The specialty of wound care as a focused area of medicine is relatively new yet the clinical need is centuries old. Clay tablets from 2,200 BCE have been discovered and these tablets illustrate the concepts of washing or cleaning the wound, applying topical agents (plasters) and bandaging the wound. These ancient wound care approaches are the basis for todays wound care nurses, wound care physicians, and a plethora of advanced wound care dressings.
Over the past 30-40 years we have seen the proliferation of wound care centers and the growth of wound surgery. However, it has only been in the past 20 years that wound consultants (practitioners with specialized training and wound certification) have left the office setting and returned to the patient bedside.
A wound consultant provides care at the bedside to patients with a variety of wound and skin complaints. These highly trained physicians offer care to patients within skilled nursing facilities and can also perform wound surgery at the bedside. A consultant with proper training, experience and technology will assess the wound, and determine etiology, staging, contributory comorbidities or medications and provide treatment and care plans that address all of these variables so the wounds heal and resolve quickly.
Wound consultants collaborate closely with certified wound care nurses in the facility to ensure that patients with wounds are treated with the necessary topical medications, wound dressings and bandages. Consultants in wound care utilize specialized electronic medical records to document and coordinate care and they are trained in the government and state regulations around wound care. The practitioners also follow evidence-based care guidelines for wound care and are integral to proper antibiotic stewardship. Wound care physicians bring to the bedside the ability to perform surgical debridement, incision and drainage, as well as perform wound and skin biopsies.
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Debridement is the removal of necrosis (dead tissue), bacteria, and cellular debris from the wound. Necrosis in a wound is the number one reason for a wound to deteriorate or to fail to heal. Commonly, patients may develop a black necrotic eschar (a dry scab like covering to the wound) at the site of pressure injury to the heel. An eschar can initially be stable and non-infected but can then rapidly deteriorate and become a wet and infected necrotic eschar. It is extremely important that necrosis be removed by a wound consultant so that the spread of infection is stopped, and the wound can heal.
Other procedures that wound consults perform help to diagnosis skin cancer, determine why a chronic wound is failing to heal, and even diagnose auto-immune conditions. When a wound consultant comes to the facility and to the patient’s bedside and collaborates and coordinates care a reduction in hospitalization, infection, amputation, and cost occurs.
Vohra Wound Care physicians recently developed an augmented intelligence tool also known as AI for use in determining how long it will take for a wound to heal and the impact of different treatment options on wound healing. This tool is the most innovative and specialized technology available to wound consultants today. You can download the tool in the mobile app stores today by search for the Vohra App. AI has brought us extremely far from 4,000 years ago with an era of clay plasters and leaves. Vohra provides wound consultants across 27 states in over 2,600 skilled nursing, assisted living, and hospital settings. With 6 million plus wounds healed Vohra consultants lead the world in wound care and wound consultation services.