APWCA NEWS UPDATE
February 2010

Opening Statement:

APWCA continually seeking growth and new members
APWCA, “Synergy of Disciplines in Wound Care” — The APWCA Motto — It Matters!

All types of wound care providers are vital to the goals, objectives and the principles on which this Association was founded. APWCA is the leader in promoting a synergistic quality that represents best practice and best outcomes for wound care patients. So join with our Board of Directors who have committed to bringing in at least one new member this year. There is not a more cost effective organization in wound care: providing terrific education, provider and patient advocacy, representation to insurance carriers, coordinating members to provide medical relief in Haiti, and so much more!!  So help us help you!!  

As we continue to grow we have increasing ability to provide more services and address more of your needs to  provide best care and be reimbursed properly. Sit back and enjoy catching up on APWCA through this eMail News Update.

In Case You Missed it - Updated Billing News

CPT codes finally included for the Application
of below knee multi-layer venous wound compression system

Marcia Nusgart, RPh, APWCA member reports that the AMA recently released its CPT codes, and finally the code for "Application of multi-layer venous wound compression system, below the knee" was included. The code is 29581 and will be in effect January 1, 2010.  The 29581 CPT code was assigned to an APC group 0058 which has a reimbursement rate of $71.03 for 2010. 

This is certainly good news and as reported in previous eMail News Updates has been something which APWCA has worked on for the past several years along with the Alliance of Wound Care Stakeholders for which Ms. Nusgart serves as executive director. We all thank and congratulate the Society of Vascular Surgeons (SVS), who submitted the application, for their leadership and to all others involved. 

APWCA believes our next challenge will be to ensure that the Medicare MACs are knowledgeable about this new code. Look for a more detailed article on this in the next APWCA eMail News update.

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APWCA2010 - APWCA National Clinical Conference

APWCA welcomes the American College of Hyperbaric Medicine (ACHM)

April 8-11, 2010 – Philadelphia, PA

Have you registered for the meeting yet?  Here is your opportunity to gain 30 CME/CE Credits at  Reduced Rates.  Rate increases start February 23.  Register early to obtain best course selection as some have limited seating and be sure to secure your hotel registration in the conference hotel!  As a member, you save up to $140 in a full conference package.

For information, lecture schedule and registration and hotel links:

http://www.apwca.org/apwca2010

For Hotel Room Registration at the Sheraton Conference Hotel click here.

Register today and save. Early Bird Rates end Feb 22
Remember: Thursday Evening Lectures and Dinner Symposium are at NO ADDITIONAL FEE!

Earn Additional CME/CE with great lectures and a terrific dinner symposium, open to ALL Preconference and/or General Session Registrants. The Dinner Symposium will sell out so register Early to Secure your seat for a terrific, interesting and social evening!  Have an opportunity to network with fellow colleagues and listen to over 40 faculty members, internationally renowned for their expertise in wound care.

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Darlene McCord, Ph.D., FAPWCA, will be busy at the 2010 APWCA Conference

Darlene McCord will be featured at a signing of her book, “Living Well at One Hundred”; her company, Pinnaclife, Inc., will host an exhibit booth, and she will moderate the Annual Scientific Address. 

Dr. McCord’s book combines her personal and professional perspectives on good health and healthy aging.  It offers a simple, straightforward approach to living well into your later years by achieving wellness and avoiding illness. To learn more and to read excerpts from “Living Well at One Hundred,” visit http://www.LivingWellatOneHundred.com. The book is available to purchase through that site or at www.Amazon.com and www.BarnesandNoble.com.

APWCA's past President Robert Gunther, DPM, FAPWCA, and his wife Linda will join the Pinnaclife team at their exhibit booth throughout the conference.  Dr. McCord and her husband founded the company in 2008.  Based in Coralville, Iowa—in the heart of the Midwest—Pinnaclife is a nutritional supplement company built upon Dr. McCord’s well-known Olivamine®.  Olivamine is also found in the Remedy medical skin care brand that currently enjoys the number one position in the hospital and long‐term care markets.  To learn more about Pinnaclife, visit http://www.pinnaclife.com.

From 2 to 3 p.m. on Saturday, April 10, Dr. McCord will moderate the Annual Scientific Address. APWCA Executive Director Steven Kravitz, DPM, FAPWCA, will discuss “Can We Slow Skin Aging Process? How does that Effect Disease?”

This is the largest APWCA meeting to date providing a comprehensive picture with a full scope of practice options, patient treatment and management concepts for best practice and business that matters covering and coding and billing aspects of daily practice.  The conference is designed to be immediately applicable to daily practice.  

Full outline of the scientific programming, and registration: http://www.apwca.org/apwca2010.

TIP: Register early as preconference courses all have limited seating!  Be sure to check out the wide selection of Pre Conference Courses that will fit the needs and interests of anyone in wound care... from the provider new to those with years of experience.

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APWCA congressional update and a perspective from Founder and Executive Director: Steven Kravitz, DPM, FAPWCA

Congress resumes sessions this week after the historic closing of Washington, DC from all but emergency business due to one week of two record breaking back to back snow storms. We are looking for Congress to stop the 21.2-percent Medicare fee reduction that is scheduled to start on March 1, when the 2-month freeze at 2009 rates expires. The Senate a few weeks ago already extended the freeze until October 1. We are monitoring and will keep you posted. There is no doubt or at least no doubt by APWCA that the short term extensions to prevent the fee reduction does not resolve the problem. There at some point needs to be a consensus to address this with a more permanent approach that deals key issues rather then this “patch” approach. We are not alone. Other medical groups have been in the news expressing a similar viewpoint.

Information is also available by contacting the APWCA offices at wounds@apwca.org or 215-364-4100.

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OIG and Medicare News

From Legislative & Regulatory Update For All Coalitions Provided by Marcia Nusgart, R.Ph., AAPWCA, Executive Director, Alliance of Wound Care Stakeholders, Bethesda, MD

CMS Issues "Various OIG Reports That Have Medical Review Implications"

On January 15, 2010, CMS issued a transmittal on "Various OIG Reports That Have Medical Review Implications, "which provides instructions to contractors to take steps to strengthen program safeguards to prevent improper payment for areas identified by the OIG.  Reports highlighted by CMS include the OIG's reports on "Inappropriate Medicare Payments for Pressure Reducing Support Surfaces" and "Comparison of Prices for Negative Pressure Wound Therapy Pumps."  CMS instructs contractors to use the information contained in the OIG reports and follow the processes and procedures already in the Medicare Program Integrity Manual concerning data analysis, contractor strategies, and the progressive corrective action process.  The transmittal is posted here.

Medicare Payment Advisory Committee (MEDPAC) - MedPAC Recommendations for Home Health and Skilled Nursing in its March 2010 Report to Congress

Home Health Recommendations:

•   Home health agencies will not receive a payment update for fiscal year 2011 under a Jan. 14 recommendation by the Medicare Payment Advisory Commission (MedPAC).In a series of unanimous recommendations, commissioners voted to eliminate the marketbasket payment update for the provider group next year while requiring the Department of Health and Human Services to rebase home health's base payments to better reflect the cost of providing care.

•   Commissioners also said that fraud and abuse in home health needs to be addressed more aggressively. Currently, Medicare lacks the authority to stop enrolling providers when fraud accelerates in areas with known risks. Several patterns, including geographic variation in home health use, suggest that increased scrutiny is necessary, commissioners said, echoing results published in a MedPAC report released in December 2009 (229 HCDR, 12/2/09).                         
•   Commissioners also recommended that the HHS secretary modify the home health prospective payment system to create a financial safeguard that would protect home health beneficiaries from provider stinting or giving a lower quality of care in response to the payment rebasing.

•   HHS identify the groups of beneficiaries most likely to benefit from home health care and develop outcomes measures for quality of care.

•   Centers for Medicare & Medicaid Services to review home health agencies that exhibit unusual patterns of claims for payment. The recommendation also called for Congress to provide additional authority to implement safeguards, like a moratorium on new providers or a suspension of prompt payment, in areas that appear to be at high risk for fraud.

Skilled Nursing Recommendations:

•   MedPAC commissioners also voted to eliminate the fiscal 2011 marketbasket update for skilled nursing facilities (SNFs).

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APWCAinternational

Haiti Volunteer Project
We have 60 responders as volunteers to travel to and provide relief services for wound care. We are working jointly to support efforts put together by Dr. Robert Kirsner through the University of Miami. Our volunteer are in the process of filling out the required material with Dr. Kirsner and the Department of Homeland Security.  Additional members that may want to volunteer can click here.

Taiwan – Asian trip planning meeting during APWCA2010

APWCA members interested in the APWCA follow up trip to Taiwan: APWCA2010 will host a planning meeting. Time table for venue, July 2010 or Sept-Oct 2010.  Conference Registrants interested in attending a planning session should contact APWCA at 215-364-4100 or Wounds@apwca.org.

Israel Joint Conference
Early planning discussion, Conference Registrants interested in attending a planning session should contact APWCA at 215-364-4100 or Wounds@apwca.org 

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Website Member Directory
To Go LIVE ONLINE the end of February
Update your Online profile if you have not already accomplished this

APWCA Membership Directory is operational, currently running in the background and hidden on the website. We have automatically entered your contact information based on your existing membership profile. Before we open for access, we need to make sure that the data for each member is correct and that members have the ability to participate or drop out and not be listed.  The default is to opt out and therefore any member not contacting the site to confirm or update and correct their profile will NOT be listed in the directory.  We are asking ALL members to take just a few minutes and modify and/or correct as appropriate their contact information and select how their information will be used.

There are three options:

1. Participate with Access to Public at Large & Membership
2. Participate with Access to Membership Only
3. Opt-Out and not participate with the directory (This is the Default) 
   
   

Get involved!
To Add Your Practice(s) to the Directory – Visit http://www.apwca.org/member

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SCALE Final Consensus Statement Released

Following over a year and a half of effort, the SCALE Panel is pleased to announce the release of the Skin Changes At Life’s End (SCALE) Final Consensus Statement.  An international panel of 18 members developed the document that was then peer reviewed by 51 Distinguished Reviewers from around the world.  The final document went through a modified Delphi process and has been submitted for publication to wound, geriatric and hospice journals.

The SCALE Final Consensus Statement and an Annotated Reference List can be downloaded free of charge from: www.gaymar.com  > Clinical Support and Education > SCALE Consensus Documents

Please share this important document with colleagues and stakeholders.

Cutaneous Biopsy Techniques in the Management of Chronic Wounds

Bradley Bakotic, DPM, DO

Many clinicians rely exclusively on clinical acumen when determining how to manage chronic wounds. Though an ulcer’s clinical features may be fairly indicative of its etiology, in some instances, such is not the case. Even among the most characteristic-appearing ulcerations, masqueraders do exist.  Ruling out the possibility of an unsuspected neoplastic or inflammatory condition could be necessary for the successful management of chronic wounds.   In this context, cutaneous biopsy techniques may be invaluable; however, their utility does not necessarily end here.

There are three common clinical settings in which a biopsy may be used in the management of a chronic wound. Clinicians may use histopathology to 1) confirm a clinically suspected diagnosis at the outset of care, to 2) rule out a mimic in cases where a wound is showing recalcitrance or unusual progression, to 3) assess for an underlying predisposing condition independent of the ulceration, or to 4) assess for compounding feature, such as an excessive bacterial burden.  Because the clinical presentation of cutaneous ulcerations may be virtually pathognomonic of a particular etiology, the first of these scenarios should not always give rise to a biopsy; however, in some instances, confirmation is warranted.  In a minority of cases, the clinical manifestations that surround an ulceration are entirely nonspecific and a biopsy is indicated prior to the initiation of medical care.

For wounds that appear characteristic of a particular etiology, biopsies are usually not initially necessary; however, as a rule of thumb, biopsies should be considered for all ulcers that cannot be readily explained or fail to show improvement after 2 months of treatment. In instances such as this, biopsies are being used to verify that the implemented therapeutic regimen is appropriate. Delays in the diagnosis of some mimics may be medicolegally treacherous. For instance, malignant melanoma, particularly amelanotic variants, may create ulcers that are virtually identical to non-neoplastic ulcers. Delays in this diagnosis may have serious implications with regard the affected patient’s outcome.   Simply stated, the failure to reassess ones differential diagnosis in cases where ulcerations show unusual clinical behavior, or recalcitrance, is may be a direct cause of increased morbidity.

An additional clinical setting where a biopsy might prove useful in the management of chronic wounds, involves patients with suspected neuropathy as a predisposing condition. With a 3mm punch biopsy of skin, taken for 10 cm above the lateral malleolus, physicians may qualify and quantify the presence of small fiber neuropathy. Degenerative changes among the intra-epidermal nerves, may further be to predictive of the future onset of small fiber neuropathy. Though this examination uses a simple 3mm punch of skin, there are differences in the handling of biopsies taken for this purpose. Most important among these differences are that punches taken for epidermal nerve fiber density testing require a specialized fixative that must be requested from the lab, and care must be taken to avoid crushing the surface epithelium when removing the tissue from the biopsy site. Formalin fixative renders the biopsies useless for small fiber analysis.     

In most instances, the biopsy technique of choice for verifying the cause of an ulceration, assessing for neoplastic and non-neoplastic mimics, and characterizing predisposing conditions, is a punch biopsy.  In the initial two settings, a central and peripheral 3mm punch is usually sufficient; however, the identification of vasculitis may require additional random punches in hopes of sampling an effected vessel. As aforementioned, epidermal nerve fiber density analysis requires the same 3mm punch taken at 10cm above the lateral malleolus. To document length dependence, (as would be expected in bona-fide cases of small fiber neuropathy), clinicians may also perform a punch biopsy on the ipsilateral side, 10cm distal to the greater trochanter of the femur.       

Biopsies are not a silver bullet in the management of ulcerations; however, clinicians should keep them in mind when the indications present themselves. Not uncommonly, these techniques make all the difference!

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Update from The Effect of Blood Sugar Control on Healing Diabetic Foot Ulcers
Nancy Collins, PhD, RD, LD/N, FAPWCA; and Liz Friedrich, MPH, RD, LDN

The relationship between nutrition and wound healing is well recognized by the health care community. Today, registered dietitians (RDs) are included as members of the wound care team in most facilities to assure optimal nutritional interventions for both prevention and healing. However, the focus is most frequently on pressure ulcers, particularly in long-term care. While nutrition professionals have become quite familiar with interventions for this type of wound, many other types of skin integrity issues exist, including foot ulcers caused by diabetes. A thorough understanding of the relationship between diabetes and wound healing is essential, so that nutrition professionals can contribute to the management of this type of wound as well.

Phases of Wound Healing

Wound healing occurs as a cellular response to injury and involves the activation of many different cell types.(1) A variety of growth factors and cytokines released by these cells are needed for wound healing. Some key components involved in wound healing are outlined in Table 1. Wounds heal in three phases. The first phase, inflammation, involves vasoconstriction of small blood vessels, and an influx of inflammatory cells and plasma proteins to mediate cellular repair. The second phase, proliferation, involves fibroblastic activity and angiogenesis by endothelial cells. During this phase, granulation tissue is generated. The third phase is maturation, where collagen synthesis and breakdown occurs. This phase can last up to 2 years.(2)

When cells involved in any of these stages are impaired because of diabetes, wound healing is impaired. According to one source, more than 100 different physiological factors contribute to wound healing problems in people with diabetes.(1)

