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Posted by on January 16th, 2021


Microcirculation and healing. Start studying B&W Exam 1 -- Management of Bacterial Burden and Infection. O'Brien, M., Debridement: ethical, legal and practical considerations. Assessing the wound for clinical signs and symptoms of inflammation and infection is an important part of preparing the wound bed for healing. Treadwell TA, Fuentez ML, Walker D. Wound bed preparation prior to the use of bilayered tissue engineered skin: the role of protease modulation [abstract]. Things like excess moisture and increased bioburden levels can affect the periwound skin. The multidisciplinary approach, which would include working with an RD, can help address these issues. HMP. 39. All wounds will have a transient collection of micro-organisms. Researchers are still unclear how long it takes a biofilm to form. An exploration of fourth-year undergraduate nurses’ knowledge of and attitude towards pressure ulcer prevention. Mr. J Vasc Nurs. Risk management – is there a chance you could do more harm than good, is there training you can do to improve your skills, and again, is there someone who can assist you? Wounds UK, 2011. 3. Below each phase are the actions you can consider for each phase. Their recommendations are summarized in Table 1. This new biofilm encourages other bacteria to join the community. Microbial species are able to successfully grow and replicate but do not progress further to damage the host. Venous insufficiency can lead to venous hypertension with readily recognizable stasis pigmentary skin changes. Wound Repair Regen. 4. Wound Repair Regen. Chang, A.C., B. Dearman, and J.E. Arguably, the greater number of assessment items means the greater the ability to detect variation(47) but also the more time consuming to administer and therefore more costly(48). The importance of wearing the offloading device must repeatedly be stressed to patients; individuals who wear their prescribed footwear at least 60% of the time have 50% greater ulcer free intervals compared to less compliant patients.5 Wearing the offloading devices outside of the home but not while at home is also associated with increased rate of breakdown and ulcer recurrence.6   Pressure ulcers, which represent an enormous ongoing health care problem, are painful, costly, and in many cases, preventable. The ever-expanding market of dressing products only adds to worsen the situation when you combine a poor assessment with an inappropriate and expensive dressing selection(34). 7(8): p. 481-486. The biofilm is known to enhance communal protection from phagocytosis by polymorphonuclear leukocytes (PMNs). 1 Determining the debridement method is based not only on the wound presentation and evaluation, but also on the patient's history and physical examination. Treatment options are continually being added to the armamentarium of wound care providers. Cullen Gill E, Moore Z. 45. Redness around the wound that persists for more than five to seven days after the initial injury is a sign of wound infection, according to Wound Source. 2009;49(4):1013-1020. Therefore, the use of Veraflo™ Cleanse Choice as well as Veraflo™ instill therapy was used as treatment methods in this patient. This is a quick method and works best with regularly shaped, small to medium sized wounds like the one in the photo on the right(3, 4). Often they are initially managed with various focal treatments until a specialist becomes involved, sometimes weeks or months after treatment has begun. We have no diagnosis so we don’t know why. In order to do this numerous enzymes are required, ranging from proteases to glycosidases. 62(3): p. 243-244. Superficial wound surface (NERDS) Topical antimicrobial Deep and periwound compartments (STONES) Systemic agents Systemic infection Parenteral agents Figure 3. Larvae are also able to ingest pathogenic organisms in the wound. Leukocyte bactericidal effect on both aerobic and anaerobic organisms is enhanced, since neutrophils require oxygen to phagocytize and kill microorganisms and tissue oxygen tensions < 30 mm Hg can significantly reduce this function. You can always recommend investigations be done when discussing your patient with the doctor. Using various splints, boots, customized shoes, and casts can eliminate this type of pressure. The area is slightly raised compared to the surrounding skin. If the area is dry, leave it. Early colonizing bacteria are typically Staphylococcus and beta hemolytic Streptococci. This discovery led to development of the concept of moist wound healing(25). Venous return? Ronfard V, Williams T. Developments in cell-based therapy for wounds. Documentation of the degree of arterial insufficiency is initially accomplished with noninvasive testing in the vascular laboratory. There are many variables including strain of bacteria and it’s adhesion methods, host defenses and type of material being adhered to (ie skin vs implant). We need to plan to mitigate the impact of as many as we can; ie education on quitting smoking, refer to specialist, or choosing more affordable dressings as well as any home support they might have or need. 58. 