About six million people suffer from chronic, non-healing wounds — a serious disorder that can lead to amputation of limbs and dramatically impaired quality of life. Associated with inadequate circulation, poorly functioning veins and immobility, non-healing wounds occur most frequently in people with diabetes.
Although diabetes is a risk factor for developing wounds, pressure ulcers can result from anyone with limited mobility, especially those with lost sensation. Once a pressure ulcer forms, treating the wound is critical.
“Pressure ulcers are costly for the health care system,” says Dr. Karen Zulkowski, an associate professor at Montana State University-Bozeman and a board member of the National Pressure Ulcer Advisory Panel (NPUAP). “Healing a wound can cost $35,000 or more. Pressure ulcers are painful for the patient, result in longer length of stay, diminish quality of life and may result in patient mortality. An aggressive wound care program that includes support surfaces can reduce occurrence and enhance healing. The real cost is in ignoring the problem.”
Fortunately, improvements in wound, skin and support surface technology continue to offer the home care provider solutions for clients.
Cynthia A. Fleck, a wound care specialist and vice president of clinical marketing for Medline Industries’ Advanced Skin and Wound Care Division, says that silver dressings are making waves in the industry because of their increased healing outcomes for a variety of wounds. “Since silver has little chance of developing clinically significant resistance, very limited sensitivity and is available over-the-counter (OTC), it makes a wonderful dressing for home care,” says Fleck. “It also allows for potentially less frequent home visits due to its ability to stay put and work effectively over several days.”
Fleck recommends the following dressings for home care:
- Calcium Alginate/Carboxymethylcellulose Silver Combinations
- Silver Site Dressings
- Silver Amorphous or Semi-Liquid Gel Silver
- Ionic Silver Powder
- Ultrasonic Debridement
Fleck agrees that in addition to the proper dressing, the right support surface is key to proper healing. “Off-loading of high-pressure, bony prominences as well as the management of friction, shear, moisture and heat are basic to preventing and healing pressure ulcers as well as offering comfort and prevention of pulmonary issues,” she says.
“The support surface could be a mattress overlay, mattress replacement, integrated bed unit or variety of seat cushions,” says Zulkowski. She also warns that, “When a support surface does not match a patient’s needs or does not perform properly, it can do more harm than good and it increases the overall cost of treatment.”
Fleck recommends a group 2 support surface that offers low air loss therapy for most wounds. “Prevention of pressure ulcers can be easily addressed by one of the cost-effective group 1 products, non-powered overlays or high-density foam mattress replacements,” she says.
When fitting a support surface, home care providers should remember that the unique needs of the individual should be addressed.
For more information on wound care and support surfaces, check out Home Health Products for Fleck’s July article and Zulkowski’s column, appearing in the August edition.
