Two Echidnae Podcast from Advancing Wound Care

Donna and Monika
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Two Echidnae Podcast from Advancing Wound Care

  1. Sep 23

    Episode 14: Putting Your Finger In It

    Inspired by a quote from Dr Brad Robinson, Monika and Donna share real cases where palpating and probing wounds revealed what photos, reports and even specialist reviews had missed, from exposed bone behind a tiny hole to undiagnosed osteomyelitis. They cover pressure injuries, foot wounds, oedema and lymphoedema assessment, tissue texture, boggy heels, friable tissue, and practical ways to build the confidence to probe gently and safely. A must listen for nurses, OTs, physios and podiatrists who want to sharpen their hands on assessment skills. Chapters 00:00 Introduction 01:40 The quote that inspired this episode 04:55 What photos miss that fingers find 07:10 Teaching OTs and physios to palpate 07:55 A sneaky stage four 08:40 How shear and position change what you feel 09:20 When photos replace proper assessment 10:35 Size does not matter 11:35 Getting comfortable with probing 12:00 Undermining measurements that differed by centimetres 13:40 Wounds hide n seek 14:15 Palpating skin 18:10 Toe to groin palpation 19:30 Striking lymph node gold 20:15 Palpating pathology 21:30 Touch v  AI 22:20 Assessing mixed aetiology through touch 25:05 Turning probe findings into precise care plans 27:20 Get to know your friendly podiatrist 28:10 Education by relationship building 29:15 A reflection on probing 33:40 Consistent positioning for consistent measurement 37:00 Wrap up and where to follow the podcast Resources mentioned: Dr Brad Robinson quote https://www.instagram.com/reel/DXiMTnYj8Is/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==   Endnotes If you enjoyed this episode please like, subscribe, leave a comment or share with your colleagues. The Two Echidnae Podcast is part of Advancing Wound Care, our online education platform for clinicians. Reach out to us on our other Advancing Wound Care Socials, where you’ll also find hints, tips and resources.  For more value, connect with us at:  Website https://www.advancingwoundcare.com.au to join our newsletter mailing list to be the first to hear about online education opportunities Email consultants@advancingwoundcare.com.au   TikTok  https://www.tiktok.com/@twoechidnae    Instagram  https://www.instagram.com/advancingwoundcare  Facebook https://www.facebook.com/advancingwoundcare  YouTube https://www.youtube.com/@TwoEchidnae  Apple Podcasts https://podcasts.apple.com/nz/podcast/two-echidnae-wound-care-podcast-with-monika-and-donna/id1773976095  Spotify https://open.spotify.com/show/7EpR6vaSM6jPSRaPMvLVZS  The views expressed in this podcast are our own and is intended specifically for healthcare professionals. Always follow your organisation's policies and procedures or refer to your healthcare provider for individual wound advice.