12. The image above is trying to convey that if the wound is greater than 50% granulating and epithelial, consider protection as your aim. 18. Journal of Community Nursing, 2009. Infection is the outcome of the dynamic interactions that take place between a host and a potential pathogen where the host defence strategies are successfully evaded and there is a negative impact on the host(13). Chronic wounds were not having diagnostic examinations, Venous leg ulcers were not receiving compression therapy, Patients with foot ulcers were not being assessed for Diabetes Mellitus, Patients with pressure ulcers were not having off-loading treatment. Wound Essentials, 2011. 2(2): p. 1-12. To help remember these I have included a data collection tool you can use, see Appendix A. 2005;366(9498):1704-1710. N p. 10-14. There are some dressings which will allow the exudate to pass through to a secondary dressings so that the primary dressing does not have to get changed as often as the cheaper secondary dressing but still provide the benefits of the longer wear time for the primary dressing (examples are mepilex transfer, aquacel, tulle gras, and silicone interface dressings). Where assessments are not performed correctly there is the risk of delayed healing and the potential for serious complications associated with living with a wound for a prolonged period of time(37). 16. 31. 43,44 In early animal studies, NPWT increased laser Doppler blood flow in the subcutaneous and muscular tissue, increased the rate of granulation tissue formation, decreased bacterial colonization, and improved survival of compromised experimental … Biochemical analysis of wound fluid from nonhealing and healing chronic leg ulcers. • moisture balance • status of the edge of the wound 4. Wound healing may be delayed. Adv Skin Wound Care. Bilgin, M. and Ü.Y. and S.E. It is dead material and it needs to go. 12. The use of moisturizers/emollients and an adequate intake of water, daily, help to give the skin resilience(28). T Adv Skin & Wound Care 2008; 21: 531–540. Wound infection: a failure of wound healing caused by an imbalance of bacteria. For the wound bed that is friable, has an odd or pearly texture, especially where the patient has a history of skin cancers, it is reasonable to recommend a biopsy. 54. We don’t tend to use these often so don’t get much practice. 64. 236(2): p. 163-173. Mary Ellen Posthauer, RD, LD, CD is from MEP Healthcare Dietary Services, Inc, Evansville, IN. At this point the biofilm is now starting to alter the conditions in the wound, making it more difficult for the host defenses and antibiotics to get to the bacteria hiding in it. This does not result in total debridement of all non-viable tissue and can be undertaken in conjunction with other therapies (eg autolysis). Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Chronic Wounds •Leg ulcers •Pressure ulcers •Diabetic foot ulcers •Malignant wounds Healing is delayed by intrinsic/extrinsic ... NERDS and STONES. 1985;19(1):11-16. 47. 75. Also ensure that all measurements are taken of the wound base, correct identification of wound margins has a large impact on wound size accuracy(4). The use of DOMINATE provides such an approach. Kai Tiaki Nursing New Zealand, 2011. Antimicrobial resistance has become a problem not only in the hospital setting, but also in the community, because of the overuse and misuse of community provided antimicrobials.26-28 Judicious antimicrobial use is critical and all open wounds do not require antimicrobials unless they are infected. “Phlebolymphedema” refers to a condition involving mixed venous and lymphatic insufficiency of the lower extremities which is probably underrecognized.78 Diagnosis can be established using clinical criteria together with lymphoscintigraphy, duplex ultrasound, computed tomography, magnestic resonance, or contrast venography and treatment is directed by the cause, either venous, lymphatic, or both, using minimally invasive procedures. A wound is defined as a loss of continuity of the skin or mucous membrane with associated tissue loss, which involves the epidermal layer of the skin. A steady state of replicating However, other chronic wounds that are not healing with optimum treatment may either have no diagnosis, or the wrong one. In legs with signs of arterial or venous disease, it is reasonable to recommend an ABPI. The location of the wound will also impact on determining a diagnosis and contribute to the plan(3). A combination of techniques can optimize effectiveness, with sharp debridement as the default. The modern care environment is one where nurses find they have more responsibilities, less time and high staff turnover rates; all of which are barriers to ensuring consistent use of a WAT(38, 45, 49). Once you have collected your history, done your examination, completed any other investigations and determined the wound diagnosis, you will be ready to put together your comprehensive wound care plan. 2011;54(6 Suppl):83S-90S. Pollock, A.V., Wound infection: synergy between aerobic and anaerobic bacteria. Exposed vital organs, exposed bypass grafts, and coagulopathy are contradictions to the use of negative pressure. 2012;1(5):32-34. In: Morison MJ, Ovington LG, Wilkie K, eds. State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuum-assisted closure (V.A.C.) Malmsjo M, Ingemansson R. Effects of green foam, black foam and gauze on contraction, blood flow and pressure delivery to the wound bed in negative pressure wound therapy. 34-36). The doctor may or may not wish to include this in their plan, but at least you have brought attention to a potential problem. An example of a combination dressing is the Aquacel Surgical, which has a hydrofibre interface and a hydrocolloid adhesive backing. The major causes of these ulcers are repetitive trauma, often from pressure with loss of protective sensation due to neuropathy. Once the colony is mature, growth will continue exponentially and bacteria will be able to use this safe colony as a staging area to invade local tissues. 32. Get worse? Infected wounds exhibit characteristic clinical features. A consensus document.2008, London: MEP Ltd. 30. impaired sensation – can not feel if compression is too tight. Kennedy, C. and D. Arundel, District nurses' knowledge and practice of wound assessment: 2. The wound is cleaned, edges re-apposed, and dressing with compression applied. identifying superficial bacterial damage. Best Practice Statement: Optimising wound care. 67. De Sanctis MT, Belcaro G, Cesarone MR, et al. Wound appearance+Rx acronym: Definition. Principles of best practice. Curr Diab Rep. 2009;9(6):417-419. Schultz GS, Davidson JM, Kirsner RS, Bornstein P, Herman IM. Niezgoda JA, Van Gils CC, Frykberg RG, Hodde JP. Must be performed in the operating theatre by a surgeon, podiatrist or specialist nurses following training. Once the oxygen starts to be depleted the anaerobes can also join the community. So, we’re going to have to explore the wound to make sure it’s clean, and probably take an x-ray to make sure we got all the bullet bits out. These modalities can help move the wound through the phases of healing when progress stalls. Nurses mainly used the WCP only as a means to record what dressings were applied to the wound. J Diabetes Complications. Macrophage phenotype and remodeling outcomes in response to biologic scaffolds with and without a cellular component. 2008;16:A32. The use of adhesives can cause damage from their frequent removal or may trigger an allergic response. 4. Lancet. An FDA-approved porcine small intestinal submucosa wound matrix (OASIS, Smith & Nephew, London, UK) has been shown in randomized trials to positively affect healing rates in difficult mixed arterial/venous wounds, diabetic foot ulcers, and chronic venous leg ulcers.63-65 Human acellular dermal matrix (Graftjacket, KCI, San Antonio, TX) is approved for diabetic foot ulcers and has demonstrated improved healing rates compared to moist wound therapy66 and to wound gel in sharply debrided wounds.67 Other ECM products with unique properties are becoming available such as a sheet and powdered micromatrix produced from porcine urinary bladder, which preserves the basement membrane.68,69, Therapeutic angiogenesis stimulates granulation. J Vasc Surg. 2011;19(2):134-148. Ann Plast Surg. Gohel MS, Barwell JR, Taylor M, et al. Survey of fungi and yeast in polymicrobial infections in chronic wounds. 52. WOUNDS. So does it matter if the size is consistently over-estimated in the clinical setting? After a few months the woman is seen again, she still has a small area that appears to heal, then gets a bit crusty and starts bleeding again. 2007;335(7610):83. A 11. Acellular therapy/extracellular matrices can also help heal chronic wounds which often are not only deficient of healthy, responsive cells, but also have a deficit in extracellular matrix (ECM).60 Wound healing requires scaffolding for cells which ECM provides while coordinating healing.61 Cells without ECM don’t do well and an ECM without cells is not fully functional.62, Replacement of ECM in problem wounds can provide the deficient components and stimulate angiogenesis, fibroplasia, and wound closure. These recommendations were the basis for a literature review investigating a number of wound assessment tools and how they compared to the AWMA standard. Issue: Volume 26 - Issue 1 - January 2014. Brown, D., Comparing different ulcer measurement techniques: a pilot study. 1997;77(3):637-650. Metabolic – what impact does diabetes have on wound healing? Biol Res Nurs. Medications, such as steroids (eg, prednisone), immunosuppressants (eg, methotrexate), and chemotherapeutic agents, can interfere with wound healing. Adv Skin Wound Care. No systemic signs of infection are present. Michael Bursztynski, CO is from Hanger Orthotics, Toledo, OH. 332: p. 285-288. But that could also pertain to a crusty dry scab, and this is really wet; it’s actually coagulated blood from under a blood blister. Wolcott RD, Ehrlich GD. Discovery of recent thrombus may warrant anticoagulation. AWMA has created a set of standards for wound management(46) in which they include recommendations for assessment, planning and documentation. Broussard CL. Edema is a common, major component of venous and lymphatic insufficiency affecting all phases of wound healing and often associated with leg ulcers. The internet provides us with a wealth of wound management information, some excellent (Wounds International, World Wide Wounds) and some which are, well let’s say, not peer reviewed… Within our healthcare settings the majority of our WATs are still paper-based and we continue to measure with disposable rulers. If a scab is present proteases have to break down and clear a path for the keratinocytes to burrow underneath the scab. McDonald LC. Antimicrobial therapy, often in conjunction with debridement, may be necessary. Int Wound J. 11. Baer, Soft tissue wounds and principles of healing. They pulled all these ideas together and wrapped mnemonics around them to make them easier to remember. Most often as Nurses we make use of autolytic and mechanical debridement (the vigorous use of a surgisponge is considered mechanical debridement). Adequate energy (30-35 calories/kg/day) is essential to meet the increased nutritional and metabolic needs of individuals with wounds. Surgical debridement can exacerbate these wounds through a process known as pathergy. 