Wound Care Essentials Practice Principles Fifth Edition Clinical Editors Sharon Baranoski,MSN, RN, CCNS-APN, CWCN, MAPWCA, FAAN Advanced Practice Nurse Nurse Consultant Services/Private PracticeChicagoland/Shorewood, Illinois Elizabeth A. Ayello,PhD, MS, BSN, RN, CWON, ETN, MAPWCA, FAAN Co-Editor-in-Chief, Advances in Skin & Wound CarePhiladelphia, PennsylvaniaExecutive Editor Emeritus, WCET® JournalOsborne Park, West Australia, AustraliaFacultySchool of NursingExcelsior CollegeAlbany, New YorkPresidentAyello, Harris & Associates, Inc. New York, New York Acquisitions Editor: Nicole Dernoski Development Editor: Maria M. McAvey Senior Editorial Coordinator: Lindsay Ries Production Project Manager: Kim Cox Design Coordinator: Holly Reid McLaughlin Manufacturing Coordinator: Kathleen Brown Marketing Manager: Linda Wetmore Prepress Vendor: SPi Global Fifth Edition Copyright © 2020 Wolters Kluwer Copyright © 2016 by Wolters Kluwer, Copyright © 2012 by Lippincott Williams & Wilkins. 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To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of this work. shop.lww.com Dedicaton To my colleagues—Over the course of my nursing career, I‘ve had the privilege of working with and interacting with the best and the brightest colleagues in wound care. It has been my honor to be involved in educating, influencing, and shaping the world of wound care. It is exciting that our book will debut in 2020 the “The Year of the Nurse.” To my family—Years have been very good to us. Our families have grown, dealt with sadness, and great change BUT we’ve had the strength to continue and always remember “family first.” To my much loved, children and grandchildren—You’ve been the best part of my life. The laughter, smiles, tears, and “out of the mouth of babes” will stay with me forever. Love you, Madison, Lexi, Brek, Lanie, Brooklyn, Morgan, Alia, Tyler, and Taryn. To Jim, Deborah, Jeffrey, JR, and Carissa, thank you for giving me my most beautiful gifts, my grandchildren. May your lives all be filled with new adventures and exciting new chapters. To my granddaughter and future nurse, Madison—May your career bring you as much joy and happiness as mine did. May you always remember, there is a person attached to every wound. To my husband, Jim—Thank you for accepting me and supporting my drive, ambition, and career: you are and always will be my perfect partner, husband, father, and grandfather. With Love, Sharon/Mom and Gramma “Family is everything, a la famiglia” This is the motto of my parents, Phyllis and Tony; my brothers, Bob and Ron and their families; and of course me and my family. Now more than ever is this true especially as more and more of my loved ones become a blessed memory. So, thank you to my families both biological, professional, friends, and patients who have shared their experiences, supported, and nurtured me through this incredible life and skin/wound care journey. As 2020 is the international year of the nurse and the 200th anniversary of the birth of Florence Nightingale, I want to especially acknowledge all my colleagues from the professional organizations that have enriched my nursing career especially while serving in volunteer positions—National Pressure Injury Advisory Panel (NPIAP), American Professional Wound Care Association (APWCA), Wound Ostomy and Continence Society (WOCN), and the World Council of Enterostomal Therapists (WCET®). In the almost five decades of my nursing career, there are too many of you to mention individually; hopefully I have done a good job of expressing my gratitude and appreciation to you often. To: Mom, Dad, Bob, Ron, and their families for the food, laughs, and the smiles Roberta, who mentored and taught this clinical nurse specialist the skill of writing and editing over 30 years ago My “Dream Team” for having me as part of an extraordinary group of educators, authors, and researchers Katie, the sister I never had, who taught me the real meaning of unconditional friendship Sarah, whose joy of music taught me that when words fail, listen to the true meaning of healing Wendy and Andrei, who give me hope for the future of health care and the promise of tomorrow. I am so proud of you A. Scott, who brings the art through his paintings, guitar playing, and singing to balance my science. Thank you for your patience while I was busy with “the book.” Now let’s dance. Love E.A.A. Contributors Elizabeth A. Ayello, PhD, MS, BSN, RN, CWON, ETN, MAPWCA, FAAN Co-Editor-in-Chief Advances in Skin & Wound Care Philadelphia, Pennsylvania Faculty School of Nursing Excelsior College Albany, New York President, World Council of Enterostomal Therapists (WCET®) (2018-2020) Executive Editor Emeritus WCET® Journal Osborne Park, West Australia, Australia President, National Pressure Ulcer Advisory Panel (1999) Board of Director (1996-2002) Chair of 5th and 6th National Conference (1996-1997) Co-Chairperson for the 3rd World Union of Wound Healing Society (2008) Toronto, Ontario, Canada Faculty International Interprofessional Wound Care Course University of Toronto Toronto, Ontario, Canada and Abu Dhabi, United Arab Emirates Founder and Course Co-Director WoundPedia Basic and Intermediate Courses Manila, Philippines Wound Ostomy and Continence Society Chair Accreditation Committee (1996-2002; 2004-2005) Senior Adviser Hartford Institute for Geriatric Nursing President Ayello, Harris & Associates, Inc. New York, New York Sharon Baranoski, MSN, RN, CCNS-APN, CWCN, MAPWCA, FAAN Advanced Practice Nurse Nurse Consultant Services/Private Practice Chicago/Shorewood, Illinois President of International Skin Tear Advisory Panel (2009-2017) President of National Pressure Ulcer Advisory Panel (NPIAP) (1999- 2001) Board Member (1998-2006; 2016-2017) Chair of Education & National Conference (2016-2017) Dimitri Beeckman, RN, MSc, PhD, FEANS Professor of Skin Integrity and Clinical Nursing Ghent University Ghent, Belgium Professor of Skin Integrity and Clinical Nursing Örebro University Örebro, Sweden Dan R. Berlowitz, MD, MPH Professor and Chair Department of Public Health University of Massachusetts-Lowell Lowell, Massachusetts Jonathan S. Black, MD, FACS, FAAP Assistant Professor of Plastic Surgery University of Virginia School of Medicine Charlottesville, Virginia