Wound-Care Resources on the Internet. An Update

This report is intended to update information about Internet wound-care sites presented previously in the Journal [1]. Uniform Resource Locators (URLs) have been updated, new sites of potential usefulness have been added, and some of the older sites that have not been updated have been omitted. The Internet has rapidly become a convenient source of information in the area of biomedicine. As always, one must carefully evaluate all material obtained from the Web. Information and Web sites referred to in this article are intended to provide a sampling of the information available on the Internet on the topic of wound and ulcer care. As stated in the previous article, this information is for general academic discussion and should be applied in practice only after prudent consideration and podiatric medical evaluation.

Wound and Ulcer Care

Table 1 lists the URLs for Internet sites providing information on wound and ulcer care. Only newly added sites will be discussed in this article.

A very informative and well-presented site entitled Burnsurgery.org is maintained by a not-for-profit educational organization of the same name in Boston, Massachusetts. Several modules are available that guide the user through topics such as burn prevention, management of burn patients (including nutrition), and technologic advances in wound care for burns. Each module provides a wealth of information on the topic. Excellent illustrations are included that provide detailed criteria and algorithms for the management of burn wounds.

The Diabetes Ambulatory Care Centre of the Royal Prince Alfred Hospital, located in Sydney, Australia, runs Diabetic Foot Disease–An Interactive Guide. Naturally, this guide contains facts about the different foot problems encountered by people with diabetes. Foot infections, peripheral neuropathy, peripheral vascular disease, Charcot’s arthropathy, and general diabetic foot care are described. The bone scans, x-rays, and photographs make this site stimulating. The simple manner in which the information is presented makes this site beneficial for patients, particularly the sections on daily foot inspections and advice on proper socks and footwear.

The Web site of the Hawaiian Lifeguard Association in Honolulu contains excerpts from the book All Stings Considered, published by the University of Hawaii Press in Honolulu, that describe the treatment of wounds caused by the dangerous ocean organisms around Hawaii. Wounds discussed include bites, stings, and punctures from barracuda, sharks, anemones, jellyfish, and several other species. There is also a page on staphylococcal and streptococcal infections as well as general wound care. Although this site is intended for lifeguards offering first aid, it contains important information that may help if the clinician is the first person to render medical assistance.

Hyperbaric Medicine Today Online describes the use of hyperbaric oxygen in the treatment of wounds. This Web site of the journal Hyperbaric Medicine Today is administered in West Palm Beach, Florida. Multiple articles on the subject can be accessed online. The user can discover the geographic locations of hyperbaric chambers—pressurized chambers that circulate oxygen—by browsing the links section. A calendar of courses and meetings on hyperbaric topics is also available.

Updated on a weekly basis, the Intramedicine Web site is maintained by Intramedicine Inc, located in Westlake Village, California. This comprehensive integrative-medicine site provides information on natural health and wellness to health-care practitioners and consumers. The research staff reviews the full range of scientifically validated complementary and conventional medical therapies and provides clinical data in support of the synergistic nature of these medical disciplines. A medical reference guide allows consumers to search for specific health conditions and contains an informative section on wound care. The site is user friendly and easy to understand. One section is devoted to medical terminology; another section gives detailed information about drug and vitamin supplements. Viewable abstracts for the references are included.

The Association for the Advancement of Wound Care, located in Malvern, Pennsylvania, has a site of the same name that is devoted to the enhancement of clinical practice, education, research, and public policy in the area of wound care. Information about the association, updates on wound-care reimbursement issues, discussions of ethical issues, and links to other wound-care sites are provided.

The Canadian Association of Wound Care, located in Toronto, Ontario, operates a helpful site of the same name. Practice guidelines on such topics as diabetic foot ulcers, pressure ulcers, venous leg ulcers, and preparing the wound bed area can be freely downloaded from this site. In addition, users can order books on wound care, with discounts given to members of the association.

Wounds, the official Web site of the journal of that title published by the Association for the Advancement of Wound Care, is concerned with wound-care research. Produced by HMP Communications, LLC, located in Wayne, Pennsylvania, this online journal is a major source of peer-reviewed clinical research, treatment methodology, and current protocol in the field of wound care. The site is useful to a broad range of wound-care professionals and is presented in a user-friendly format. Registered users have access to additional site links such as “Educational Tools,” “Events and Symposia,” and “Archives.”

Everyday Wounds: A Guide for the Primary Care Physician is a site run by the American Society of Plastic Surgeons and the Plastic Surgery Education Foundation, located in Arlington Heights, Illinois. The section on suturing provides illustrations of many useful suture techniques and might prove very valuable to podiatric medical students entering surgical training.

The Wound-Healing.net page of the ALtruis Biomedical Network is produced by ALtruis, LLC, located in Birmingham, Alabama. This very comprehensive and user-friendly Web site is oriented toward the consumer, providing health-care and biomedical research information on various topics. The wound-care section, after providing some basic definitions of wounds, is divided into three major sections: the healing process, treatment, and dressings. A very nice feature of this well-presented and uncluttered site is the hundreds of highlighted internal links providing further explanation and detail.

SkinWound.com is maintained by Hyperion Medical, Inc, located in Celebration, Florida. The site is intended to serve both the health professional and the health consumer. One of the unique features of this site is an Online Training Manual that includes forms to document wound- or ulcer-healing progress. Nursing-care plans for wound treatment and treatment protocols for many types of wounds are also presented.

