Dr. Angela Driskell

With the aging population in the U.S. combined with the increase in obesity and diabetes, demand for wound care is increasing and cases are more complicated. Physicians are seeing more patients with difficult to heal wounds such as chronic venous stasis ulcers, pressure ulcers, diabetic foot ulcers, and arterial ulcers. 

Complicating matters is that it is rare for a patient to have only one disease process, said Angela Driskill, MD, Physician Certified in Wound Care, Baptist Health Wound & Hyperbaric Center, North Little Rock.

“Diabetics are living longer and often have severe renal disease, as well as peripheral arterial disease,” Driskell said. “These patients in the past were simply amputated, but that is fraught with complications, both emotional and physical.  If these patients can undergo aggressive limb salvage including diabetic management, revascularization and wound care, they can often be spared the trauma of an amputation.”

Driskell said in an ambulatory, independently living patient, the positive implications of limb salvage are obvious. Some of the less obvious benefits are the financial benefit to the healthcare system since it is estimated that it costs about $200,000 per year to care for an amputee. And the mortality of lower extremity amputees is 50 percent in the five years after amputation. 

“So limb salvage, though expensive, is less costly in the long run than amputation,” Driskell said.

Another concern with wound care is that the incidence of resistant bacterial infections is on the rise. Driskell said methicillin-resistant Staphylococcus aureus (MRSA) has been prevalent, but historically has been sensitive to Sulfa based drugs, Clindamycin, Tetracyclines and Floxins. 

“Now we are seeing resistance to these antibiotics but we are also seeing an occasional wound culture that is Methicillin-sensitive Staphylococcus aureus (MSSA),” Driskell said. “It is going to be very important for us all to reserve the newer antibiotics for the truly resistant infections and to treat only based on culture sensitivities.”

Some of the latest developments in wound care are the ever-increasing array of topical products to improve the delivery of antibacterials and also collagen to the wounded site. 

“There are advances in debridement techniques to minimize pain to the patient such as the ultrasonic debriding device,” Driskell said. “The use of the negative pressure vacuum assisted wound closure device and the skin substitutes such as Dermagraft and Apligraf are some of the advanced treatment options. Each year there are more and more advances in wound healing therapies that are FDA approved. It is an exciting time to be in wound care.”

Tags:

Bookmark:

Facebook

Technorati

Newsvine

Google

Related: