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Tom Sharon
The line of defense - healing wounds at an early stage


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What to Do About Healing Wounds When Prevention Fails

All right, let us say you discover that your loved one has a bedsore, as I discovered when I visited my mother. Although this problem should be nonexistent, as long as substandard care is rampant, there will be pressure ulcers. This is an unpleasant fact, and we have to deal with it by going to the second line of defense - healing the wounds at an early stage.

The first priority is to make sure that everyone knows about it - the charge nurse, nursing supervisor, director of nursing, attending physician, social worker, chief of medicine, risk manager, patient's advocate, and CEO. They might think that you are overreacting, but you will get the message across that you will not tolerate anything less than an aggressive approach to this potentially lethal problem. If you do not act as if this is life or death, neither will they. Additionally, find out if there is a functioning pressure-ulcer prevention committee (all hospitals are required to have one, but for some it is in name only). If there is, go to the chairperson and say that you will forgive their failure if they can show you an aggressive care and treatment plan.
 
There are many differing opinions on how to treat wounds. The big pharmaceutical companies have a variety of high-technology dressings. The bottom line is that the human body has to heal itself.
 
There are products that will aid the process, but that is a subject for another book. You will have to consult the attending physician and see which he or she prefers. Whatever the doctor prescribes, the regimen must provide the following protocols:

  • Clean the wound with irrigation and surgically remove all necrotic (dead) tissue one time only.
  • Increase blood flow to the affected area.
  • Absorb drainage away from the center of the wound while keeping it moist. Do not let it dry out.
  • Avoid any pressure on the wound area.
  • Do not disturb the wound in any manner. The initial healing stage is very delicate.
  • Test the blood for the patient's nutritional status and improve it if needed.
  • If diabetes is present, check the blood sugar every eight hours and keep the blood glucose levels between 90 and 180.

You have the right and responsibility to demand that the physician assure you that the list of orders will accomplish all the preceding items. If you are unable to get that assertion, then find another doctor -preferably someone who knows how to promote healing of chronic wounds.

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