Effects of Hyperglycemia

Hyperglycemia can affect wound healing, both long term and short term. Uncontrolled blood sugar levels over time lead to peripheral neuropathy, which is a cause of chronic foot ulcers. By one estimate, 20% to 49% of older adults with diabetes have neuropathy, peripheral vascular disease, or both.(3) Those with peripheral neuropathy lose feeling in their feet and hands. In the event of a callous, scrape, or skin breakdown at a pressure point on the foot, the patient may not notice the wound, because pain is not felt. Diabetic foot ulcers, also known as neuropathic ulcers(4), rarely heal well and are complicated by peripheral vascular disease or other circulatory problems. As many as 15% of adults with diabetes will develop chronic ulcers during their lifetime.(2)

Acute episodes of hyperglycemia, even in newly diagnosed patients with diabetes, can make wound healing more difficult. Several cellular mechanisms involved in wound healing are affected when blood sugar levels are high. For example, granulocytes show impaired function in the presence of high blood sugars, especially in the inflammatory phase of wound healing.(5) A delay in the inflammatory response may prevent formulation of granulation tissue.(5) Uncontrolled blood glucose also impairs blood flow through the microvascular system at the wound surface by impeding red-blood-cell permeability, preventing flow of oxygen and nutrients to the cells, and increasing cell wall rigidity.(6) Experts agree that controlling blood sugar on a day-to-day basis can help expedite wound healing. Unfortunately, no recommendations pinpoint a certain blood glucose level or HbA1c level, which may contribute to impaired wound healing.

In addition to the direct effect of diabetes on wound healing, individuals with diabetes are at an increased risk of infection, because of decreased host resistance. Infection can have a separate effect on blood sugar, resulting in a delayed healing process.(6)

Nutritional Goals

Medical nutrition therapy for patients with diabetic foot ulcers should focus on maintaining skin integrity and controlling blood sugar levels. Adequate protein is necessary to support the growth of granulation tissue.(7) While specific recommendations for nutrition care for patients with diabetic foot ulcers are not available, it seems prudent to follow the general guidelines for pressure ulcer healing. This includes 30-35 calories/ kilogram (kg) body weight, 30 milliliters (mL) of fluid/kg body weight, and 1.2-1.5 grams (g) protein/kg body weight. Comorbid conditions may affect these guidelines. Dietitians should evaluate HbA1c levels, finger-stick blood sugar results, and blood glucose levels, but use HbA1c as the primary target for glycemic control.(8) Regular monitoring and evaluation of body weight trends, meal consumption, lab values, and the wound healing progress are essential. Dietitians should use clinical judgment to modify the nutrition plan of care based on these findings.

When treating patients in long-term care, the goals may differ from those for younger patients in an acute or rehabilitation setting. Clinicians are divided on the degree of aggressiveness for managing blood sugar levels. Older adults who are functional, cognitively intact, and have significant life expectancy should use treatment goals for diabetes that are designed for younger adults.(8) These guidelines are outlined in Table 2 and suggest a target HbA1c of < 7%. For institutionalized older adults with a life expectancy of <5 years, a target HbA1c of 8% sometimes is more appropriate.(3) However, according to the 2009 Standards of Medical Care In Diabetes, attempts to control blood sugars are necessary if patients experience side effects such as dehydration or poor wound healing, even in those individuals with life-limiting illnesses or substantial cognitive impairments.(8)

Achieving glycemic control in long-term care patients often is difficult. Frail elderly patients sometimes are unwilling or unable to comply with medical regimens. Acute infections such as urinary tract infections, which are common in nursing home patients, may increase glucose levels.(3) Many commonly prescribed medications can cause hyperglycemia, including thiazide diuretics, antipsychotic agents, glucocorticoids, and megestrol acetate.(3) Reducing or eliminating medications in an attempt to reduce hyperglycemia is not a realistic approach for many patients.

