“Sowing the Seeds” Part I

Dear Readers,   It is that time of year again—time to begin preparing the green fields in anticipation of deer hunting season. Many of you probably think that it is a ridiculous waste of time and money, while others of you will understand the project. As a city boy, farming even on a very small, intermittent scale does not come easy, but I am learning. As one of my colleagues who also participates in the endeavor says, “I may not be much of a hunter, but I am becoming a fairly respectable farmer!” I am not sure I can truthfully say that yet, but I am learning. Yes, planning what to plant, preparing the fields, sowing the seed, and growing the finished product can be challenging at the best. As my elder son and I were out working on the green fields recently, the thought occurred to me how similar growing crops and taking care of wounds can be. I know that may sound strange, but it is true.   When we take care of wounds we choose what we are going to put on the wound in the form of dressings and bandages much like we choose which seed we shall plant. We prepare the wound bed by debridement, ensure optimal moisture, control the bacterial bioburden, and optimize the environment by controlling edema and lymphedema in an attempt to get all the factors involved in wound healing working at the optimal time to heal the wound. Growing crops is much the same in that we disc (plow) the fields, check the pH of the soil, and apply fertilizer to optimize the chances of the seed germinating. We choose the dressings and bandages that we believe will be the most beneficial to the patient’s situation. This is the same when we choose the seed we plant; it has to be the right seed for the right environment. In wound care, we also know we must apply the bandages and dressings correctly in order to obtain an optimal result. This is also true with planting. To optimize the outcome with planting, some seeds need to be planted about an inch deep, while others must be sown on the surface. If you do not get it right, the seeds will not sprout and no crop will grow. Wound care, like farming, requires proper knowledge: how to prepare the wound for optimal healing; how to choose the best dressing and bandage for each individual patient; and how to use these dressings and bandages correctly. If this is not done in the appropriate manner, the expected and desired results will not be forthcoming.   The next time you see a lush field, reflect on what it took to produce the crop. Reflect on your wound care practice and think of what kind of results your efforts are producing. Do you need to do a better job preparing the land, choosing and sowing the seed better, or becoming more proficient at utilizing the resources available to get the best outcomes? I encourage you to see how you are doing and determine if changes are needed to provide the best care for your patients.   Terry Treadwell, MD, FACS