Commentaries☆

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Abstract 

J Vasc Nurs 2003;21:4.

I have been asked many times in my career to consult on a patient with a wound. I was often asked to recommend what could be put on or in a wound. Addressing products only does not take into consideration what caused the wound. As Lois Kittenplan's editorial discusses, many health care professionals fail to invest the time into researching and addressing wound etiology. Wounds are evaluated as though they are detached from the patient's body. The wound is treated as a separate entity, extending the already lengthy treatment and resulting in poor outcomes despite a high cost.

Wound healing will not be promoted or enhanced if the patient's underlying comorbidities are ignored. The strategy outlined presents a common sense approach to detecting the source of a nonhealing wound. Comorbidities are considered, wound manifestations are identified, and possible causes of the wound are considered. Evaluating the possible causes can point to the need for further diagnostic testing, allow for prompt referrals, and provide overall better and more cost-effective wound management. Also important to effective wound assessment and management is the identification of any nutritional deficit(s) that may be contributing to poor wound healing. If a patient is experiencing pain, assessment of that pain is important because pain can influence mobility, nutrition, rest, and sleep.

There are many categories of excellent wound care products available, but if the etiology of the wound is not considered, the wound type cannot be appropriately matched to the category of product. Wounds are dynamic, and the best treatment for the wound today may not be the best treatment for the wound in a week or two. Thus, continual reassessment is also important to cost-effective wound management.