Chronic Wounds: Healing the Problem Pt. 1
Part 1: The physician’s perspective
About 6.5 million Americans suffer from chronic, non-healing wounds—at an annual cost of $25 billion. Problem wounds are particularly prevalent among patients in post-acute care (PAC) facilities, many of whom have chronic conditions that compromise their immune systems and make healing difficult.
“The most common wounds encountered in post-acute care are pressure sores, vascular ulcers, diabetic ulcers, and surgical site wounds, says Shark Bird, MD, chief medical officer for Vohra Wound Physicians, the nation’s largest wound care group serving PAC facilities. “Typically, these wounds are slow to heal because of underlying disease that interferes with the healing process.”
Focusing on the patient
Progressive PAC facilities are launching patient-centered innovations for comprehensive wound care management. One such program is offered by StoneGate Senior Living, a leading provider of rehabilitation, skilled nursing, assisted living, and memory care services. To continually improve the quality of wound management and achieve optimum outcomes, StoneGate has partnered with Vohra, which provides physician-led wound check-ups at 25 StoneGate communities.
“StoneGate creates an optimal healing environment for patients with chronic wounds,” Dr. Bird says. “Traditionally, PAC patients have been sent out to a wound care center or a hospital. We believe it makes more sense for patients to be seen in their own setting. We come directly to the facility to provide the same services to the patient in the comfort of their own room—saving time and making patients happier.”
Bedside wound care also produces cost savings—more than $19,000 per patient, according to a study from the Lewin Group.
Factoring in chronic diseases
The wound-healing process is most complex with patients who have chronic conditions. “Our bodies have a finite amount of resources to deploy in healing wounds,” Dr. Bird says. “Many chronic diseases use up these resources and impede the body’s natural ability to recover.
Cardiovascular conditions are among the most damaging, often hindering the flow of blood, oxygen, and nutrients to the wound site.”
Another major condition that affects wound healing is diabetes. Up to 15 percent of the estimated 17 million Americans with diabetes suffer from chronic wounds. “High glucose levels can restrict blood vessels and stiffen the arteries, decreasing blood flow to the wound,” Dr. Bird says. “A small foot blister can quickly become a chronic open sore. Without early intervention and effective treatment, the patient may be at risk of amputation.
“Successfully treating problem wounds requires assessing the entire patient, not just the wound. A holistic approach, considering all factors that can delay wound healing, is essential to effective wound care management.”
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Following best practices
In addition to partnering with physicians who have expertise in successfully treating chronic wounds, StoneGate follows several other best practices:
- Engaging a multidisciplinary team—including clinical, rehabilitation, wellness, and nutrition specialists—trained in chronic-wound management to monitor wound sites for signs of infection and manage the healing process from start to finish.
- Abiding by clinical practice guidelines and standardized procedures to document wounds, track recovery, and achieve improved outcomes.
- Performing physician-led debridement (removing any accumulated dead tissue) to improve blood flow and supply of nutrients to the wound.
- Using preventive interventions, from ensuring adequate nutrition to turning and repositioning patients to prevent pressure wounds.
- Providing advanced therapies to relieve pain, restore mobility, and prevent infection.
- Educating patients and families to identify barriers to effective treatment, accelerate the healing process, and prevent future wounds.
“With constant vigilance and proper management, most wounds can heal,” Dr. Bird notes.
About 45 StoneGate nurses have completed Vohra’s Wound Care Nurse Certification course, confirming their dedication to delivering quality wound management. Also, four StoneGate facilities—Medical Park West Rehabilitation & Skilled Care, Baybrooke Village Care and Rehab Center, Garnet Hill Rehabilitation & Skilled Care, and Emerald Hills Rehabilitation & Healthcare Center—have been certified as Centers of Excellence through Vohra’s Center of Excellence for Wound Management Program, and additional StoneGate communities have started the certification process. Key characteristics of the Center of Excellence designation include having a 24/7 Vohra wound-certified nurse, achieving a rehospitalization rate of less than one percent for chronic wounds, and conducting regular team meetings with a focus on quality and process improvement.
“This distinction recognizes StoneGate’s leadership in delivering quality care,” Dr. Bird says. “The StoneGate team is clearly committed to meeting the complex challenges of chronic wound care management—and collaborating dynamically to heal the wounds, improve patient outcomes, and enhance patient satisfaction.
This article originally appeared on StoneGateSL.com