6D AGO

Ep10 - Welcome to Advancing Wound Care

29 min

12/30/2025

Ep9 - 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 professionalsnurse, doctors and all clinicians involved in wound caremanagers 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/NlEvPxvvOe4SF5SzTaRnKAustralasian 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 a...

42 min

11/15/2025

Ep8 - 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-InjuriesInternational Consensus Optimising Wellbeing in people living with a wound a href="https://woundsinternational.com/consensus-documents/international-consensus-optimising-wellbeing-in-people-living-with-a-wound/" rel="noopener noreferrer"...

45 min

04/25/2025

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 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-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-injury If...

34 min

02/23/2025

Ep6 - Wound Education, from novice to who is the expert?

Wound Education, the subject everyone wants, from novice to expert, but where so many barriers exist to getting it just right. In this episode we burrow down into a recent Australian publication discussing recommendations for undergraduate wound education. This is another prickly concept our listeners will have dealt with and have opinions on, no matter what your discipline, experience level or clinical setting. So let's know what your thoughts are because we will talk more in future episodes about the status of wound education. Timestamps: 00:00 Intro 00:34 Wound education for novice clinicians 01:34 Novices desperate for education 03:35 The needs of wound management education for medical staff 05:15 The assumption that everyone in the healthcare workforce has basic wound care knowledge 06:45 Critiquing research on wound education 09:32 How is the term wound expert defined 10:36 Academic wound education models versus clinical realities and the needs of clinicians 11:10 Irony of clinicians requesting advanced wound education when the basics are not understood 12:08 Fragmented, illogical, or misrepresented content 14:02 Polysemy in healthcare 14:32 What is a simple wound? 14:44 What is a wound? 15:34 Challenges of developing clinically realistic educational wound frameworks 15:47 A tiny wound 17:15 Sterile versus clean technique. Really really? 17:39 Coveting and naval gazing 19:35 Translating academic wound educational models into clinical practice 20:42 When “new” evidence is based on superseded guidelines 21:59 Clinically relevant undergraduate education 22:26 What about foundational content for consistent safe practice 23:04 What’s on the wall of your treatment room that can guide you 23:31 When foundational content is advanced in clinical reality 24:44 Recommended foundational content 26:54 Need for real-world research 28:10 Opportunities for nurse coaching/mentorship 29:10 Are wound management standards and expectations too high? 30:35 When non wound “experts” talk on expert wound topics 31:31 Profiling what wound management experts do 33:06 Read the antibiofilm and International Wound Infection documents for clinical pearls Resources mentioned: The Australian Guidelines for the Prevention and Control of Infection in Healthcare 2019 are published on the MAGICapp allowing for ‘point of care’ use where the guidelines can be viewed on any tablet, phone or computer (updated multiple times a year).Haesler E. and Carville K. (2023). Australian Standards for Wound Prevention and Management. Australian Health Research Alliance, Wounds Australia and WA Health Translation Network.a href="https://www.magonlinelibrary.com/doi/full/10.12968/jowc.2022.31.Sup4a.S1?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org" rel="noopener noreferrer"...

35 min

01/19/2025

Ep5 - Let's start measuring up compression

Compression, the topic everyone has experience with, an opinion on, and something to learn - including us. This will be the first episode of many on compression because there is so much to unwrap. We would love to hear your feedback on this one as we touch on so many points. Timestamps: 00:00 Introduction 01:00 How lymphoedema training has informed our practice as wound consultants 02:11 Looking wholistically at hard-to-heal wounds through a lymphoedema lens 02:33 Clearing oedema in proximal body parts first before moving oedema in the legs 03:10 Assessing oedema 03:32 The problem of less research and experience in non-cancer related chronic oedema than cancer-related 04:14 Location and distribution of fibrotic tissue composition 05:05 Lymphoedema wound nurses the outliers 06:42 Where are the compression companies at wound management events? 07:55 Wound clinicians without lymphoedema training do not understand compression prescription in chronic oedema 08:09 Prioritising lymphatic function and compression over wound hygiene, including debridement 10:12 Reluctance of some allied health professionals to apply lower limb compression in the presence of wounding 11:22 Practice gaps in wounds and compression prescription 12:54 Motivation to understand more about lymphoedema 13:51 Myth of venous oedema being different to lymphoedema 14:00 More on reluctance to treat chronic oedema when wounds present 14:48 Lymphoedema escalation pathway 15:11 Becoming a lymphoedema mentor 15:43 Self-care in lymphoedema 16:18 The gaps in staging lymphoedema 16:40 Inadequate compression prescription, application and troubleshooting leading to bad patient experiences and money down the drain 17:36 What do we mean by the term “tolerating” compression? 21:34 Using the term” they don’t tolerate” compression when it is the healthcare system that is intolerable 22:09 The S.T.R.I.D.E. document to guide compression selection 23:11 Practical considerations when using S.T.R.I.D.E. principles 25:36 Round versus flat knit garments 27:31 Wound lymphoedema clinicians have two computers of formulary open simultaneously 28:52 More on round versus flat knit 30:47 Muffin-topping a red flag that compression needs to be applied into the thigh or higher 32:19 The Australasian Lymphology Association resources and courses 32:56 When nurses speak the same language around wounds and chronic oedema 34:38 Prioritise leg hygiene, understanding chronic oedema before debridement and dressings 36:38 The influence of industry on the science, education and clinical practice of wound management Resources mentioned: STRIDE document https://lymphoedemaeducation.com.au/wp-content/uploads/2019/07/S.T.R.I.D.E.-Professional-Guide-to-Compression-Garment-Selection-for-the-Lower-Extremity.pdf (if you’re curious what STRIDE stands for, it’s Shape, Textile Type, Refill, Issues, Dosage, aEtiology)Australasian Lymphology Association https://www.lymphoedema.org.au/ 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...

