Wound care has come a long way since the days when Mercurochrome and gauze bandages were considered an acceptable form of treatment.
That’s a good thing. Especially for today’s seniors.
According to the Centers for Disease Control, this country’s aging population is especially prone ulcerous wounds and open sores that do not heal on their own or keep returning.
Fortunately, today there are whole teams of wound care specialists operating at both the Indian River Medical Center and the Sebastian River Medical Center.
Debbie Dill, nurse manager with the IRMC wound care team is frank in her observations. According to Dill, “We see a lot of patients that already have wounds [when they’re admitted to the hospital]. They’re not necessarily admitted because of their wounds. They’re admitted for something else.”
Dr. Dawn Davidson-Jockovich at the SRMC center for wound care and hyperbaric medicine explains that, “Everyone’s wound is different. Instead of just treating the wound, we like to get the big picture of what’s going on and make sure we address everything we can.”
Registered nurse, Erin Ploutz, at IRMC echoes Davidson-Jockovich’s sentiments with a somewhat snappier line: “We want to treat the patient as a whole,” says Ploutz, “not just the hole in the patient.”
Non-healing wounds are usually brought on by chronic diseases and conditions including diabetes, peripheral vascular diseases, hematologic conditions such as anemia, cardiopulmonary problems, (including chronic obstructive pulmonary disease and congestive heart failure), as well as gastrointestinal problems that can lead to malnutrition and vitamin deficiencies. Obesity is also a potential contributing factor.
Pressure sores or pressure ulcers – sometimes called bedsores – are among the most common wounds seen. The Mayo Clinic says, “Bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone,” adding that, “People most at risk of bedsores are those with a medical condition that limits their ability to change positions, requires them to use a wheelchair or confines them to a bed for a long time.”
According to the National Institutes of Health, “Approximately 70 percent of all pressure ulcers occur in the geriatric population.”
Treatment for these and other ulcerous wounds can be quite complex.
For starters, bacterial infections need to be treated. Any necrotic or dead tissue needs to be debrided or medically removed and any moisture imbalances need to be addressed by wetting dry tissue and drying wet tissue. All that takes time, along with special training and expertise.
So, Carrie Duprey, program director of IRMC’s wound care operations, took this bull by the horns and rounded-up the hospital’s entire nursing staff to help take on wound care.
“The biggest thing we’re doing here,” explains Duprey, “is something new. We’re getting all the nurses involved. We’re educating every nurse on the floor and every certified nursing assistant. The doctors are involved, too, so we’re getting everybody on board for this big in-patient program.” Even the hospital’s social workers are being enlisted.
At IRMC, that means more than 300 nurses now being prepared to watch for and to treat wounds. As Duprey puts it, “We’re making everybody an advocate for the patient.”
According to Duprey, “The hospital has been very supportive in everything including investing in special therapeutic beds,” which registered nurse Ana Chavalo jokingly refers to as being, “Like sleep number beds with a mind of their own,” because they automatically and gently change patients’ sleep positions.
Donna Jones, director of SRMC’s wound care and hyperbaric medicine program admits her facility can’t match IRMC’s sheer staffing numbers but she is nonetheless adamant that the Sebastian facility is also training more nurses and adding new beds as well as other new equipment to help with wound care. She also points to the hospital’s Care-A-Van program.
Many seniors, she points out, are unable to drive anymore so the hospital offers free transportation to and from the hospital or wound care center. The phone number for that service is 772-581-2010.
Dr. Davidson-Jockovich adds, “There are a lot of new treatment modalities. We now use wound-vacs, which is negative pressure that is applied over a wound and there are new, smaller wound-vacs that are easier for the patient.”
Wound care, however, is not exclusively in the hands of medical professionals like Dr. Davidson-Jockovich or nurses like Dill, Ploutz and Chavalo. The patient has a responsibility, too.
Davidson-Jockovich urges any and everyone with a scratch or wound or other trauma that hasn’t healed within a week to contact their primary care physician right away. Treating problems early, she says, is always the best course of action.
The good news is that the arsenal of weapons used at both hospitals to fight ulcerous wounds and sores has never been bigger. Or better.
Tools available include specialized beds, new hydro-gel dressings, foams, hydro-fiber composite and alginate dressings, artificial skin substitutes, hand-held vacuums to debride and cleanse, more effective topical antiseptics and, when called for, both wound centers have hyperbaric oxygen chambers available.
As to that old bottle of Mercurochrome? Forget about it. Back in 1998, the Food and Drug Administration labeled the once-popular over-the-counter antiseptic as “not generally recognized as safe and effective” and essentially forbade its sale across state lines.