Maceration is a common clinical complication that poses challenges in chronic wound treatment.1 Excessive moisture can be trapped on the wound surface, especially when occlusive dressings are overused or when nonbreathable cover dressings are applied for extended periods.
By Thomas E. Serena MD, FACS, FACHM, FAPWCA
One of the greatest honors of my life was being inducted into the Athletic Hall of Fame at The College of William and Mary. I was a gymnast there during my college days, a sport I chose early in life. My first loves were basketball and football, but I was always either too small or too light to play these sports competitively for my school teams. Even on the playground I was frequently chosen last in basketball pick-up games. To this day I remain sensitive to team picking. I recently received a call from a physical therapist looking to join my wound care team. Her hospital had enlisted the services of a management company that had marginalized the role of physical therapy in the outpatient wound care center.
In the world of wound and hyperbaric centers, we speak about a multidisciplinary team, but the physical therapist is frequently the “odd man out” when it comes to staffing or participating in the wound care center. I have never understood this exclusion.
The majority of our wound and hyperbaric centers embrace physical therapy as part of the intra-professional team. As a vascular surgeon I think I know everything — which is an occupational hazard. I am often humbled, however, by suggestions from my physical therapy colleagues. “Why don’t we try ultrasound or pneumatic compression for this patient?” One of our physical therapists might ask. A Brilliant idea! Why didn’t I think of that? Because I was not trained as a physical therapist.
The goal in building an effective wound care team is to fill the wound clinic with clinicians from a variety of specialties with multiple points of view. In addition, physical therapy offers several therapeutic physical modalities that promote wound healing such as ultrasound, electrical stimulation, and lymphedema management. Our own physical therapy assistants (PTAs) have even become proficient in total contact casting for the treatment of neuropathic foot ulcers, broadening their role in the clinic, and adding to the level of care we offer our patients by actively including physical therapists in our wound care practice.
About The Author
Dr. Thomas Serena has published more than 75 peer-reviewed papers and has made in excess of 200 presentations worldwide. He has been elected to the Board of Directors of both The Wound Healing Society and the American College of Hyperbaric Medicine (ACHM), the leading academic society in the field of Hyperbaric Medicine. In 2013 Dr. Serena was elected vice president of the American Professional Wound Care Association (APWCA). Dr. Serena has opened and operates Wound Care and hyperbaric oxygen treatment clinics across the United States.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of aWoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.
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