Don’t All Wounds Deserve Palliative Care?

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by Aletha Tippett MD

For over a decade now I have treated wounds in palliative care patients and non-palliative care patients. The “funny” thing is that there is no difference in how I treat these wounds, all are approached the same way, with similar treatments used. As I teach more and more about palliative wound care, it seems obvious to me that all wounds and all people deserve this approach. Who does not deserve less pain? Who deserves to be embarrassed by wound odor? Who deserves to have an infection? Who deserves a lesser quality of life? When asked these questions I would think the answer would be NO ONE.

The goals in palliative wound care are to reduce pain, control odor, prevent infection, and enhance quality of life. These should be goals for everyone. Wound care needs to be humanistic, holistic and compassionate. You can still use state of the art tools and products, but use them in a humane way. One of the primary teachings in palliative wound care is to first assess your patient and the wound, determine what is possible and appropriate, and what is the goal of and for your patient. If possible, remove the cause of the wound, then treat the wound to meet the goals for the patient. Palliative wound care is taught to be very patient-centered. This should be done with every wound; it should not only be the province of palliative wounds.

Being a good steward of resources and not spending more than necessary is a key feature of palliative wound care. This tenet should hold for regular wound care too, which is “breaking the bank”, costing almost $2 billion a year. The motto taught in palliative wound care is to select the least expensive option that will accomplish the goal. Why spend $1 when a dime will do?

There are ways to learn more about the goals of palliative wound care, and these would be helpful for anyone caring for wounds. To learn many of these, attend the 4th Annual Palliative Wound Conference, held this year May 16-18 in Indianapolis, Indiana. At this conference participants will learn how to manage pain, how to have a palliative approach to wounds, how to handle fungating tumors, how to correctly manage an ostomy, how to use nutrition at the end of life, ways to handle gangrene and ischemic disease, how to use maggots in wound care, techniques to manage incontinence, how to select a support surface, and what ethics are involved in palliative wound care. There will be hands-on workshops on wound dressings, wound wrappings, maggot therapy, and ostomy care. Go to www.palWCC.org for more information and to register. Hope to see you there.

About The Author
Aletha Tippett MD is a family medicine and wound care expert, founder and president of the Hope of Healing Foundation®, family physician, and international speaker on wound care.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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