Why is it so hard to do the right thing in wound care?

NewsBot · Jun 13, 2013

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Why is it so hard to do the right thing in wound care?
Fife CE, Carter MJ, Walker D.
Wound Repair Regen. 2010 Mar-Apr;18(2):154-8

"Doing the right thing" in wound care is not an easy task. Studies suggest that 3 factors determine compliance with performing basic wound care from an evidence-based medicine perspective: complexity, cognitive effort, and the compensation system. Two models were explored to investigate compliance with basic wound care at hospital based wound centers: offloading of diabetic foot ulcers (DFUs) and compression bandaging for venous leg ulcers. Using a very large wound-care registry it was determined that only 6% of DFU patients received the gold standard of care for offloading, i.e., total contact casting (TCC), but among those patients who received it, the average cost of treatment was half the cost of those who did not. Although inexpensive to administer, TCC is a relatively time-consuming procedure which is poorly reimbursed. Other DFU treatments such as bilaminate skin, are more costly but are reimbursed much more generously. Thus, the reimbursement system favors the use of more expensive therapies over more economical ones. In the case of venous leg ulcers (VLUs), only 17% of patients received adequate compression. Provision of adequate compression among VLU patients has been similarly hindered by inadequate reimbursement policy. Lack of familiarity with clinical practice guidelines increases the cognitive effort for clinicians. Improving the economic model to favor the provision of effective basic care, creating easier-to-use products, and making clinical practice guidelines available at the point of service may make it easier to "do the right thing(s)" in wound care.
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Tracy.gill · Jan 17, 2014

Is there a standardised form for assessing wound care ? There are so many forms out there, I need a simplified version to make an assessment and be able to forward onto GPs as I am a home visiting Podiatrist? Any help appreciated...

David Smith · Jan 17, 2014

Tracy

I think a standardised assessment form might be difficult to produce because there are so many variable between patients. However I think a clear referral pathway might help. E.G. GP or MDT - Nurse or Podiatry for short or long term intervention.
The referral path way would depend on your professional assessment of the individual patient. as a general rule i'm not in favour of algorythmic paradigms for the skilled professional since they can never account for all situations and variables that a health professional is presented with.

Regards Dave

Lizzy1so · Feb 14, 2014

We use the TEXAS wound care score (http://www.fpnotebook.com/surgery/exam/UnvrstyOfTxsDbtcWndClsfctn.htm ) to grade all wounds apart from Heel pressure sores in which case we use the EPUAP, although both scores are open to interpretation it does provide a uniform system of wound description and grading. I agree with Dave, an algorithm is no use on its on, one must look at the individual and the wound holistically the use photographs and additional tools such as Waterlow and MUST can provide a more rounded view.

Why is it so hard to do the right thing in wound care?

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Tracy.gill Active Member

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Lizzy1so Active Member

Why is it so hard to do the right thing in wound care?

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Why is it so hard to do the right thing in wound care?

NewsBot The Admin that posts the news.

Tracy.gill Active Member

David Smith Well-Known Member

Lizzy1so Active Member

Why is it so hard to do the right thing in wound care?

Pain and hardness in skin adjacent to right side of left big toe nail

Hard Lump outside of right foot?

Hard lump on right foot, pain when walking, another lump forming.

Justin Blake talks with Richard Dubin from the Lower Extremity Review

Treatment of Hard Corns Using Microwave Energy

Treatment of Hard-to-heal Diabetic Foot Ulcers With a Hepatic-derived Wound Matrix

Share This Page

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