Treating the Whole Patient and Not Just the Hole in the Patient

When creating a plan of care for patients suffering from chronic wounds or non-healing wounds, it’s important to note internal factors of wound healing but also external factors of wound healing. Very few clinicians seek to uncover daily life habits that could contribute to stalled healing outcomes, such as appetite, sleep habits, medications, self-care regimes, etc. These all play a pivotal role in the healing outcome of the patient and it’s critical to grasp this knowledge before beginning any treatment regime.

The Cork Medical clinical team is hoping to shine a light on some basic questions you should be asking patients and why to better assess the healing stage and when you should involve a wound care specialist.

Assessing the Wound:

1. What caused the wound?

2. What have you done to reduce the causative factor?

3. What does the wound look like?

   1. Examine the wound bed color, slough or eschar, wound edges, and periwound derma to determine its healing progress. A proper balance of moisture is important to the overall healing rate. Dry wounds or excessively moist wounds are detrimental. Always make sure to protect the periwound derma to prevent excess moisture which can cause maceration.

4. What is the exudate like?

   1. Evaluate its consistency, color, odor, and amount to gage healing progress. The odor also needs to be assessed after wound cleansing.

5. Has the amount of exudate increased or decreased?

   1. An increase of heavy drainage could be an indication the wound is still in the inflammatory stage so slow or stalled healing will be expected.

Assessing the Patient's Health:

1. Is the patient taking any medications?

   1. It’s important to know if the patient is taking any medications and what kinds of medications. Many medications can cause slow healing such as steroids, cancer drugs, NSAIDs, and anticoagulants.

2. Can the patient easily access these meds?

3. Are the patient’s vital signs within normal limits?

   1. Be sure to include blood sugar levels if the patient is diabetic.

4. What’s the patient’s appetite like and what kinds of foods are they eating?

   1. The body’s protein needs are increased during wound healing. The patient should be consuming a healthy amount of meat, eggs, fish, milk and cheese to maintain increased protein levels.

5. Are they feeling depressed or anxious?

6. Is the patient getting sufficient amount of sleep?

   1. Adequate rest is needed during the healing period.

Assessing the Patient's Environment:

1. Do they have the resources to obtain the proper nutrition?

2. Do they have a good support system in place?

3. Does the patient have a clean place for dressing changes?

   1. While wound care in the home is not a sterile procedure, it should be clean. Keep dressings in a container off the ground and away from animals.

After you’ve answered these questions and assessed the patient’s wound healing stage and are still experiencing a stalled wound, please contact a local physician or the Cork Medical clinical team at 866.551.2580 or complete our request form.