40 min

12/30/2024

Ep4 - Monika and Donna's path to Wound Consultancy

Join Mon and Don as we burrow into our journey's to wound consultancy. We hope you learn a little more about what has shaped us as individual wound clinicians, as we share some of our defining professional experiences as nurses. Timestamps: 00:00 Get to know us 00:56 Mon’s journey 02:38 High value education and training 02:38 Benefits of lymphoedema education and training in wound management 03:09 How the podcast started 03:59 Alternative pathways to wound consultancy 07:20 The complexities of wound management across the sectors 09:52 Don’s journey 10:33 The fundamentals of wound care 10:45 Advanced practice in the community setting, going back to basics and helicoptering 12:25 High value, low-cost benefits of washing legs 14:36 Takes time to save time 15:25 Advantages and opportunities in community nursing and wound management 17:01 The value of the helicopter view in wound consultancy 17:22 Workplace culture as a barrier to best practice wound care 18:30 More benefits of lymphoedema education and training in wound management 19:19 Trauma-informed and weight-neutral care 19:58 Can’t get to the wound unless you go through the head 20:24 Wound management is not about the dressing and it’s not even about wound care 20:59 I should be a psych nurse with skills in chronic disease 23:00 Changing the language of wound consultancy 24:08 Recommended PhD topics for hard-to-heal wounds 25:19 The trauma stories of wounding 25:29 Misunderstanding the term non-concordant 26:23 Wound care is not always about looking at the wound 28:44 The importance of networking and future episode topics 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.

31 min

11/15/2024

Ep3 - Wound aetiologies, teaser topics and more

We celebrate reaching 3 episodes with a lot more prickly topics affecting anyone attending woundcare. Join Mon and Don as we burrow into the issues inherent in reaching a wound aetiology - or is that a mechanism of injury? How confident are we? What are the barriers and pitfalls and are we setting unrealistic expectations for the everyday clinician in documentation that informs the care planning? Timestamps: 00:00 Celebrating making the third pancake 04:31 Not as simple as just telling someone what to put on the wound 10:53 Wound aetiologies and broader issues 12:03 Siloing aetiology and treatment 13:09 Unrealistic expectations of general and wound care clinicians to determine aetiology 17:49 Mechanism of injury vs aetiology, do humans fit into a box? 18:56 When wound charts don't support complexity 20:13 What is a hard to heal wound 20:48 Limitations of wound documentation systems including EMR 25:45 Wound education is not a panacea 27:43 Health economics and healthcare systems affecting wound outcomes 28:15 Raising awareness and reflections for future episode topics for emerging and more advanced clinicians 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.

31 min

10/31/2024

Ep2 - When wound care isn't just about the person with a wound

Let's continue burrowing down into prickly conversations. Join Mon and Don as we unpack caring for the carers including the array of clinicians (nursing, allied, medical) plus formal and informal carers. Everyone plays a role in determining what happens to the person's wound. Timestamps: 00:00 Caring for clinicians and carers 06:56 The community nursing team, does it match the needs of the person with a wound? 12:45 The challenges of a depleted workforce and lost skills 14:58 When complex skills are required such as debridement and compression, the cons of a risk averse, task-oriented system 17:10 When caring for the team sometimes means saying 'no' when foundational interventions aren't being attended. Challenges when clinicians disagree 23:58 Puggles (baby echidnas). Clinicians seeking a career in wound management. Using foundational versus advanced treatments 26:01 Is puggle-ise a word?. Infantilising concepts in wound management 26:52 Reflective practice. Passing on the mantle of knowledge. 28:33 Future prickly topics 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.

32 min

10/15/2024

Ep1 - Listen in as we kick off our prickly conversations

Are you a clinician interested in wound care? Maybe you're just starting or know a little about hard to heal wounds? Or are you more seasoned in your career? Perhaps you work in the community, aged care, a hospital or a subacute setting. Join Monika and Donna, 2 advanced practice nurses and lymphoedema practitioners, as we kick off and introduce our wound care podcast. In our first episode, we discuss why we're here and why the name 'Two Echidnae'. We are so excited to be sharing with other clinicians (not just nurses), our experience and frustrations inherent in the discipline of wounds. Humour is essential. We will be burrowing down into some prickly conversations, digging up myths and chewing over real-world evidence. Timestamps: 00:00 Intro 00:40 Who we are 02:22 Why a wound podcast? 07:55 Why the name Two Echidnae? 10:20 Why a wound care nurse is like an Echidna? 24:50 What to expect from our podcast 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.

29 min

Two Echidnae Podcast from Advancing Wound Care

Episodes

Ep10 - Welcome to Advancing Wound Care

Ep9 - Wound Measurement and Photography

Ep8 - Unhealable Wounds

Ep7 - Wound Aetiology vs Mechanism of Injury

Ep6 - Wound Education, from novice to who is the expert?

Ep5 - Let's start measuring up compression

Ep4 - Monika and Donna's path to Wound Consultancy

Ep3 - Wound aetiologies, teaser topics and more

Ep2 - When wound care isn't just about the person with a wound

Ep1 - Listen in as we kick off our prickly conversations

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