|
.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
{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.}
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:
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,
and
- Wounds that
have not shown any healing progress in 30 days,
and
- 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) |
