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NT EXPERT NEWS | Wound Care Ask Attitude appears to affect healing process for wounds The Treatment Expert Donna Sardina, RN, MHA, WCC President, Wound Care Education Institute By John O’Connor “Individuals with confronta- We have several clinicians at our Residents’ coping styles and tional coping may experience facility who insist eschar on the heels levels of depression can affect distress and frustration because should always be debrided and heel healing times for diabetes-relat- their attempts to take control blisters should be popped. What are ed foot ulcers, new research do not result in rapid improve- the correct interventions? shows. ments,” said Kavita Vedhara, of In a recent study, 93 diabetic the University of Nottingham Stable intact (dry, adherent, intact with- patients with foot ulcers were in England. out erythema or ﬂuctuance) eschar on monitored for 24 weeks. The Full ﬁndings appear in the the heels should NOT be removed. The size of each patient’s ulcer was August issue of the journal reason? Blood ﬂow in the tissue under measured at the start of the A study found that diabetic foot Diabetologia. the eschar is virtually non-existent. study, and again after six, 12 ulcers were less likely to heal in The work has sparked a patients with confrontational Therefore, the wound is susceptible to and 24 weeks. The researchers coping skills. follow-up project to develop infection with limited to no ability to ﬁght also examined the participants’ psychological treatments to off invading bacteria. levels of psychological distress, ation, researchers discovered. reduce depression in suffer- The eschar acts as a natural barrier coping styles and levels of the The ulcer was less likely to be ers and help them cope more to infection, keeping the bacteria from stress hormone cortisol. healed in patients who had effectively with this debilitating entering the wound. The following are The likelihood that the a “confrontational” method and potentially life-threatening treatment options for intact stable ulcer would heal over the 24 of coping (characterized by a condition. Up to 15% of peo- eschar: wrap the heel in dry gauze, paint weeks correlated to how an desire to take control) with the ple with diabetes develop foot with Betadine or liquid barrier ﬁlm, and individual dealt with the situ- ulcer and its treatment. or leg ulcers. ■ relieve the pressure. However, should the eschar become unstable (wet, draining, loose, boggy, edematous, red), the eschar should be debrided. Cost containment driving wound market Blisters usually form because the By
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