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Wound Preparations for the Management of Chronic Wounds

Wound Preparations for the Management of Chronic Wounds

By Kevin Cleary

A chronic wound can prove to be extremely difficult to heal for both the patient and the healthcare professional. These types of wounds can be stubborn and are often impacted by another physical malady such as diabetes or ischemia. In recent years there has been a dramatic increase in the rate of successful treatments of chronic wounds. Wound bed management was first developed by Dr. Vincent Falanga and Dr. Gary Sibbald from their vast experience dealing with chronic wounds. Despite these improvements there still are a small amount of chronic wounds that fail to heal, but through due diligence and adherence to proper protocol the majority can be healed.

Chronic Wound Healing Requires TIME

The definition of a chronic wound is one that won’t heal in an orderly set of stages or in an appropriate amount of time. These type of wounds can be problematic to the sufferer, healthcare professionals, and our healthcare system overall. In a paper written for woundsinternational.com, CJ Moffatt explains a new thinking in the field of treating chronic wounds. The overall approach to chronic wound management has become focused on factors that influence wound healing and preparation of the wound bed. One process that has evolved is the concept of TIME. It’s an acronym that represents the four components of wound bed management. It stands for:

  • T: Tissue management
  • I: Inflammation and infection control
  • M: Moisture balance
  • E: Epithelial (edge) advancement

 

An article written for worldwidewounds.com authored by Kathryn and Peter Vowden, states that the purpose of wound bed preparation is to create an optimal wound healing environment by maintaining a stable wound bed with minimal exudate. They point out that chronic wound exudate can delay healing and reflect changes in bacterial content of the wound. In a chronic wound this exudate has enzymes and other components that can have a corrosive effect on the wound bed and surrounding skin.

Create the Best Healing Environment Possible

When dealing with a chronic wound that is slow or refusing to heal, it’s important to try and create the optimal healing environment. The question is how do we achieve this? As the Vowdens point out, the processes involved are not new and have been a component of good wound care for some time now. By following a regiment of wound cleansing and protection it will give your wound its best chance to heal and ward off infection. With the help of your doctor or nurse you can develop a plan that will create the best possible environment for your wound to heal.

The Tools You Need

Once you develop a plan of action with your doctor or nurse, you need to know what wound preparation supplies you need. One of the first steps you may need to undertake is to cleanse your wound of any foreign debris. Wound cleansers such as the 3M Tegaderm Hydrogel Wound Filler can create a moist healing environment and can be used for dry to minimally draining ulcers and open surgical wounds. Another option is the 3M Wound Cleanser which offers a no rinse liquid with a zinc nutrient formulation and provides a moist, mildly acidic environment which is conducive to healing. For the removal of foreign debris in a wound bed one option is the Ameriderm Wound Cleanser Spray which is a mild cleansing agent that is pH balanced and great for low to high wound exudates. Other options for wound cleansing include Amerigel’s Wound Wash Spray and their Wound Hydrogel Dressing. Both are affordable options that may meet your needs. For a wound that needs to be flushed of foreign debris, the Church & Dwight Simply Saline Sterile Wound Wash Saline is designed to flush and cleanse wounds of debris and help eliminate infection painlessly.

Now that our wounds are flushed clear of foreign debris we need to protect them from the dangerous dirty outside world. Your choice of dressing may be determined by your type or size of wound. For small wounds, the 3M Steri-Strip Wound Closure System provides a convenient and waterproof coverage of the wound site. 3M also offers the Medipore Plus Pad Soft Cloth Adhesive Wound Dressing that can be used over light to moderately draining wounds. It’s a sterile dressing that is comfortable and absorbent and flexes with your body’s movements and contours. One option for dressings is one that contains an antimicrobial agent. The Argentum Silverlon Antimicrobial Wound Contact Dressing provides a topical antimicrobial agent and can be left in place for several days depending upon wound drainage and necrotic tissue present. They also offer patients the Silverlon Antimicrobial Wound Packing Strips and the Non Adherent Wound Pad Dressing so you can choose the right dressing for your type of wound. If you’re chronic wound needs a hydrogel, you can choose the Carrington CarraGauze Hydrogel Impregnated Gauze Pad to be a primary cover for wound deficiencies to absorb wound exudates and create a moist healing environment. For a wound that is exudating heavily, a different approach may be needed. The ColActive Plus Ag Collagen and Silver Advanced Wound Care Dressing can absorb up to 40 times its weight in wound drainage and still maintain a moist wound environment for proper healing and reduces the risk of infection by controlling bio burden. They also offer the ColActive Plus Collagen Advanced Wound Care Dressing that aids in the formation of granulation tissue, highly absorbent, and provides a cooling, soothing effect for patient comfort. For wounds that require draining, Coloplast offers the One Piece Post-Op and Wound Management Transparent Drainable Pouch, with or without window. It’s safe for sensitive skin and its cloth backing absorbs moisture and is perfect for high output uses. The window allows for visual inspection of the wound area.

Through due diligence, hygiene, and a little bit of common sense chronic wounds have a chance at healing. Patients should listen to their doctor and/or nurse and stick to the prescribed hygiene maintenance plan and the path to healing is within reach. With the current understanding of wound management, chronic wounds may one day be a thing of the past.