    Episode 14: Putting Your Finger In It

  2. Aug 9

    Episode 13: Wounds and Lymphoedema

    In this enlightening episode, the hosts engage in a rigorous exploration of the intricate interplay between lymphoedema and wound care management. They articulate the crucial role that an understanding of lymphatic health plays in the healing processes of various wounds, particularly in patients presenting with chronic conditions. The dialogue transitions fluidly through their personal clinical experiences, emphasising the need for clinicians to adopt a holistic view of patient care - wherein the assessment and management of swelling take precedence over the mere treatment of visible wounds. The hosts advocate for a paradigm shift in clinical practice, suggesting that clinicians should first interrogate the causes of swelling before attending to the wounds themselves. Timestamps  00:00 Introduction 01:20 Wound consultancy though the eyes of an accredited lymphoedema practitioner 01:55 Swelling the inflammatory soup 02:50 Wounds, lower priority than managing chronic oedema 03:30 The acetic acid, chronic oedema/lymphoedema and pseudomonas conundrum 06:40 Unwounding yourself 09:24 Exudate v lymphorrhoea 10:15 Understanding the overlap of wounds and lymphoedema 12:09 The importance of understanding lymphoedema management in wound management 13:21 Moving the big paradigm ship around (link to Wounds Australia, Australasian Lymphology Association, Beat the Swell, Australasian College of Phlebology, Roelene Faihst, Matt Cash) 17:12 Howler to industry. Is it lymphorrhoea? 19:20 Marketing dressings for lymphorrhoea handling, not just exudate 19:47 When the lymphatics are excluded in wound research 22:14 Why aren’t wound clinicians attending phlebology conferences? 23:58 The emotional lability of wound consultants who understand lymphoedema 31:01 Shout out Matt Cash from Lily Clinic 32:20 More clinicians are talking about lymphoedema 32:42 Don’t forget to refer on to a lymphoedema practitioner 34:00 Call to action for managers to support accredited lymphoedema education Resources mentioned: Matt Cash – Lily Clinic, Virginia Lily Clinic - YouTube https://www.youtube.com/@LilyClinicforlymph Roelene Faihst – Durbanville MediClinic, Cape Town https://www.instagram.com/lymph_draining_plus/ Australasian Lymphology Association https://www.lymphoedema.org.au/education-&-resources/lymphoedema-training-courses/ Beat The Swell https://www.beat-the-swell.org/ Wound Australia https://woundsaustralia.org/ Therapeutic wound and skin cleansing: Clinical evidence and recommendations https://woundsinternational.com/wp-content/uploads/2025/03/IWII_2025_Wound-cleansing-web-3.pdf The Australasian College of Phlebology https://www.phlebology.com.au/ Australasian Lymphology Association socials https://www.facebook.com/ALAlymphoedema# Endnotes If you enjoyed this episode please like, subscribe, leave a comment or share with your colleagues. The Two Echidnae Podcast is part of Advancing Wound Care, our online education platform for clinicians. Reach out to us on our other Advancing Wound Care Socials, where you’ll also find hints, tips and resources. For more value, connect with us at: Web https://www.advancingwoundcare.com.au to join our newsletter mailing list to be the first to hear about online education opportunities Email consultants@advancingwoundcare.com.au TikTok Instagram Facebook LinkedIn YouTube  Apple Podcasts  Spotify The views expressed in this podcast are our own and is intended specifically for healthcare professionals. Always follow your organisation's policies and procedures or refer to your healthcare provider for individual wound advice.

    Episode 13: Wounds and Lymphoedema

  3. Jun 7

    Episode 12: WTFoam

    This episode critically examines the use of foam, combine, crepe and skin closure strips in wound management, addressing their potential misapplications and the resultant complications that may arise from such practices. Our discussion encompasses the phenomenon of “foam fights” among clinicians, reflecting the confusion stemming from the myriad of products available, which often appear deceptively similar yet serve varying purposes. Timestamps  00:00 Introduction 00:51 WTFoam and the C word 01:47 Foam fights and confusion 04:24 Financial and clinical governance confusion 06:59 Are foams a panacea? 11:36 Foam fantasy 12:05 C words 15:34 Crepe alternatives 16:38 Combine maybe but then there’s that green dressing? 18:40 What ifs, clinical governance and risk reporting. 22:24 Enter and exit stage left – skin closure strips 25:35 Challenges and enablers of reporting harm 28:57 Summary Don’ts and Dos Resources mentioned: Edwards–Jones V, Idensohn T, Westgate S et al (2025) Dialkylcarbamoyl Chloridecoated wound dressings: An evidence review and position document. Wounds International. https://woundsinternational.com/wp-content/uploads/2025/09/ESS25_PD_DACC_WINT-web-v2.pdf Nokaneng E et al. Best practice recommendations for the prevention and management of skin tears in aged skin. Wounds International 2025. (p26). Available to download from www. woundsinternational.com https://woundsinternational.com/consensus-documents/best-practice-recommendations-for-the-prevention-and-management-of-skin-tears-in-aged-skin-2nd-edition/ Endnotes If you enjoyed this episode please like, subscribe, leave a comment or share with your colleagues. The Two Echidnae Podcast is part of Advancing Wound Care, our online education platform for clinicians. Reach out to us on our other Advancing Wound Care Socials, where you’ll also find hints, tips and resources. For more value, connect with us at: Web https://www.advancingwoundcare.com.au to join our newsletter mailing list to be the first to hear about online education opportunities Email consultants@advancingwoundcare.com.au  TikTok Instagram Facebook LinkedIn YouTube  Apple Podcasts  Spotify The views expressed in this podcast are our own and is intended specifically for healthcare professionals. Always follow your organisation's policies and procedures or refer to your healthcare provider for individual wound advice.

