WoundSource Practice Accelerator's blog

Effective wound management often requires attending to multiple aspects of the wound itself, including properly preparing the wound bed and managing moisture and exudate, among other facets of wound care. Tissue viability is another crucial aspect of wound management. Unfortunately, many types of wounds, including acute and chronic wounds, contain devitalized tissue.

Devitalized tissue inhibits healing in multiple ways. It can serve as a source of nutrients for bacteria, especially if the tissue is necrotic. Devitalized tissue also acts as a physical barrier for re-epithelialization, thereby preventing topical compounds from penetrating the wound bed when required. Further, this tissue can prevent angiogenesis, granulation tissue formation, epidermal resurfacing, and standard extracellular matrix (ECM) formation. It can also cover the wound and render it difficult for clinicians to assess the extent and severity of the wound adequately.

The COVID-19 pandemic has profoundly impacted many aspects of patient care and medical practice. Changes have ranged from supply chain adjustments to transformations in patient interactions. Many of these practices may be standard for the foreseeable future. Although many medical professionals have attended to patients with COVID-19, there has been a major decrease in other necessary aspects of medical care, including wound management.

Patient-centered care is a philosophy that stresses communication, collaboration, and health promotion while also respecting patients' expectations, autonomy, and values. It is at the heart of global efforts to enhance the delivery of safe, high-quality, and cost-effective health care. Patients who are involved in their own treatment are more motivated and capable of caring for their own health and well-being, according to most research, because they understand the impact the treatment will have on their health.

Advanced wound care technology: Technological advances that simplify and facilitate the process of wound care. This technology is used to improve diagnostics, communication, monitoring, complication prevention, and the rate of healing.

Automated measurement: Technology used to capture wound measurements instantly and accurately.

Clinical workflow: A systematic and repeatable pattern to guide clinicians through a delivery of care while streamlining standard of care.

The most effective wound care is patient-centered and individualized. Consideration must be made for unique population characteristics during an inpatient stay to decrease the risk of hospital readmission or further wound complications. Variations in wound care needs may exist among patients based on their ethnicity, age, socioeconomic status (SES), and comorbidities. Early identification of these characteristics and interventions to combat disparities should be considered.

Complex wounds require increased attention, time, and resources to treat. Certain populations, including pediatric patients, immunocompromised patients, and older adults, are at higher risk of developing complex wounds as a result of age or comorbidities. For these populations, a multidisciplinary approach is required for the most effective wound care. Additionally, comprehensive documentation and standardized wound assessments can help clinicians identify areas of concern quickly and proactively given the unique needs of the population.

By equipping nurses with the tools necessary to document wounds quickly and accurately, care can be prioritized more effectively. The equal standard of care is maintained from admission to discharge. This continuity is especially important during times of the pandemic where we have experienced increases in nursing shortages and traveling nurses moving among hospitals. What has become even more critical is the requirement for a systematic approach to wound management.

Patient engagement in wound care improves patient experience and satisfaction and results in increased clinical and economic benefits. As such, it is a worthwhile approach to take, but there are some considerations. The level of involvement desired by a patient is determined by their age, the duration of their wound and underlying disease, and their level of education and literacy.

Cellular and/or tissue-based products (CTPs) comprise an exciting and emerging technology in wound care. Deep and large wounds require more than just a standard dressing, topical ointments, and time. Wounds that penetrate the reticular dermis and below (deeper than ~0.57 mm) require additional scaffolding to support wound closure and prevent significant scarring.¹ CTPs provide this scaffolding as well as naturally occurring chemicals and cells that support wound healing.

Wounds have a significant negative impact on patients, including pain, decreased quality of life, and social isolation. Optimal wound healing can help patients and the health care system cope with the burden of chronic wounds. Wound management may not always be the priority in patients whose cases are complicated by severe comorbidities, palliative care, hospice care, surgery, chemotherapy, radiation, or management of a chronic condition.