Our skin is the primary barrier for protection against microbes, water loss, ultraviolet light damage. Furthermore, our skin is the largest organ and assists with the thermoregulation process and provides our sense of touch. However, when a wound develops but does not pass through the typical healing process in a timely manner, it is defined as a chronic wound. A rule of thumb is a poorly healing, full thickness wound that has been present for 30 days or more. For those who suffer with chronic wounds it’s common to experience loss of function, pain, a recurrence of wounds, and significantly higher morbidity rates.
The most common underlying cause of chronic wounds is diabetes, vascular disease and limited mobility. Diabetes, especially long-term or poorly controlled diabetes, affects the circulatory system causing deficiencies in blood flow. The decreased blood flow is further compromised in the smaller vessels such as those of the lower extremities, small vessels in the eyes, brain, heart, and kidneys, and in the lower extremities. Changes in the vascular system that decrease or disrupt blood flow is broadly referred to as vascular disease. Also, those who have mobility problems may develop pressure ulcers. Pressure ulcers occur when there is a disruption in blood flow for long enough periods of time to cause tissue damage. Pressure ulcers are often seen in those patients who have factors that limit their ability to move themselves or even shift their weight while sitting or lying down.
The care for chronic wounds requires a comprehensive evaluation and thoughtful medical approach that incorporates the entire patient picture into the care plan.
In addition to physical considerations, our goal is to also engage the patient in their care plan. After the initial evaluation is complete the clinician is able to assess all of the known factors that may affect wound healing. Some areas of concern in wound healing are poorly controlled diabetes, limited mobility, tobacco use, smoking, poor nutrition, age, mental status, socioeconomic status, and support group engagement. Our team is able to present the treatment options and the risks and benefits of each plan.
Part of every good plan should include addressing the underlying causes of wounds to help lessen the chances of the wound developing again in the future. We excel at this also by developing key relationships with quality medical providers in the community. We strive to provide as many in-home treatment options to allow the patient to avoid the hassles of the waiting room and office or clinic settings. Available treatments options depend on insurance approvals, the type of wound, and the indication for treatment.
We are always looking for ways to improve our wound care delivery model to be able to offer our patients the best evidence-based wound care possible. Our team closely monitors and accurately records treatment progression to ensure the patient receives a streamlined treatment and the care they deserve.