    Episode 12: WTFoam

  4. Jun 6

    Episode 11: Closing the wound care referral gap

    This episode delves into the essential components that constitute effective referrals to wound consultants. Monika and Donna, advanced practice wound consultants and accredited lymphoedema practitioners, articulate the critical nature of comprehensive and precise information in wound referrals, emphasising that inadequate details can significantly impede the healing process. They explore the myriad factors influencing wound care while also lamenting the frequent absence of this vital data in referrals. The conversation serves as a clarion call for clinicians to prioritise clarity and completeness in their referrals, thereby ensuring a more streamlined and effective patient care journey. Timestamps  00:00 Introduction 00:26 Competing echidnas and fun facts 03:56 Ponderings on what makes a good referral 06:30 Negligible value of a wound management chart 07:04 High value high impact information on a referral 09:45 The dream of an accurate and up-to-date medical summary 12:16 High value of knowing who is or was on the team 13:59 Yes patient/client goals by why did you want me there in the first place? 16:04 The systemic barriers to the perfect referral in non-acute settings 19:10 What do the key clinician think that they can’t say out loud or document? 21:30 Never too early to refer 22:10 Initial appearance of wound and rate of deterioration as a reference point 23:50 Bare essentials on a referral 20:15 How not to send a wound photo 26:33 When the quality of the referral reflects the quality of care 29:40 What other medical specialists have consulted 32:16 Does the wound probe to bone? 34:00 Presence and extent of cognitive impairment? 35:22 Foot wounds then who is the podiatrist? 35:46 Diagnostics 38:19 The golden elements of a referral Endnotes If you enjoyed this episode please like, subscribe, leave a comment or share with your colleagues. The Two Echidnae Podcast is part of Advancing Wound Care, our online education platform for clinicians. Reach out to us on our other Advancing Wound Care Socials, where you’ll also find hints, tips and resources. For more value, connect with us at: Web https://www.advancingwoundcare.com.au to join our newsletter mailing list to be the first to hear about online education opportunities Email consultants@advancingwoundcare.com.au  TikTok Instagram Facebook LinkedIn YouTube  Apple Podcasts  Spotify The views expressed in this podcast are our own and is intended specifically for healthcare professionals. Always follow your organisation's policies and procedures or refer to your healthcare provider for individual wound advice.

    Episode 11: Closing the wound care referral gap

  5. Feb 24

    Episode 10: Welcome to Advancing Wound Care

    In episode 10 of the Two Echidnae podcast, we say hello to double figures and welcome in Advancing Wound Care. While we are still burrowing down into prickly conversations in wound and oedema management, we are launching our new logo, website and socials as we build out online education and resources to further equip clinicians with clarity and confidence. Timestamps  00:00 Introduction 01:23 The Big News 02:40 The evolution of Advancing Wound Care 02:55 Advancing Wound Care filling the gaps in wound education 03:51 Hop on hop off 04:44 Click on the Advancing Wound Care website for updates and don’t forget the au 05:56 The arrow, the face, the heart and the star 11:23 Advancing Advancing Wound Care 11:36 The socials 12:16 We get it 14:42 Being caught in the middle and not knowing what to do 17:14 Future episode topics 19:59 Recap of our collective experience in the context of real-world clinical practice. 22:43 Both Accredited Lymphoedema Practitioners as well 22:55 Addressing the gaps between wound and lymphoedema/chronic oedema management 26:54 Shout out to current and future followers and links to all the places we hang out Resources mentioned: Advancing Wound Care https://www.advancingwoundcare.com.au Australasian Lymphology Association https://www.lymphoedema.org.au/education-&-resources/lymphoedema-training-courses/ Endnotes If you enjoyed this episode please like, subscribe, leave a comment or share with your colleagues. The Two Echidnae Podcast is part of Advancing Wound Care, our online education platform for clinicians. Reach out to us on our other Advancing Wound Care Socials, where you’ll also find hints, tips and resources. For more value, connect with us at: Web https://www.advancingwoundcare.com.au to join our newsletter mailing list to be the first to hear about online education opportunities Email consultants@advancingwoundcare.com.au  TikTok Instagram Facebook LinkedIn YouTube  Apple Podcasts  Spotify The views expressed in this podcast are our own and is intended specifically for healthcare professionals. Always follow your organisation's policies and procedures or refer to your healthcare provider for individual wound advice.

