Hello,
What do you do after that wound that you have been coaxing along finally covers with that last bit of new skin? I usually do the chicken dance over the difficult ones, I’m sure you know what it’s like to get a hard to heal wound to that end point. But what next? Often for clinics and home care agencies, it is discharge. For LTC’s you get them off of your wound rounds list. I want to ask you to think about a few things before you break ties with your patients who cross the finish line.
First, the wound is closed, not healed. Remember in video segment two you learned about the Maturation Phase. The body has a lot of work left to do underneath that fragile new skin. Go back and look at your notes. Second, we have responsibilities to help the wound safely move from closed to finally healed. Yes, you are going to have to step them off of that Group II surface, but get them on a great Group I. And make sure that the chair cushion is performing well. Negotiate with the patient about the plan for gradual increased pressure over the closed wound, let them know that the pressure should be very gradually increased over weeks or months. Daily skin inspections are a must. And remember that skin barrier wipes are great products to consider as you discontinue the wound dressing s at wound closure. And don’t forget to teach your patient to continue nutrition/hydration interventions during the Maturation Phase!
I’m working on putting these guidelines into a downloadable handout that you’ll be able to give to your patients. It will be part of the “Taking Care” series.
Thanks for letting us help you with your patients.
Happy healing,
Beth