Therefore, the way in which chronic wounds are viewed and managed should be based on a model that is both different from the acute wound paradigm and representative of the complex nature of nonhealing ulcers. By generating such a model, the scientific understanding and clinical management of nonhealing wounds could be optimized. Because it is based on the clinical knowledge and physiology of ulcers, wound bed preparation provides a model that is effective for the evaluation and treatment of wounds.
This article is a culmination in itself wherein it maps the assessment, diagnosis and treatment of wounds and also incorporates the methods towards continuation towards optimal healthy healing.
The author specifically mentions methods for treating non heal able wounds in which he has mentioned the NERDS & STONEES , Sibbald approach to be amiable and effective for the healing of wound much more specifically chronic wounds.
There are diverse patterns in wounds varying from acute to sub acute to chronic wounds, which ranges from post-traumatic abrasions, lacerations and burns to high-energy-explosive wounds. In acute wounds, the normal healing process has not been impaired and healing is ensured if the wound conditions are not compromised. Chronic wounds are wounds that are arrested during certain phases of wound healing and fail to heal in a timely manner, even with standard wound care. Thus, when wound...
... middle of paper ...
...or wound-cleansing techniques and solutions used
• most chronic wounds are stuck in the late inflammatory phase of wound-healing and have not progressed to the regenerative phase
• Considering when fluid removal or exudate absorption / bacterial removal should be done using various adjuncts.
• Understanding the need and techniques to be used to manage wound fluid
The approach to the local wound bed has 4 components starting with the mnemonic DIM: Debridement, Infection/ prolonged Inflammation control, and Moisture balance, before the mnemonic DIME that includes the advanced Edge-effect therapies for wounds with the ability to heal.
Of the detailed explaining of the methods and criteria for better wound bed preparation the author also insists on the combined work of the medical team and the family to gain the appropriate results for the healing process of the wound.
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