    Episode 10: Welcome to Advancing Wound Care

  6. 12/29/2025

    Episode 9: Wound measurement and photography

    Everyone (hopefully most clinicians) undertake wound images and measurements. Don’t get us wrong, these are important. But from our prickly position, they aren’t as robust in our clinical practice as many would like to think. In this episode Monika and Donna provide an experience informed conversation on the common issues with digital photography and unpack the reasons why these affect quality practice and decision making for patients with wounds. Episode 9 is jam packed with practical pearls for all clinicians to take and use no matter what their experience or setting. This episode is valuable for: novice to experienced healthcare professionals nurse, doctors and all clinicians involved in wound care managers focused on quality of care and practice improvement Timestamps 00:00 Introduction 00:49 Wound measurement and photography as a component of wound documentation 02:40 Argggh rulers 04:51 Photos as important medico-legal documentation 05:10 Ban the Ruler! 07:37 If you really feel compelled to use rulers 09:15 Controversies and lack of standardisation in wound measurement 12:43 Is your photo a true and accurate record? 13:53 Photography tips 14:33 Wound chart v photos 16:05 Flash v natural light 16:35 Doing a retrospective on your photography 17:23 When it is important to use a flash 18:27 How to make wound measurement more consistent 19:36 Best time to measure and take a photo 21:06 How often should wounds be measured? 22:03 Do the world a favour 22:50 Context of wound measurement and questions that should be answered 24:16 Circumferential wounds and shout out to managers 29:06 Measuring depth 29:51 Probing wounds 31:16 Measuring pressure injuries within an interdisciplinary team 33:00 Wound measurement and photography in Chronic Oedema 34:12 Wound Hygiene consensus resource 34:35 Do you measure the height of hypergranulation? 35:19 Don’t just look at the numbers 37:52 Photographing pitting test 38:20 The value of clinicians undertaking a lymphoedema course accredited by the Australasian Lymphology Association Resources mentioned: Murphy C, Atkin L, Swanson T, Tachi M, Tan YK, Vega de Ceniga M, Weir D, Wolcott R. International consensus document. Defying hard-to-heal wounds with an early antibiofilm intervention strategy: Wound Hygiene. J Wound Care 2020; 29(Suppl 3b):S1–28 https://convatec.showpad.com/share/NlEvPxvvOe4SF5SzTaRnK Australasian Lymphology Association - Accredited Training Courses https://www.lymphoedema.org.au/education-&-resources/lymphoedema-training-courses/ If you enjoyed this episode please like, subscribe, leave a comment or share with your colleagues. Connect with us at: Email consultants@advancingwoundcare.com.au  TikTok https://www.tiktok.com/@twoechidnae  Connect 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.

