High-Tech vs. Low-Tech Wound Management: Which is Best?

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Wound Management Technology

by Paula Erwin-Toth MSN, RN, CWOCN, CNS, FAAN

What's the best approach to wound management: use of the latest advanced technology or "back to basics" treatment methods? How many times have you, the experienced wound clinician, been asked this question? It is only natural for people (especially patients and their families) to gravitate to a solution that seems to offer a quick fix for a very complex problem.

Even other health care providers who are not experienced in wound management may be tempted to immediately select a high-tech solution to manage a wound that a lower-tech approach may be more suitable for. Let's face it – we are all attracted to advances in technology, no matter what the field.

Factors to Consider in Managing Wounds

Have you ever presented a lecture on managing the care of people with complex wounds? You discussed the need to understand the etiology, conduct an in-depth wound assessment, identify co-morbid conditions and plan how to optimize the patient’s intrinsic and extrinsic wound environments including sociocultural and economic factors. You discuss the wide varieties of wound management options – high-tech, low-tech and in-between; and how to select an approach best for your particular patient.

At the end of your presentation several eager attendees wait in line to speak with you. Some come with photos of complex wounds, some ask for more information regarding education and resources and there always seems to be one eager person that asks "But what do you use to treat a stage III pressure ulcer?" You can see in their eyes they are earnest and want to give their patients with wounds the very best care. In many cases this was the first wound conference they ever attended and a few have told me, sometimes tearfully, their employer expects them to become the wound resource person when they get home-all after one conference!

I give them a big sympathetic hug and invite them to have a cup of coffee with me. What I hear is usually a cascade of fear and frustration. "The people I work with say all full-thickness wound should have negative pressure wound therapy, others say it is only the support surface that matters, some say they all need flaps, others want to use plain gauze and some just want to transfer the patient and make it someone else's problem." After the venting takes place we begin to work on problem solving and assuring them it is not humanly possible for one person to solve all the wound woes of a facility.

The Best Approach to Wound Care

During such meetings, we work together to map out the challenges and opportunities in the wound management scenario. We list the stakeholders in wound care. We identify potential champions and those who might oppose new treatment initiatives and which champion may be helpful in wooing them. Just like wound management – whether your choice is high-tech or low-tech – all options in staff education and patient care should be high touch. High touch approaches help people develop a sense of investment and that they are a valued part of the decision-making process. As wound clinicians we are preparing the next generation of health care providers to carry the torch. The technologies of the future will further our abilities to prevent and heal wounds – one thing it cannot replace is the high touch approach needed to support clinicians, patients and their family caregivers in delivering effective wound care.

Do you have examples of high touch patient care that you would like to share? Comment below or email us at editorial@kestrelhealthinfo.com with your strategies. I will be presenting on this topic in future blog posts and welcome your contributions to the discussion.

About The Author
Paula Erwin-Toth has over 30 years of experience in wound, ostomy and continence care. She is a well-known author, lecturer and patient advocate who is dedicated to improving the care of people with wounds, ostomies and incontinence in the US and abroad.

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.


Our greatest issue in wound is the variability in care. The use of high-tech equipment and supplies does not equate with better outcomes. It drives up the costs, creates confusion by the patient and family and clinicians, and often prolongs the correction of the underlying pathophysiology of what caused the event to begin with. As CMS (and therefore, all of the other payers) ratchet down their reimbursements and tighten the restrictions for the care of wounds, we will have to blame ourselves that we let too many untrained, inexperienced clinicians have full reign on 4000+ products and countless therapies on the market.

Thank you for the insight. I agree that there is not a one size fit all approach to wound care. It is unfortunate that organizations have such high expectations of the inexperienced clinican. I particularly like the comment about staff education and patient care being high touch. Could you provide examples of high touch and staff education? Thank you again for a great post.

Thank you for your question, Ann. I will be presenting more on 'high touch' strategies with staff education and patient examples in my next blog post. I would love to hear what you and other readers do to help communicate the need for 'high touch' in all aspects of wound care. Please feel free to share your experiences below, or direct your comments to editorial@kestrelhealthinfo.com.

What works for one patient does not always work for another. And High Tech does not always mean better outcomes.
So many variables come into play in wound healing or non healing: Co-morbidities, Nutrition, Bio-burden, function & mobility, age, and economic situation to name a few. In addition, clinician education and family/significant other education should be a priority. I have noticed a lot of confusion and apathy on the part of some bedside nurses with remarks like "I don't want to take care of wounds, let the Wound Consultant do it." How do we get nurses to value their role in Skin Integrity: Prevention and Management.

One must use High-Tech in treating wounds. These days technological helps improves healthcare and minimize risk of any damage. I would highly thankful to you for sharing such a informative post.

In almost 20 years of wound management with thousands of patients, I have not found any wounds yet that could not be closed with low-tech properly applied, but that could be closed with high tech. The very few patients (fewer than 10 in all) for whom I was not able to support wound closure using polymeric membrane dressings had severe underlying disease processes that could not be adequately ameliorated, and even in those cases their quality of life was improved with polymeric membrane dressings. These are pretty impressive low-tech dressings, but most clinicians do not know how to use them correctly. I work for the company now so that we can change that.

Patients need adequate nutrition, offloading, circulation, and compression to heal optimally, and sometimes medications which can delay healing can be adjusted. However, most of the high tech (and expensive) interventions we clinicians try to add to the mix are usually just gratifying our own egos, rather than helping our patients' wounds close more quickly.

I'm delighted by this discussion. I speak from the perspective of a wound healing specialist in private practice where high tech resources are available to most of my patients and a disaster nurse where only basic conventional therapy is available. In my experience, using the TIMES model of wound bed prep and ensuring adequate nutritional supplementation to support the greedy metabolic process of healing has delivered very satisfying results. I remind myself every time I explain healing to my patients that neither I nor the dressings are responsible for healing, the patient's body is! I only clean the wound really well and help to create an environment conducive to healing. This is why a comprehensive patient assessment is so vital. We can't always negate the effects of comorbidities and medication, we should though address all the factors which we have the power to change and do so.
In our present failing economy, I'm compelled to consider the more conventional therapies to accommodate my financially strapped patients. While this is often argued to be more expensive when this option is exercised over high tech dressings, it does not take the patients perspective into account who can only afford paraffin impregnated gauze and gauze as a dressings with increasing frequency.
The bottom line is that if you've addressed the cause of the wound, effectively prepared the wound bed and support healing, healing will occur in most patients. This is Africa where creativity is borne from necessity.

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