Wounds : an overlooked burden (Part 2) - Wound treatment : a daunting decision

Abstract

Various types of wounds are encountered daily in medical practice, and due to the numerous treatment options available on the market, making the most appropriate choice of treatment may be a rather daunting decision. The wound treatment should not inconvenience the patient to the point that the wound care becomes compromised. It is for this reason that a proper assessment of the wound status be conducted in order to select an appropriate treatment intervention or dressing type, as this will directly impact the way in which the wound heals. This article is based on the expertise of three active wound care practitioners and aims to provide guidance to clinicians when providing primary wound care. The downloadable tables can be printed and used as reference materials in daily practice.

A ‘game of dressings’: Strategies for wound management in primary health care

“…Hence the use of measurement tools such as tape measurements, tracing paper or photography is important to document the progression of treatment. 16,25 Once the wound bed is assessed, the choice for the dressing will become an easier task (Figure 3 13 ).…”

“…If after 2 weeks of treatment, there are minimal changes in the measurements of the wound in comparison with the initial measurements (edge effect), or if the wound bed shows changes in the type of tissue, levels of exudate/moisture, subtle or classic signs of local infection, non-advancing edges or new wound breakdown, then one can modify or change the treatment plan accordingly. 12,16,17,25 Strategy number 5: Choosing the dressing At any particular time in the assessment of any wound, clinicians should keep in mind that the wound status is an evolving process and adapt their choice of dressings accordingly. There is no single perfect dressing in the market that can be used for all stages of the wound healing process until the complete closure of the wound.…”

“…An ideal dressing should have the following characteristics: be easy to apply, safe to be removed without causing skin damage or pain; be cost-effective, stay intact for longer periods, avoid the need for frequent changes; conform to the wound bed/anatomical location, prevent leakage and suit the level of exudate; absorb odour when indicated, control bacterial proliferation and not cause allergic reactions. 20,25,26 Certain dressings are classified in South Africa as noninvasive medical devices and not medication and some of the advanced dressings need to be prescribed by a physician. The guidelines aim to maintain the safety, quality and performance of those classified as medical devices; the classification may differ from other countries.…”

“…Hence the use of measurement tools such as tape measurements, tracing paper or photography is important to document the progression of treatment. 16 , 25 …”

“…If after 2 weeks of treatment, there are minimal changes in the measurements of the wound in comparison with the initial measurements (edge effect), or if the wound bed shows changes in the type of tissue, levels of exudate/moisture, subtle or classic signs of local infection, non-advancing edges or new wound breakdown, then one can modify or change the treatment plan accordingly. 12 , 16 , 17 , 25 …”