    Episode 9: Wound measurement and photography

  7. 11/15/2025

    Episode 8: Unhealable wounds

    We are back continuing on the prickly conversations, this time about unhealable wounds. How is the ability to heal determined, and how do clinicians’ factor in a wounded persons goals and priorities, sometimes when there’s conflict with health care recommendations? We discuss if palliative wounds are the same as an unhealable wound and a range of ethical considerations when caring for people with these wounds. These wound types need to be discussed more, we hope you find the content relevant and stimulating for your clinical practice. Timestamps:  00:00 Introduction 00:37 A big thank you to our audience for connecting 0:37 A big thank you to our audience for connecting 02:53 Love the feedback 03:20 How do the different professions and expertise determine what is unhealable 04:24 When an unhealable is in fact healable 05:24 How is a wound determined as unhealable 06:14 It’s not always about the healability but quality of life and symptom management 07:29 When a person is given evidence-based comprehensive information wounds can be healable 07:42 Once fully informed, despite being potentially healable, people may have different goals and priorities 08:27 Wrong information risks wrong decisions 08:35 Lack of knowledge and skills defaulting to unhealability and a “palliative” wound 08:54 What is a “palliative” wound 12:26 The unethical systemic barriers that result in unhealable wounds 13:16 Is a wound “palliative” when someone is transitioning to end-of-life care 14:23 Dying a dignified death without a wound 14:54 Medical professionals more likely to label a wound as unhealable 16:06 Lack of evidence-based wound diagnostics resulting in a wound being assessed as unhealable 16:17 Many wounds need to be biopsied 16:49 Everything is called a venous leg ulcer due to lack of diagnostics 17:29 Skin failure and the Kennedy Terminal Ulcer. Trombley-Brennan Terminal Tissue Injury 18:14 Barriers to identifying and documenting Kennedy Terminal Ulcer versus skin failure versus pressure injury at end-of-life 19:41 An evidence-based approach to determining if a pressure injury on the foot is unhealable 21:38 Questions to ask to assess if a wound is unhealable 22:44 Why are wound consultants not needed when a wound is unhealable? 22:52 Conversations around healability, capacity and dignity of risk 24:35 Healing not always an endpoint especially when linked to unrealistic claims 26:36 Healing plan vs maintenance vs palliation plan 28:42 The role of hygiene and mobility in the unhealable wound 28:54 Impacts of intersectionality and labelling a wound as non-healable 32:23 Clinical callout regarding unhealable wounds 33:15 Agency and the unhealable and healable wound 35:09 Well-being and wounds 39:04 Ethics of labelling a wound “unhealable” and moral injury Resources mentioned: Kennedy Terminal Ulcer (KTU) and Trombley-Brennan Terminal Tissue Injury (TB-TTI) https://www.caresearch.com.au/Health-Professionals/Nurses/Clinical-Care/Symptom-Management/Skin-Failure-and-Pressure-Injuries International Consensus Optimising Wellbeing in people living with a wound https://woundsinternational.com/consensus-documents/international-consensus-optimising-wellbeing-in-people-living-with-a-wound/ If you enjoyed this episode please like, subscribe, leave a comment or share with your colleagues. Connect with us at: Email consultants@advancingwoundcare.com.au  TikTok https://www.tiktok.com/@twoechidnae  Connect 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.

    Episode 8: Unhealable wounds

  8. 04/25/2025

    Episode 7: 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 Introduction 01:12 Mechanism of injury versus aetiology 02:30 The value of clinical audit and quality indicators 03:20 Misdiagnosis of Incontinence-Associated Dermatitis (IAD) 03:56 Intertriginous dermatitis misdiagnosed as IAD 05:29 The challenges of addressing gaps in clinical guidelines 06:03 Be confident to be unconfident 06:20 What is the mechanism of injury for skin loss in IAD? 07:21 When experts conclude that the simple ain’t that simple 08:45 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 ulcers 11:52 When wound education is siloed and does not replicate clinical reality 13:35 Making clinical hunches and not always on the first visit/assessment and that’s OK 13:50 Current wound documentation does not support multiple aetiologies and impediments to healing 14:00 Challenge of teaching clinical realities to students when they are taught in siloes 14:33 Figuring out what is the predominant aetiology 14:50 How do we define and teach simple versus complex wound 15:13 Mixed aetiologies presenting above and below the groin 15:56 Prioritising which aetiology to treat / manage 16:57 Post operative wound dehiscence and lymphoedema 17:48 Capacity building in lymphoedema 19:27 The need for clinicians working in Hospital in the Home to understand lymphoedema 19:43 The challenge of diagnosing inflammatory conditions such as IAD and intertriginous dermatitis of the pelvic girdle 20:30 Influence of climate on dressing performance and skin injuries 21:00 Mixed aetiologies of the pelvic girdle 22:20 Is IAD avoidable and how easy is it to categorise, manage and report 24:00 Continue reevaluating aetiology 24:12 It is OK change or add to aetiology if clinical rationale can be provided 24:57 Call it what it is. A vascular assessment includes arteries, veins and lymphatics, not just the arteries 25:21 Venous disease plus a wound on the same leg does not necessarily mean the wound is of venous aetiology 26:57 Mechanism of injury v aetiology v impediments to healing. Simple v complex 28:40 Opportunities to improve accuracy of wound data reporting and quality improvement 30:27 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-iad Australian 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-injury If you enjoyed this episode please like, subscribe, leave a comment or share with your colleagues. Connect with us at: Email twoechidnae@gmail.com  TikTok https://www.tiktok.com/@twoechidnae  Connect 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.

    Episode 7: Wound aetiology vs mechanism of injury
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Two Echidnae Podcast from Advancing Wound Care

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