WoundSource Practice Accelerator's blog

The presence of more than one chronic condition in an individual is often referred to as comorbidity. Various comorbidities can interfere with, or inhibit, wound healing processes. These conditions are associated with complex management, economic burden, and poor outcomes. Some of these obstacles to healing include nutritional abnormalities, aging, diabetes, and infection to name a few. The prevalence of such comorbidities in patients with complex wounds reinforces the importance of identifying these conditions and finding ways to mitigate the risks they pose to wound healing.

Vascular ulcers are wounds on the skin that form as the result of abnormal blood circulation in the body, including arterial and venous etiologies. Estimates suggest 3-5% of those over 65 in the United States have a vascular ulcer. Of those with peripheral arterial disease, approximately 20-70% have chronic wounds, according to data up to 2018. Since arterial ulcers may be underdiagnosed, certain experts theorize that the number of chronic wounds developed due to arterial insufficiency is higher in reality.

Severe burn wounds are among the most debilitating injuries because they can significantly affect the entire body. The body’s inflammatory response to a severe burn injury can lead to fluid loss, dangerously low blood pressure, and shock. The risk of infection is also elevated in patients with severe burn wounds. Therefore, prevention of these complications is a key component of care for these patients.

Surgical wounds originate when a surgeon cuts into tissue with a surgical tool, such as a scalpel. The size and placement of a surgical wound will depend entirely on the procedure performed due to varying incision requirements.

Regardless, most surgical interventions aim for wound closure with primary repair. Tissue edges are typically brought together and held in place by various modalities, such as sutures or staples. However, this result isn’t always the case, as some wounds may be left open to heal secondarily or may fail to heal primarily. This piece will discuss the surgical wound timeline, various complications of a surgical wound, signs/symptoms of infection, along with the recovery process for patients.

Acute wound: An alteration in skin integrity, such as a simple laceration or a surgical wound, that typically moves through the healing process and heals in a predictable timeframe without complication. An acute wound results from a documentable event with the assumption that it will progress normally through the 4 phases of wound healing.

The National Quality Forum (NQF) introduced the term never event in the early 2000s, and it refers to a preventable error that may represent fundamental issues with the quality or safety of care within a medical setting. This wording was initially selected because these events are situations that should never happen to any patient, such as surgery to the wrong leg or leaving a sponge in a patient after surgery. In recent years, the NQF has adopted the term serious reportable events (SREs), but in many instances, the term never event is still used.

Avoidable pressure injury: The development of a new pressure injury or the worsening of an existing one that results from a failure of the facility or caregivers to adequately identify, prevent, or manage the patient using acceptable care standards.

Even before the onset of COVID-19 and certainly since, health care facilities have faced challenges related to resources, staffing, and infection control. However, telehealth resources can aid across the care continuum. These resources can facilitate patient data dissemination to the multidisciplinary team. For example, a telehealth encounter may help determine the need for an in-person appointment, thus minimizing the amount of travel required by staff and patients to uphold a certain level of care. Mobile technology can also involve patients in their care in new and innovative ways, potentially increasing adherence and optimizing wound care outcomes in the face of evolving obstacles.

Health care delivered in the home or outpatient setting has continued to increase. According to the latest figures in 2018 and 2017, over 11,500 home care agencies treated 4.9 million individuals in the United States. As the aging population increases, the nuances of optimal wound care delivery in the home health setting should be examined.

Wounds, including chronic and complex wounds, represent a tremendous challenge to the US health care system. In the United States alone, chronic wounds impact approximately 6.5 million patients, and the treatment of these wounds is estimated to cost $25 billion per year. Trauma, burns, skin cancers, infections, or underlying conditions, such as diabetes, can all contribute to a wound’s development and course. If one looks at the structure of wound terminology, they could ascertain that wound care is usually considered comorbid, defined by terms like diabetic foot ulcer, venous leg ulcer, and pressure injury.