Two Echidnae Podcast from Advancing Wound Care

Ep10 - Welcome to Advancing Wound Care

Wed, 25 Feb 2026 23:40:00 +1100

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

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.

Ep9 - Wound Measurement and Photography

Tue, 30 Dec 2025 11:30:00 +1100

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.

Ep8 - Unhealable Wounds

Sun, 16 Nov 2025 01:37:00 +1100

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.

Ep7 - Wound Aetiology vs Mechanism of Injury

Sat, 26 Apr 2025 00:37:00 +1100

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:

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

Sun, 23 Feb 2025 11:31:00 +1100

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.
Murphy C, Atkin L, Vega de Ceniga M, Weir D, Swanson T. International consensus document. Embedding Wound Hygiene into a proactive wound healing strategy. J
Wound Care 2022;31:S1–S24
International Wound Infection Institute (IWII) Wound Infection in Clinical Practice. Wounds International. 2022.
Clegg H, Fetherston C & Wei R. Required wound care content for nursing curricula in Australia: a Delphi study. Wound Practice and Research 2023; 31(4):190-196.

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:

Ep5 - Let's start measuring up compression

Sun, 19 Jan 2025 18:11:00 +1100

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:

Ep4 - Monika and Donna's path to Wound Consultancy

Mon, 30 Dec 2024 20:32:00 +1100

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:

Ep3 - Wound aetiologies, teaser topics and more

Fri, 15 Nov 2024 20:46:00 +1100

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:

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

Thu, 31 Oct 2024 17:52:00 +1100

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:

Ep1 - Listen in as we kick off our prickly conversations

Tue, 15 Oct 2024 19:30:00 +1100

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.