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Wound Therapy
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overview of healing wounds

 

   

  
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The high cost of care for non-healing wounds, as compared to the improved outcomes from more aggressive use of adjunctive therapies is well documented. A chronic wound is a huge ongoing burden to the patient that seriously affects quality of life.

Merely caring for a wound with bandaging and ointments is no longer considered to be an adequate level of care for a non-healing chronic wound.

Recent reviews of Best Practices by provincial (RNAO) and national (CAWC) organizations in Canada recommend the use of therapeutic modalities, including electrical stimulation, ultrasound and compression therapy for patients with recalcitrant wounds.

 
 

When a wound occurs, such as following an injury or surgical procedure, nurses can apply wound care as the healing process moves forward. The problem is that when healing becomes stalled due to infection or poor blood flow, the wound is often classified as non-healable. This is not true. In nearly all cases, the reason for non-healing is the failure to apply timely wound therapy modalities to stimulate the wound bed and produce healing.

Several types of therapeutic modalities have been shown in the medical literature to be highly effective and safe when used as adjunctive therapies in treating a range of chronic wounds and ulcers:

  • Galvanic stimulation using a High Volt Pulsed Current (HVPC) electrical stimulator

  • Cardio-synchronous compression

  • Germicidal UVC lamp

  • Ultrasound

  • Biostimulation laser

  • Sequential compression

In a chronic wound, the tissues typically become stalled in an unstable state. The purpose of the treatment is to stimulated the tissues, produce a healing response and accelerate the healing process. The specific effects are: 

  • Stimulate new tissue formation
  • Increase capillary density
  • Anti-bacterial effect
  • Reduced edema
  • Increase in blood flow

Therapy has been shown to have a direct positive effect on all phases of wound healing:

  • Inflammation
  • Proliferation and granulation
  • Re-epithelialization
  • Remodeling

Randomized control studies have demonstrated significantly improved healing rates, with a 30% to 60% typical reduction in healing times. Studies of 8-week healing response have shown increases in successful outcomes from less than 5% in the control group to more than 50% in the group using therapeutic modalities. Adjunctive treatments are indicated for:

  • All wounds and ulcers needing regular nursing care,

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  • Wounds that have not shown any healing progress in 30 days, 

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  • Wounds known to be slow healing, such as with co-morbidities of diabetes mellitus, spinal chord injury, peripheral vascular disease, neuropathy, renal failure or congestive heart disease.

All of our products are effective and complete when used on their own to produce healing. However, results will be enhanced when used together, as part of a comprehensive approach including diet, weight-loss, off-loading and exercise.

Each wound is different. It is important to identify the root cause of the problem. Then use the appropriate modality as part of a comprehensive therapy program to treat the cause of the wound, and produce healing and wellness.

For the treatment to be effective and optimal, wound assessment and care should to be in accordance with Canadian best practice guidelines.

Therapeutic modalities are cost-effective for the health care system by replacing on-going expensive wound care and hospitalization with a shortened treatment and recovery period.

The choice of modality is dependent on the wound characteristics, equipment availability, and therapist training and experience.

Eight Treatment Modalities

  What to Look for in Wound Therapy for your Patients with Non-Healing Foot Ulcers (pdf)

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