Wound Management: The Challenges of a Global Pandemic

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By Martin Vera, LVN, CWS

Introduction

No one estimated the timeline on this pandemic. We just hit the two-year mark, and it’s not completely over. Positively speaking, most of us want to act like all is well and just get on with our lives.1

Unfortunately, others didn’t believe it’s over, and a massive amount of people still don’t, whereas others just thought that as long as it didn’t hit home, they were OK. Unfortunately, statistics do not lie. COVID-19 is very real and continues to cause all sorts of havoc in all aspects of our lives. According to the Centers for Disease Control and Prevention (CDC) data tracker, in the United States alone, effective the second week of March 2022, the death toll is just over 963,000—many lives have been lost to this pandemic. In lay terms, the AT&T stadium in Arlington, Texas holds a total of 80,000 seats. We have lost 12 stadiums full of Americans. TWELVE STADIUMS. Let that sink in. As health care professionals, we are committed to our patients and anyone who may need help. This pandemic has changed the way medicine is currently practiced, not to mention the effect and impact on nursing care and approach.

In this blog, I will briefly discuss the havoc we have experienced with this pandemic as we learned about it, keeping our eyes and ears open for the CDC’s ongoing recommendations to be able to follow guidelines as indicated. Most importantly, I will cover the effect that we are seeing now and what we may expect after all is said and done.

Challenges Created by the COVID-19 Pandemic

I’ve always discussed the challenges within the field of wound management, always talked of the village and, most importantly, identifying and managing barriers. Because of this pandemic, being creative, while following CDC guidelines and learning more about this virus, has been ESSENTIAL these past 2 years. And hats off to all my fellow health care professionals and staff, including clinical and nonclinical personnel, who are involved in running the MD offices that are open and the wound care clinics, hospitals, home health agencies, and any other medical practices. The challenges encountered through this pandemic have been and continue to be taxing to patients, families, and all health care workers.

These changes include:

  • A lack of care as clinics closed because of the pandemic2
  • Patients’ reluctance to return to appointments out of fear of potential COVID-19 exposure1
  • Patients becoming infected with coronavirus and then needing to quarantine
  • Clinics and areas of practice allowing patients to come in only for appointments, not for treatments, as recommended by CDC guidelines, while large numbers of those patients were seemingly unable to comprehend or repeat what they were told to implement for home care.

That’s not to mention an increase in the chronicity of wounds as a result of improper follow-ups related to the pandemic. Now, clinicians deal with almost the same risk factors that affect patients with chronic wounds falling in the same high-risk category to become infected with or exposed to the coronavirus that causes COVID-19.3

How Did We Better Prepare, Get Creative, and Battle Through This Ongoing Pandemic?

Now, more than ever, nonspecialized health care professionals and wound care providers all around must step up their game. Now, more than ever, it’s of high importance to encourage and provide information to our patients who seek high-quality wound care with MDs, DPMs, or any other wound care provider as wound care clinic visits have decreased. Wound care clinicians should find it of utmost importance to utilize evidence-based treatment approaches using best practices and standards of care, in an attempt to decrease hospitalizations related to infection and reduce the rate of amputations and limb salvage conscience. Additionally, the proper use of advanced wound care products to promote a moist wound environment, while managing exudate, decreasing bacterial burden, and facilitating autolytic debridement, all should be executed accordingly to promote positive outcomes. The use of advanced wound care products to the best of one’s ability that are appropriate for the current status of the wound should also be considered. When using these products, re-evaluate weekly rather than biweekly to modify usage as needed.

Since the pandemic, telehealth visits have become more prominent, and insurance policies have started covering telehealth. Yet, only a number of patients were adamant about telehealth visits, and this number has remained the same.2 Of course, telehealth comes with obstacles. There could be any number of technical issues with connectivity, not to mention that not all patients have a smartphone, and older phones may not be compatible with telehealth or have enough memory. All without entertaining the quality of video, would the wound practitioner be able to assess the challenges properly?

CONCLUSION…

Far from it. Above mentioned are just some challenges we have encountered these past 2 years, and we continue to polish as we go. There has been a lot of talk and written articles concerning wound care practitioners who are awaiting the results of a “pandemic within a pandemic.” There is research from March 2021 reporting that in over 50% of patients with chronic wounds, these wounds have significantly increased in severity since the beginning of the pandemic. As previously mentioned by Dr. David Armstrong, and I quote, “It is going to take years to understand the full impact of delayed wound care during COVID-19.”1 So, with that being said, great job to all in managing a pandemic, and now we will see the impact and how much more work we clinicians can do, working together and using the village and resources to overcome, as we always do.

Keep healing, my friends!

References

  1. Armstrong DG. Managing the surge: delayed chronic wound care during COVID-19. Am J Manag Care. September 2021. Accessed March 23, 2022. https://www.ajmc.com/view/managing-the-surge-delayed-chronic-wound-care-...
  2. Cole W. A look at the impact of the COVID-19 pandemic on wound care practices one year later. Today’s Wound Clinic. March 2021. Accessed March 23, 2022. https://www.todayswoundclinic.com/articles/look-impact-covid-19-pandemic...
  3. Oropallo A. COVID-19: issues related to wound care and telehealth management. UpToDate. July 2020. Accessed March 23, 2022. https://www.uptodate.com/contents/covid-19-issues-related-to-wound-care-...!

About the Author

Martin Vera has been a LVN for 19 years, a CWS for the past 10 years, and is passionate about wound management. As a new nurse, Vera experience working in a LTC facility that was premiere in wound care, and saw first hand the involvement of the SWAT team, using advanced wound care products, support surfaces, turning schedules, special diets and how with this coordination positive outcomes were achieved. Vera has experience in wound management in different settings, including: long term (ADON - wound care), acute settings (med surg/telemetry/SNF), LTACH (coordinator of wound care), post acute and consulting involving hospice patients, and working with TB related wounds.

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

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