Most experts agree that patients in long-term care are best treated by modifying the dosages of oral hypoglycemic agents or by administering insulin, rather than by mandating dietary changes. This is especially true for those patients whose meal intake already is poor and may worsen by placing additional restrictions on what foods are allowed. In most cases, a liberalized diet is appropriate in long-term care, even in patients with elevated blood-sugar levels. To maximize wound healing in patients with diabetes, the wound care team must attempt to find a balance between medical necessity and quality of life, and develop a plan of care for each patient that reflects that balance.

Table 1: Key Components for Wound Healing(2)

Table 2: Summary of Glycemic Recommendations for Nonpregnant Adults With Diabetes(8)

References

1.    Brem H, Tomic-Canic M. Cellular and molecular basis of wound healing in diabetes. J Clin Invest. 2007;117:1219-1222.

2.    Dinh T, Pham H, Veves A. Emerging treatments in diabetic wound care. Wounds [serial online]. 2002;1. Available at: www.woundsresearch.com/article/138. Accessed April 1, 2009.

3.    American Medical Directors Association. Diabetes Management in the Long-Term Care Setting: Clinical Practice Guidelines. Columbia, MD: AMDA; 2008.

4.    Takahashi PY, Kiemele LJ, Jones JP. Wound care for elderly patients: advances and clinical applications for practicing physicians. Mayo Clin Proc. 2004;79:260-267.

5.    Lioupis C. Effects of diabetes mellitus on wound healing: an update. J Wound Care. 2005;14:84-86.

6.    Litchford MD. The Advanced Practitioner’s Guide to Nutrition and Wounds. Greensboro NC: Case Software and Books; 2006.

7.    Steed DL, Attinger C, Colaizzi T, et al. Guidelines for treatment of diabetic ulcers. Wound Repair Regen. 2006;14:680-692.

8.    American Dietetic Association. Standards of medical care in diabetes—2009. Diabetes Care [serial online]. 2009;32(suppl 1):S13-S51. Available at: http://care.diabetesjournals.org/cgi/reprint/32/Supplement_1/S13. Accessed April 1, 2009.

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NYU School of Medicine

The Department of Surgery at NYU Langone Medical Center is seeking to recruit a General Surgeon, for The Helen & Martin Kimmel Division of Wound Healing & Regenerative Medicine under the direction and leadership of Harold Brem, MD.

The Division of Wound Healing is seeking a general surgeon with an exclusive practice for non-healing wounds for treatment of long term non-healing surgical wounds, specifically pressure ulcers, venous ulcers, diabetic foot ulcers. They will spend approximately three days a week in main OR and one to two days in wound center. Academic rank will be consistent with experience.  The Helen & Martin Kimmel Division of Wound Healing & Regenerative Medicine is a highly academic practice and environment focusing on Regenerative Medicine. It is a highly collaborative group of general, plastic surgeons and vascular surgeons.

Interested individuals should send their CV to the Helen and Martin Kimmel Program Manager Tracy Henry via email to tracy.henry@nyumc.org

Excellent Opportunity in Family and Outdoor Oriented Community

The Wound Healing and Hyperbaric Center is seeking a dynamic, highly motivated physician with wound care and hyperbaric certification to join our IM/wound care/hyperbaric physician in a hospital-owned facility located in Clarkston, WA, supported by two mono place hyperbaric chambers and serving an existing regional patient base.  FT clinic position includes consultations in two local hospitals.  Team approach in collegial medical community involving many specialties. Innovative approaches, aggressive and proactive management of problems involving the total patient health and a passionate and enthusiastic staff.  

Interested individuals please send CV to the Tri-State Wound Healing and Hyperbaric Center via e-mail to:  

skramer@tristatehospital.org or call Sandi Kramer at 509-758-5511, X5406.
 
