By Cathy Thomas Hess, BSN, RN, CWCN, VP/Chief Clinical Officer for Wound Care, Net Health
We’ve learned quite a bit about wound care over the past decades. Clinicians know more, manufacturers are doing more, and the entire industry is working together to advance skin and wound caring for dressings, drugs, and devices.
While it’s been exciting and inspiring to see this evolution, wound care can still be challenging, and it can exact an emotional, physical and financial toll on patients and caregivers. Wound management is complex; multiple factors affect treatment and healing. It can be frustrating for even the most experienced provider as well as the patient.
Identifying factors that delay or impede wound healing is key to improving outcomes and patients’ lives. Taking these five steps will begin to ensure that optimal wound care practices are underway. And while a simple checklist should never be considered the only arbiter of best practices, for busy clinicians and those new to wound care, it can be a good reminder of select foundational actions that help ensure better healing.
- Understand the local and systemic factors that may be delaying healing. Desiccation, infection, or abnormal bacterial presence, as well as maceration, oxygenation, necrosis, trauma, edema, and other local factors can impact healing. Systemic factors may also impede wound healing such as age, stress, comorbidities (such as diabetes), ischemia, select medications, smoking to name a few.
- Note the age of the patient. Wounds in older patients may heal more slowly. There are various factors that contribute to healing challenges, including comorbidities and compromised immune systems. If any of these are present, pay closer attention to the wound and take prompt steps to intervene.
- Consider the patient’s body type. An obese patient may have difficulties healing due to poor blood supply to adipose tissues and difficulty treating wounded areas especially within skin to skin contact (modification of treatments may be necessary). Stress the importance of proper hygiene and thoroughly check the patient to make certain new wounds are identified.
- Ensure your patient is getting proper nutrition. Ongoing nutrition assessment is necessary because the visual appearance of the patient or wound is not a reliable indicator of whether the patient is getting enough nutrients. Partnering with dieticians and reviewing the patient’s medical record and lab values can help identify deficiencies.
- Pay close attention to patients who are immunosuppressed or undergoing radiation therapy. Suppression of the immune system by disease, medication, or age can delay wound healing. Radiation therapy can cause ulceration or change in the skin, either immediately after a treatment or aftercare has ended.
This checklist is just a start. You should add other care strategies that work best for your environment and patient demographics. Additionally, to achieve successful wound healing, it’s important to follow industry and facility best practices, including assessment, planning, implementation, evaluation and documentation.
We’ve seen tremendous advances in skin and wound care over the past decades and learned much about best treatment practices. Paying attention to the primary factors that impact wound healing – local and systemic – is essential to ensuring better outcomes. Using a basic checklist that covers key areas will start you on the journey toward better wound care results.
Please share your ideas for a wound care checklist with our blog readers. We look forward to hearing from you.
Cathy Thomas Hess is VP, Chief Clinical Officer for Wound Care at Net Health. She has over 30 years of experience in wound care, authored hundreds of journal articles, spoken at both national and international events, and has authored book chapters and the best-selling handbook titled Product Guide to Skin and Wound Care, 8th edition. She continues to be influential in the wound care community today and serves on the Editorial Advisory Boards for Advances in Skin and Wound Care, authoring a monthly column entitled Practice Points, and Today’s Wound Clinic.