Open Wound Treatment
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Wound Care Treatment options
First of all, I think it’s important for everyone to understand that your treatment choice is always driven by the condition of the wound bed and the surrounding tissue. That’s a key point to understand. Treatments can be optimized to create an optimal healing environment in an economical way. So we always want to keep the economics in mind as well whenever we’re making our treatment choices.
Any given wound can actually have several different treatment options that are appropriate. Every physician or every clinician has their own personal preferences, and just because one clinician would choose a certain dressing or even a certain type of dressing over another doesn’t mean that the other clinician is wrong or incorrect. So they can both be correct, and they may be both addressing the needs of the wound itself.
When you do make a treatment choice, it’s important to continue to evaluate the wound on a regular basis. During this evaluation, you’ll be able to gauge whether or not the treatment that you’ve chosen is making a change, for the better hopefully, but is making a change in the wound. If, however, you notice, after two to four weeks, that the wound is not getting better, it may be time to reassess whether the dressing choice that you’ve made is appropriate or not. Now this doesn’t mean that, if you’ve made a dressing choice and after two to four weeks the wound is not improving, that you have to change the topical dressing choice that you’ve made. It may be that, in your evaluation, that that dressing choice still is deemed as the appropriate choice. There may be other factors that are preventing that wound from healing, whether that be the nutrition or whether that be the fact that the patient may not be getting offloaded or repositioned appropriately, or they may be noncompliant with treatment. So it’s important to understand it doesn’t mean that you have to change the topical treatment always, but you do need to step back and reevaluate and make sure that treatment choice is appropriate or there isn’t something else that you may want to try to move the wound along and have it heal more quickly.
I kind of break my treatment choices down into some basic categories. The first one is a moisture donating category, so these are dressings that actually provide hydration and moisture to the wound. There’s moisture absorbing dressings. These are kind of the opposite. They take excess moisture and soak it up and absorb it. Hopefully, it’ll be place in a manner that won’t wick that on to the skin and cause maceration to the surrounding tissue. There are enzymatic debriding agents that are out there, and we’re going to discuss in a little more detail enzymatic debriding agents and when they may or may not be appropriate. As you know recently, there’s been a significant increase in the cost of these agents, so we have to use them very judiciously.