Wound Care Protocols, Inc, is a site run by an educational and consulting firm for wound and skin care of the same name located in Oregon City, Oregon. The site has a newsletter covering various pertinent topics. The newsletter’s spring 2001 issue—the most recent issue on the site—discusses relief of pain during dressing changes, pain management for lower-extremity wounds, and a comparison of the healing time of two foam dressings. The “Protocols” page gives the currently published protocol guidelines for dressing and culture techniques, wound cleansing, and obtaining ankle-brachial indices. A section on wound-care practice provides information on different dressing categories and a downloadable example of a “Skin Care Progress Chart.” A glossary page has definitions for many of the terms used when discussing wound care. Software entitled Wound Healing Protocols is available for purchase. It is designed to aid clinicians and caregivers with the assessment, documentation, and tracking of wound treatment. A section of this site is dedicated to the business of wound care, specifically dealing with managed care.

The Tissue Viability Society home page, produced by the society of the same name, is administered in Salisbury, England. The society attempts to raise the standards of practice in the prevention and treatment of pressure sores, leg ulcers, discomfort and pain, immobility, and chronic wounds. This charitable organization publishes the Journal of Tissue Viability and offers patient information booklets, which can be purchased by mail, on topics including skin care, foot care, and leg ulcers.

Wound Healer is a site owned by Stanley N. Carson, MD, of Fountain Valley, California. Pleasing and amusing graphics augment this very well referenced site. Many practical flow diagrams are available on wound classification, diabetic wounds, arterial wounds, venous wounds, and other topics. Detailed information is given on nutritional factors in wound healing, diabetic wound healing, vacuum-assisted closure, and other subjects. Links to other wound-healing sites are provided that could prove extremely helpful to the podiatric medical professional as well as the student. Finally, an international listing of meetings of potential interest to people involved with wound healing is presented.

Woundbiotech is a site run by Vincent Falanga, MD, of the Boston University School of Medicine, located in Boston, Massachusetts. The goals of this superlative site include the dissemination of information about the development and use of therapeutic products for wound healing, including the wound-healing process, common and uncommon wounds, and clinical situations of failure to heal. Emphasis is on technologic advances in the field of wound care. Several lectures are available on various topics including rheumatic ulcers involving the lower extremity, scleroderma ulcers, bioengineered skin, and the use of growth factors in wound healing.

Wounds1.com is a consumer-oriented wound-care site maintained by Body1, Inc, located in Cambridge, Massachusetts. Many topics such as diabetic foot ulcers, traumatic wounds, venous leg ulcers, burns, and keloids are presented in language the patient can understand. Also featured at this site is an interactive wound-assessment guide for the consumer. A section on pressure ulcers is also included.

Kestrel Health Information, Inc of Bristol, Vermont, maintains a site of the same name that provides health-care product directories. The site is well presented and easy to use, providing a search function by company, product, or product category. This company publishes the Wound Product Sourcebook, an annual directory of products for the prevention and healing of chronic wounds, combining clinical information with product summaries and manufacturers’ product information. An “Educational Resources” link provides helpful information on associations, continuing education, books and journals, conferences, and much more.

Pathology of Wound Healing is a site of the New York University School of Medicine, located in New York City. Slides related to wound healing, keloid formation, and fibrosis are presented along with text and interactive questions to challenge one’s knowledge of pathology. Students of pathology may find this site of particular use, as many other topics are also covered.

Antibiotic and Wound-Prevention Information

Table 2 lists Web sites containing information on antibiotics. GlobalRPH is a site run by the Veterans Affairs Medical Center in Detroit, Michigan. Created by a clinical pharmacist, this resource presents dosing guidelines for various medications as well as intravenous dilution guidelines. Also provided are drug tables, renal adjustment dosages, clinical calculators, and a search section. Especially helpful to the clinician is the infectious disease section, which contains antibiotic guidelines for cat and dog bites, diabetic foot infections, decubitus ulcers, cellulitis, osteomyelitis, and wound infections.

The Johns Hopkins Antibiotic Guide is run by the Division of Infectious Diseases of the Johns Hopkins University in Baltimore, Maryland. After a brief registration process, visitors can view the latest news and developments in infectious diseases. Navigating the site is easier after reading a list of frequently asked questions on how to use the site and the information contained within. Of utmost importance is the antibiotic guide for treating infectious diseases. Users can choose to search by diagnosis, pathogen, or antibiotic, as well as subsets of each of these topics. After narrowing down the topic, the user is given the diagnostic criteria and the appropriate treatment regimens.

Information related to prescription medication can be obtained on RxList, maintained by RxList.com of Benicia, California. This site has a database of approximately 5,000 drugs, with the information presented in a package insert format. The Rxboard is a message index that allows users to discuss the top 21 most researched drugs.

Web sites dedicated to the prevention of wounds and ulcers are presented in Table 3. Primarily government owned, these sites are very authoritative and provide a great deal of information useful to both health professionals and consumers.

Table 1. Wound- and Ulcer-Care Sites

Table 1. Wound- and Ulcer-Care Sites

Table 2. Antibiotic Information Sites

Table 2. Antibiotic Information Sites

Table 3. Wound- and Ulcer-Prevention Sites

Table 3. Wound- and Ulcer-Prevention Sites