Canadian Medical Alliance for the Preservation of the Lower Extremity
Treatment For Wounds
Wound care can be a complicated field, one that often requires
multiple factors to be addressed. The patient’s wound must be
tended to, of course, but the patient’s overall health, glucose
levels, circulation, nerve function, kidney function, eyesight, mental
health, biomechanics, bacterial burden, nutrition, footwear, and
ability to function on a day-to-day basis must all be considered.
Each aspect may involve a different field in medicine, and multiple specialists may be involved in your care. These may include your family physician, a diabetologist or endocrinologist. This may involve a vascular surgeon (circulation specialist, a neurologist (nerve specialist) or nephrologist (kidney specialist). This may involve an optometrist and ophthalmologist (eye specialists), a psychologist or psychiatrist. It could involve a dietician or nutrition specialist. It could involve infectious disease specialists. It could involve a podiatrist or orthopedic foot specialist. It could involve plastic surgeons, cast techs, and pedorthists. And it could involved specialist nurses.
Even the patient’s financial health plays a role, as government insurance may not cover all the care a patient needs. And wounds often preclude a patient’s ability to work and provide for oneself and one’s family.
But let's cover some basics.
Assuming the overall health of the patient and the control of his sugar is under control, and assuming there's enough blood supply and adequate nutrition to heal, the basics of wound healing come down to this:
Control of Infection (if present)
Debridement (the removal of dead, nonviable tissue from the wound)
Offloading (the removal of pressure and friction from a wound)
Dressings (the bandage applied to the wound)
Specialized treatments (negative pressure, engineered dressings, hyperbaric oxygen)
We've given each its own page, so click on the topic of interest.
"Healing is a matter of time, but it is
also a matter of opportunity."
--Hippocrates (460 BC - 370 BC)