faced when there are multiple causes - what actually is a mixed wound?. We canvass all the major hard to heal wound types including incontinence associated dermatitis, pressure injury, skin tears, moisture lesions, chronic oedema, venous, arterial and more. How does this all relate to management of these wounds? We're sure our discussions in this episode will raise a few clinical conundrums and questions for you. Indeed, you may start to see more of these in your own practice and become more aware of these prickly challenges. The simple isn't always so simple.Timestamps:00:00 Introduction01:12 Mechanism of injury versus aetiology02:30 The value of clinical audit and quality indicators03:20 Misdiagnosis of Incontinence-Associated Dermatitis (IAD)03:56 Intertriginous dermatitis misdiagnosed as IAD05:29 The challenges of addressing gaps in clinical guidelines06:03 Be confident to be unconfident06:20 What is the mechanism of injury for skin loss in IAD?07:21 When experts conclude that the simple ain’t that simple08:45 When clinicians are approached by academics to fit a square peg into a round hole 10:36 Tips for researchers undertaking research in venous leg ulcers11:52 When wound education is siloed and does not replicate clinical reality13:35 Making clinical hunches and not always on the first visit/assessment and that’s OK13:50 Current wound documentation does not support multiple aetiologies and impediments to healing14:00 Challenge of teaching clinical realities to students when they are taught in siloes14:33 Figuring out what is the predominant aetiology14:50 How do we define and teach simple versus complex wound15:13 Mixed aetiologies presenting above and below the groin15:56 Prioritising which aetiology to treat / manage16:57 Post operative wound dehiscence and lymphoedema17:48 Capacity building in lymphoedema19:27 The need for clinicians working in Hospital in the Home to understand lymphoedema19:43 The challenge of diagnosing inflammatory conditions such as IAD and intertriginous dermatitis of the pelvic girdle20:30 Influence of climate on dressing performance and skin injuries21:00 Mixed aetiologies of the pelvic girdle22:20 Is IAD avoidable and how easy is it to categorise, manage and report24:00 Continue reevaluating aetiology24:12 It is OK change or add to aetiology if clinical rationale can be provided24:57 Call it what it is. A vascular assessment includes arteries, veins and lymphatics, not just the arteries25:21 Venous disease plus a wound on the same leg does not necessarily mean the wound is of venous aetiology26:57 Mechanism of injury v aetiology v impediments to healing. Simple v complex28:40 Opportunities to improve accuracy of wound data reporting and quality improvement30:27 When is a stage 1 Pressure Injury of the foot, a “Diabetic Foot Ulcer”Resources mentioned:GlobIAD Incontinence Associated Dermatitis - Tools https://www.skintghent.be/en/onderzoek/tools/2/incontinence-associated-dermatitis-iadAustralian Aged Care Quality and Safety Commission - Incontinence associated dermatitis and pressure injury https://www.agedcarequality.gov.au/news-publications/clinical-alerts/incontinence-associated-dermatitis-and-pressure-injuryIf you enjoyed this episode please like, subscribe, leave a comment or share with your colleagues.Connect with us at:Email [email protected] https://www.tiktok.com/@twoechidnaeConnect with Donna's resources and sign up for the Woundy Wisdom's newsletter at https://goodwoundcare.carrd.co/Disclaimer:The views expressed in this podcast are our own. This podcast is intended specifically for healthcare professionals. Always follow your organisation's policies and procedures. Please consult your own healthcare provider for individual wound advice.