Cost containment driving wound market by ProQuest


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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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