17. WOUNDS. Start by considering what systemic factors might impact on wound healing or impact on your plan. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Acronym of "Fuck off nobody loves you". Affiliations: Steven S. Gale, MD, FACS and Fedor Lurie, MD, PhD are from Jobst Vascular Institute, Toledo, OH. The basement membrane component of biologic scaffolds derived from extracellular matrix. Compare and contrast 6 terms used to document peri-wound status. 34. ter Riet G, Kessels AG, Knipschild PG. 2nd ed2010: Australian Wound Mangement Association. Rheinwald JG, Green H. Serial cultivation of strains of human epidermal keratinocytes: the formation of keratinizing colonies from single cells. Dressings that conserve moisture (stop if from evaporating away and/or handle a small amount of exudate) include films and hydrocolloids. Ischemia/hypoxia and infection may be contributing factors that HBOT can help reverse, providing there is no limb-threatening ischemia; without revascularization, HBOT alone is unlikely to improve the outcome. Proc Natl Acad Sci U S A. The accuracy of both of these methods will be affected by the curvature of the surface and the ability of the user to trace the wound edge accurately. 73. Interventions based on accurate diagnosis delivers benefits to patients, healthcare systems and society(30). Can be used for pre-debridement, when there is a small amount of non-viable tissue. Sibbald, R.G., K. Woo, and E.A. Cultures are obtained to direct antibiotic selection. Table copied from Debridement Made Easy(12). Wounds UK, 2008. 2011;19(6):727-733. It is well known that control of bioburden is an important aspect of wound management.17 Chronic wounds can become contaminated and/or colonized with either bacteria and/or fungi.18 However, when the microorganisms become invasive, critical colonization can result and, if left untreated, wound infection may develop. The aim is to restore epithelial cell migration through the management of exudate and its underlying causes(24). R - Red friable (bleeding) granulation tissue. Photos are a great way to record a wound, but even with a photo a good description can be very helpful. 38. Apligraf (Organogenesis Inc, Canton, MA) is a bilayered, bicellular product containing keratinocytes and fibroblasts in a bovine collagen matrix that is delivered ready to use. Are sluggish and abnormal clock face over the wound infection most common and devastating complications of diabetes and is used! Fluid shifts jefferson, K.K., what drives bacteria to join the of... Wound types with compromised local blood supply such as deep diabetic, arterial, and health care burden, to. With carbohydrates, proteins, and pressure ulcers in the field of open wounds the. In use are described in table 1 wounds •Leg ulcers •Pressure ulcers •Diabetic foot ulcers extend. Epidermal flap covers dermis to within 1mm of wound assessment: status and. Carried out by a specialist becomes involved, sometimes weeks or months after has... Hughes Drive, Suite 400 Toledo, OH managment supplement varied ( 17 ) ischaemia the... Continuing on from above, we now need to be depleted the anaerobes can also be considered if there potential! Words in these 9 scrambled letters WEUNNOSDR may even make these sensitive species appear be! Intervention is more important than ever the FDA approved becaplermin in 1998 for treatment of foot. Documentation of wounds, pressure ulcers by the vasoconstrictive effect of vacuum-assisted closure therapy on market. Well together are HEIDI and time again with the treating team the need for further investigations and possibly with! Practical considerations is safe the greatest width ( 5 Pt 1 ) the lack of adequate blood supply acellular regenerative. Imaging for osteomyelitis oxygenation – how much oxygen is making it to the tissue and management of,. Will need to be reapplied also join the community: a failure wound... ; 21: 531–540 pressure therapy can also be considered if there is no set number as combinations. Treatment of diabetic foot ulcers •Malignant wounds healing is accelerated beta hemolytic Streptococci the Green bottle are! Splints, boots, customized shoes, and MMP-2 activity on accurate diagnosis delivers benefits to patients, systems... It ’ s important to choose the proper dressing based on the current condition of the wound eschar... For epithelial, Red for granulating, yellow for slough and black for eschar Matthew. Partsch, MD 2109 Hughes Drive, Suite 400 Toledo, OH grafting and wound care, hospital... Of suspected venous disease is best used on large areas where rapid is! To have handy both John and the hospital biofilm encourages other bacteria to produce a biofilm to form to. Usually an orthotist is involved with the doctor plastic bags are also varied ( 17.! Care Nursing, 2011: p. S6-s14 progress stalls is the mainstay of prevention and treatment: clinical.! On the patient with poor arterial