Related links:
http://www.tristatehospital.org/wound/wound.html - http://clarkstonchamber.org/

LIMB PRESERVATION/PODIATRIC SURGEON POSITION AVAILABLE
MADIGAN ARMY MEDICAL CENTER, TACOMA, WA

Chief, Limb Preservation Service: The Vascular Surgery Service in the Department of Surgery at the Madigan Army Medical Center is recruiting a Podiatric Foot and Ankle Surgeon to be Chief of the Limb Preservation Service. Madigan Army Medical Center, a combined inpatient and outpatient level II trauma center, is a comprehensive military training facility in the Pacific Northwest serving active duty personnel, military retirees, and family members. The Chief of the Limb Preservation Service will be responsible for out-patient clinic and in-patient surgical management of patients; Function as Director of the Council on Podiatric Medical Education approved 2-year Limb Preservation Complex Lower Extremity Surgery and Research Fellowship; Director of the 4th Year CORE Podiatric Medical Student Education; Work in conjunction with the Vascular Surgery Service and Wound Care Clinic; Educate rotating allopathic, osteopathic, and podiatric medicine and surgery students and residents;  Lecture to medical, surgical, and nursing departments;  Coordinate, write, conduct, and present research;  Promote evidence-based medicine to students, residents, fellows, and attending physicians; and Provide national and international recognition for the Madigan Army Medical Center. Patients with complex medical conditions admitted for surgical intervention by the Limb Preservation Service are medically co-managed with the Vascular Surgery Service, Department of Internal Medicine, or Department of Family Medicine.

Compensation: Salary commensurate with training and experience in a location with a modest cost of living. Paid vacation; CME; sick leave; and medical malpractice coverage provided at no cost.  Comprehensive health insurance is available at nominal cost.

Requirements: Completion of a 3-year residency; ABPS Board Qualified or Certified; and Sound academic record.

FAX or EMAIL CV and letter of intent: Charles A. Andersen, MD, FACS; Chief, Vascular Surgery Service; Fax: 253-968-5997; e-mail  Charles.Andersen@us.army.mil.

APWCA Patient Information Pamphlets

Brochures are available to distribute to patients, place in waiting room, etc. They explain the benefits you as a provider offer patients through your APWCA membership.  These can be purchased through the APWCA at a nominal fee of $30.00 per 100 copies (includes $25.00/100 plus $5.00 for tax, shipping and handling).  Charge card orders can only be processed by phone or fax. Do not use email for credit card orders as our email address is for our general box and is not secured. You will also have availability to order the brochures on line through our website over the next few weeks. Until then, drop us a line and call us or fax your request.

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Lab Coat Patches

APWCA Lab Coat Patches are attractive color embroidered patches for sleeve or front of lab coat with APWCA logo and the motto “Synergy of Disciplines in Wound Care”.  They are to be sewn to the garment to ensure they are secured properly. Wear them proudly to demonstrate your interest in wound care and your membership in this Association to your peers and patients. The first patch is on us at no charge or you can mail a check or charge $10.60 (includes handling, postage and tax) payable to APWCA by phone or fax and we will mail you four patches. 

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APWCA Lapel Pins

APWCA Lapel Pins for sport coats and suit jackets as well as lab coats. Our acronym, “APWCA” in center with the phrase “Synergy in Wound Care” or “Synergy in Disciplines” peripheral around the pin border. They look great. Wear the lapel pin proudly today.  Be sure to pick up your pin at any APWCA conference or related event. Check out the events schedule in this email news update.

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Power Point Slide Set for Wound Care Lectures

PowerPoint CD with nearly 100 word and picture slides, “Fundamentals of Wound Care” is available for your presentation to medical audience or your local general community, hospital outreach clubs and more. $100.00 plus tax ($106.00) for members and $250.00 plus tax ($265.00) for non-members. Allow 4 to 6 weeks for normal delivery. 10 day turn around, an additional $25.00.

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Certificate Framing

American Professional Wound Care Association certificate professionally framed with superior quality materials ready for display!

Your choice of two attractive ways to have your credential framed and ready for display.  The first is a traditional walnut burl with an inner gold edge made of a composite material.  The second produces a more contemporary look with a brushed gold aluminum frame, approximately 19”w x 16” h.  Neither frame will warp, crack, or release harmful chemicals that may damage your certificate.  Both framing choices display your certificate, double matted with acid free materials, glazed with plexi-glass and a wire attached for immediate display. 

