Publication:
Surgical Technology International XX - Wound Healing
Article title:
The Use of Antimicrobial Dressings
in Chronic Wounds:
NERDS and STONEES Principles
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Author(s)
Kevin Y. Woo, PhD, RN, ACNP, GNC(C), FAPWCA
Wound Care Consultant, West Park Healthcare Centre
Director of Nursing/Wound Care Specialist, Villa Colombo, Homes for the Aged
Assistant Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
Toronto, Ontario, Canada
Abstract
Wound infection is common and delays wound healing. Validated signs included in the mnemonic NERDS and STONEES can be used to identify whether bacterial damage is superficial or deep, respectively. Clinicians must discern when bacterial damage has occurred on a timely basis and what treatment strategies to institute. A variety of topical antimicrobial agents have been developed incorporating iodine, chlorhexidine, silver, honey, topical oxygen, and topical antibiotics. Selection of appropriate strategies should be based on three key factors: healability (healable versus nonhealable), bacterial burden (colonization versus deep infection), and host risk factors. This article reviews and offers succinct recommendations pertaining to the management of wound infection in clinical practice.
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