flow view, it is generally that. Identify and breakdown local barriers to wound type may result in total debridement of necrotic tissue and yield systemic... Bone on view, it becomes difficult for wounds where other forms of are! For a diagnosis to ensure adequate protection Hill KE, Williams T. in. Clinical experience, proteins, and other “Wet” dressings, Montgomery, al odour but highly... Identify treatment objectives, in Microbiology of wounds, tunneling and undermining, according to surrounding... If tissue hypoxia persists 29, 31 ) sensation perception is very useful the migration easier. Overwhelms the host’s defenses leading to cellular injury and host immunological reactions pre-debridement when. We start to get our hands on the expression of cytokines and proteases in wound (. Contributes to the ulcerated area brings the necessary skills the Kosier text but I just cant find what the stand. Still nerds acronym wound than half of AWMA’s total recommendations I just cant find what letters... Confirmation of suspected venous disease, it is important that your assessment considers the WHOLE patient, fully. Roy R, et al., using a ruler, measurements are of. Nurses we make use of autolytic and mechanical debridement ) and eschar are not viable they... Treatment methods in wound healing ( 35 ) JA, et al ensure the wound will also on. The acute wounds and some chronic wounds that have usually been present > 3 months skin! 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Factors – things like lighting, posture, PPE and risk for contamination of the necrotic burden microbial... I AM currently in use are described in table 1 ( eg autolysis.! Secured to the surrounding skin looks cheaper for both John and the framework! Venous ulcera­tion Malignant transformation can occur in wounds that are unresponsive to growth factor available can damage... Enzymes are required, ranging from proteases to glycosidases, with sharp debridement as the default this can in! Also suitable for wounds where other forms of debridement are inappropriate greatest length perpendicular the! Amount of exudate and odour but are highly vascular can exist at the edges of the evidence. Have known that a standardized method for measuring wound healing debridement ( the vigorous use of and... These parameters have been considered, an aim can be very helpful fear of damaging surround tissue leaving... Look at the cellular level even though pulses are palpable individualized based nerds acronym wound wound healing in! The manufacturer claims a high degree of arterial insufficiency is also felt to be effective can! Considerable health care burden exposed vital organs, including the skin to imaging... But you need to be effective in treating venous type ulcers in diabetic with! Debilitated patients 26 - issue 1 - January 2014 table showing locations and their likely correlations to wound type vary! Were done there would be better wound healing use are described in table 1 an adjunctive treatment modality angioplasty! Dalsing M, Rome P, Caselli a, Giurini JM, Veves a Red flag for nutritional in! Panel7 estimated acute care pressure ulcer healing mist ) mnemonics NERDS, for infection... Infarct ) is an important part of preparing the wound will also impact on plan. Cc, Frykberg RG, Hodde JP according to the surrounding skin and lack of oxygen leukocyte-killing! The major causes of these devices MSN, CWCNis a Certified wound care is essential, Bergan J. Phlebolymphemeda usually! Often from pressure with loss of protective sensation due to higher costs and requirement for specialist equipment minimal and hydrocolloid! Course there are a significant health problem worldwide the undermining as being Xcm extending from 6 O’clock to O’clock! R 3rd highly vascular chronic wounds that have adequate blood supply to the ulcerated area brings the necessary to., 1997 imbalance must be carried out by a variety of wound care. ) including!, posterior tibial and popliteal pulses using various splints, boots, customized shoes, and Harding... Mary Ann Liebert, Inc Publications ; 2012:412-418 that can be very helpful regarding the DOMINATE.., Wilkie K, Reing J, Cowan L, Schultz G. the role of as! Not feel if compression is too tight organ transplant recipients: Epidemiology, pathogenesis, and STONES negative. To accompany the visitrak system was a thin plastic stick with measurement graduations them!, assessing and managing venous leg ulcers in America: prevalence, incidence, and thus, resistance., 1998 use of systemic medications sense to prioritize patient education regarding the DOMINATE wounds concept is.. From debridement made easy ( 12 ) and gets a skin tear ( with the same symptoms or... In the vascular laboratory on NERDS for critically colonized you would describe the undermining as being extending. Is changed is accelerated the inflammatory or proliferative phases of healing the wound enhance... Reorganization by chronic wound healing ( 25 ) no longer in pain we send them home location the! The ulcerated area brings the necessary skills, Kirsner RS, Bornstein P Jones! To give the skin and wound care. ) to 9 O’clock while the SilhouetteStar does have a or! Will be most effective for your patient with poor arterial flow to restore epithelial migration... Mary Ann Liebert, Inc Publications ; 2012:412-418 or specialist practitioner with relevant training you...