The cost including shipping is $185.00 + 6% sales tax totals $196.10

Please allow 4-6 weeks for delivery.

Telephone: 215.364.4100, e-mail: wounds@apwca.org

AMEX, Visa & MasterCard accepted

Checks made payable to APWCA:

American Professional Wound Care Association

853 Second Street Pike, Suite #A-1, Richboro, PA 18954

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APWCA 2010 Exhibitors

We are proud to be able to acknowledge all of the following:

The American Professional Wound Care Association thanks the following exhibitors.

(The following list is complete as of date of brochure printing.)

Emerald ...       McCord Research (Pinnaclife)

Platinum ...      KCI

                        Medical Solutions Supplier

                        Medline Industries, Inc.

Gold ...            Healthpoint, Ltd.

                        Organogenesis

Silver ...          Amerx Health Care Corp.

                        Bako Pathology

                        Pamlab, LLC

Copper ...        Wright Medical

And Other exhibitors

APWCA appreciates all of these companies for their vision and support of the APWCA educational goals and objectives. They have allowed this Association to aspire and produce a gold standard, pace setting scientific program for 2010.

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To our New Members, or those who want to review an item or two,
the following news items were presented in

 previous E-Mail News Updates:

Press Release Available for Member Usage

APWCA provides educational resources, provider advocacy, consultation services, and advice and suggestions for the enhancement of practice and the business of wound care.  In that light, please note the available press release describing precautions that diabetic patients should take to reduce their risk in these hot summer months.  The release is templated to include your name and allowing you to forward on to local newspapes or other media.   We are providing this in an MS Word format giving members the ability to modify as required.   Download Now  

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Membership Drive - Join APWCA Online  www.apwca.org

Competitive Bidding Delayed, Physician Payments Maintained, Severe Limitation on Ulcer Debridements Reversed – and More!  These are only a few of the many accomplishments for which APWCA has had an active participatory role. It is why your membership is important and the reason for our new membership drive. Increased membership will provide greater visibility to CMS and insurance carriers. This will also help to supply funding to support our very active Insurance Committee and additional related staff. This will allow APWCA to have an even greater voice and more significant influence to support the needs of our membership and patient advocacy. 

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Opening & Maintaining a Successful Wound Care Center/Practice

An APWCA White Paper – Now Available on our Website

This white paper provides basic recommendations determined by an APWCA Committee and is based upon committee and panel experience on establishing and maintaining a successful wound center. Its purpose is to serve as a guideline around which further thought and discussion should be held and is not designed to represent a definitive treatise on the subject for any particular center. We want to acknowledge the core committee and an additional 50 APWCA members who reviewed the monograph and whose comments were incorporated into this document.

Download the White Paper [PDF]

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Membership Fees: Pay Online

Annual membership fees can now be paid on our website at www.apwca.org - When you receive a copy of your dues notice remember payment online is available.

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Wound Care Essentials Practice Principles

Sharon Baranoski MSN, RN, CWOCN, APN, FAAN, DAPWCA
Elizabeth A. Ayello PhD, RN, APRN,BC, ETN, FAAN, FAPWCA

Publisher: Wolters Kluwer Health/Lippincott Williams & Wilkins

ISBN: 978-1-58255-469-3

Copyright: 2008©

Page Count: 496

List price: $47.95

Written by two well-known wound care specialists and an interdisciplinary team of experts, this handbook is essential for all professionals involved in wound care, including nurses, physical therapists, physicians, podiatrists, and long-term care professionals. The book provides practical, comprehensive guidelines for assessment and management of both common and atypical wound problems and covers many topics not sufficiently addressed in other texts, such as sickle cell wounds, amputation, gene therapy, and the specific wound care needs of special populations. Features include more than 100 photographs and illustrations, recurring icons such as Evidence-Based Practice and Practice Points, case studies, and review questions.

Visit www.LWW.com/nursing or call 1-800-638-3030 to order your copy today!