Wound Care, From an Expert.
As I grow ever closer to my full societal reemergence, some of the things that have helped prepare me along the way will become no longer necessary.
Sadly, one of those things is a weekly visit from Travis, my wound care specialist. Sadly because I really like and will miss him and his guidance, though I am not sad that my wounds are mostly healed.
Today will be Travis’ last visit, and I thought I’d take a moment to glean some of the more important stuff to know when it comes to wound care, as well as to reflect on me being a patient, so I interviewed him.
And here, friends, is that interview.
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Me: What's the most common type of wound you see as a home wound care specialist?
Travis: The most common wound seen in the home setting is usually diabetic foot ulcers and pressure ulcers after being discharged from other hospital facilities.
Me: What are some suggestions you have that would help people to heal wounds aside from having you come and take care of them?
Travis: There are several keys elements to wound healing my top 4 in regard to being able to heal quicker with better outcomes is
Offloading offloading offloading! …of the affected site, taking pressure and routine use of a site that has a wound is number one key to allowing the tissue to rest and be able to begin generating viable tissue growth and produce new skin growth.
Diet high in protein, at least 100gms per day for duration of wound healing. (example: 1 6oz chicken breast has about 30 grams of lean protein, 3 eggs is 21 grams, 6 oz hamburger meat is at 25 grams and 6 oz of fish 30grams as well, 1 cup of edamame beans is at 20gms) 6oz is about the size of a deck of cards, so reaching a goal of 100grams a day when broken down is easy to reach. also remember to supplement with protein shakes or bars but not more than 2 a day.
Good diabetic control, high glucose levels for chronic duration cause slowed healing of wounds due to inflammation process as well as placing at high risk for infections with blood glucose staying elevated. (remember bacteria love a high sugary environment!)
Ensuring routine dressing changes and cleaning of the woundbed are being done per providers recommendations.
Me: How important is it to follow your doctor and wound care specialist's instructions to heal?
Travis: Like most therapies and treatments it is highlt recommended you follow your wound specialist orders and recommendations, they are specialized in wounds and have an understanding of the process of wound healing and identify what is needed to continue with the healing process.
Me: Can you talk a little about my case, and what happened with the "spit" stitch, and what we did, and why it took some time to heal?'
Travis: Sometimes, post-surgically, when someone undergoes a large procedure, such as an amputation of a leg there is alot of tissue involved with the healing process. Occasionally, you can develop something called dehiscence to the surgical site and it is due to underlying sutures becoming loose or breaking, causing the incision site to open up and develop into a wound.
Once it opens it is never recommended to reclose with sutures, as this can lead to a high risk for infection. So the wound then has to close by secondary intention, and where the need for woundcare comes into play. Causes of dehiscence are usually related to lack of offloading to site, trauma causing hit falls or striking area, and just at times the incision sites tissue and skin is weak and just opens up.
The healing process of a wound is in stages:
Hemostasis
Inflammation
Maturation
Proliferation
A wound has to go through all of these stages in order to obtain full resolve, depending on the patient's overall health there protein intake, diabetic control and offloading compliance all impact the tissues ability to heal.
Me: Was I a good patient?
Travis: Mike you were a perfect example of good patient!
Me: What's the gnarliest wound you've ever had to deal with?
Travis: The most complicated wounds I deal with are usually related to a Diagnosis called Fournier's Gangrene. It is where bacteria begin to destroy and eat away at tissue within the groin and peri area region of usually men. It is related to uncontrolled diabetes, poor hygiene and obesity. The wounds are very large and deep and, due to the patient’s overall condition very challenging to heal.
Me: How much does mind set play a part in the healing process?
Travis: Wound care and having a wound in general can be a very frustrating thing at times. Your attitude on wanting to do whatever it takes to cause faster healing and resolve of the wound is the only way to get through the process. Doesn't always have to be happy and positive. I would say more determined to succeed.
Also, ensure you communicate with your provider and nurses on understanding treatments and the process of healing, educate yourself and family in regard to what you are needing to do for success.
Don't be afraid to ask questions about your care to your wound care team, we love to educate!!!
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See? A good guy, and a font of information.
Wounds can be tricky and gnarly and frustrating, and hopefully you have professionals to turn to in an effort to help you understand and heal from them.
I am now and will always be grateful for Travis’ help.
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As always, if you have it in you, please give a thought to donating time or money to Hospice Austin. They do amazing work for people who are going through the hardest thing a person can face.
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