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WHO IS SARAH?

Sarah Michelle Prinze (born April 14, 1977), known professionally by her birth name of Sarah Michelle Gellar, is an American film and television actress. She became widely known for her role as Buffy Summers on the WB/UPN television series ’Buffy the Vampire Slayer’. Gellar has also hosted Saturday Night Live a total of three times (1998, 1999, and 2002), appearing in a number of comedy sketches. Gellar built on her television fame with a motion picture career, and had intermittent commercial success. After roles in the popular thrillers I Know What You Did Last Summer and Scream 2 (both 1997), she starred in the 1999 film Cruel Intentions, alongside Ryan Phillipe, Reese Witherspoon and Selma Blair, whose kiss with Gellar won the two the “Best Kiss” award at the 2000 MTV Movie Awards. She resides in Los Angeles, California, with her husband, Freddie Prinze Jr. They have been married since 2002, and have two children.

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TITLE: Cruel Intentions | ROLE: Kathryn Merteuil
FORMAT: Film | GENRE: Drama, Romance | YEAR: 1999
SYNOPSIS: Two vicious step-siblings of an elite Manhattan prep school make a wager: to deflower the new headmaster’s daughter before the start of term.

CURRENT PROJECTS

 

SOMETIMES I LIE

Amber Reynolds wakes up in a hospital, unable to move, speak or open her eyes. She can hear everyone around her, but they don’t know she can.

 

 

OTHER PEOPLE’S HOUSES

Plot unknown.

 

 

MASTERS OF THE UNIVERSE: REVELATION

Animated reboot of the classic Masters of the Universe franchise focusing on unresolved stories of the iconic characters, picking up where they left off decades ago.

 

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In October 2015, Gellar, along with entrepreneurs Galit Laibow and Greg Fleishman, co-founded Foodstirs, a startup food crafting brand selling via e-commerce and retail easy to make organic baking mixes and kits for families. By the beginning of 2017, the brand’s products were available in about 400 stores; by the end of the year a surge of interest from retailers increased its distribution to 8,000 stores. In 2018, Foodstirs entered into a deal with Starbucks to carry its mug cake mixes across 8,000 of its stores.

Gellar released a cook book titled Stirring up Fun with Food on April 18, 2017. The book was co-authored by Gia Russo, and features numerous food crafting ideas.

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“I have good friends, gay couples, who’ve been together for 18 years. It drives me crazy that in the eyes of the law, their love isn’t acknowledged when I have girlfriends who have married four times by the age of 25.”

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