The Role Community-Based Health Care Providers Play in Managing Hard-to-Heal Wounds

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Community-based healthcare providers (CHPs)—non-specialists in wound care—commonly provide initial and ongoing management for a wide range of wound types in diverse populations. A poster to be presented at the Symposium on Advanced Wound Care (SAWC) Fall finds that CHPs can improve healthcare efficiency and costs if they refer patients early and strengthen their ability to deliver good evidence-based wound care.¹

The authors note that wounds in any setting can rapidly become stalled, hard-to-heal wounds, and failing to recognize or address issues that can cause delayed healing can lead to increased costs, healthcare utilization and suffering.^2,3 To encourage early intervention by CHPs, a panel of wound care experts developed actionable evidence-based recommendations for CHPs delineating characteristics and appropriate care in identifying and treating hard-to-heal wounds:

• The wound and periwound should be cleansed with a non-cytotoxic antiseptic or pH-balanced surfactant solution post regional skin hygiene.
• If appropriate, prompt wound debridement with gauze or a soft pad is recommended.
• For draining wounds, the periwound should be protected with a barrier product.
• When increased risk of a hard-to-heal wounds is identified, healing is delayed, or infection is suspected, a topical antimicrobial/antiseptic agent should be used.
• For highly draining wounds, a superabsorbent/gelling fiber dressing is recommended.
• Alginate or foam dressings are recommended for wounds with medium drainage, and hydrocolloid, sheet hydrogel or thin foam dressings for minimal drainage.
• A basic toolkit for wound care should include antiseptic/surfactant wound/skin cleansers, debridement products, a barrier product to protect the periwound, a selection of absorptive dressings appropriate to the level of exudate observed to ensure a moist wound environment, and a secondary cover dressing if needed.

References

1. Beeckman D, Cooper M, Greenstein E, et al. (PI-016) The role community-based health care providers play in managing hard-to-heal wounds. Poster presented at the Symposium on Advanced Wound Care (SAWC) Fall. Nov. 2–5, 2023.
2. Milne J, Searle R, Styche T. The characteristics and impact of hard-to-heal wounds: results of a standardised survey. J Wound Care. 2020;29:282-288.
3. Vowden P, Vowden K. The economic impact of hard-to-heal wounds: promoting practice change to address passivity in wound management. Wounds Int. 2016;7:10-15.