By Diana (DeeDee) Bycoffe, BSN, RN, CWOCN
Nurse Care Manager
Recently The Option Group posted a blog entitled, Steps to Take Now to Reduce Your Risk of Falls.
To reiterate, according to the U.S. Centers for Disease Control and Prevention, one-fourth of Americans over the age of 65 do fall in any given year, and that over half of all falls take place in the home. The truth is that most falls can be prevented and there are things we can all do to reduce this risk.
Falls are scary and can lead to serious consequences.
At The Option Group, we want everyone to live a safe, enriched life. Our experienced care managers have the tools and resources to help navigate this journey of aging, discovery, and the healthcare maze. If you or a loved one is experiencing stress, frustration, and the consequences or risk of falls, contact us. Let us help evaluate the situation and provide clear choices that lead to better care.
One of the consequences of falling is the possibility of incurring a wound.
Wounds can occur for a variety of reasons and are classified as either acute or chronic. Acute wounds usually result from surgery or trauma and progress through normal stages of wound healing, while chronic wounds fail to do so. As such, they require different methods of treatment.
Acute wounds generally heal naturally and within about 10 to 14 days. Sue Currence, BSN, RN, WOCN and past manager of the Wound Center at the University of Maryland St. Joseph Medical Center’s Wound Center, states that “after four weeks, if no improvement seen in your current treatment, the wound has probably moved into the chronic phase and will require further evaluation. Additionally, poor nutrition, aging, smoking, diabetes, vascular disease, and immobility are some factors that impact a wound’s ability to heal.”
Choosing the right dressing.
When talking about wound care, the question that is usually asked is “what dressing/treatment do I use for this type of wound?” The answer is that there is not one dressing that applies to every wound. Wounds are dynamic and as they change (heal or stall or worsen), so too must the treatment.
To choose the right dressing for the right wound, a few principles should be kept in mind.
DIME is an acronym that can be used to choose an appropriate dressing.
- ‘D’ stands for devitalized tissue and comes more into play when dealing with chronic wounds, but it is important to keep in mind fresh wounds as you want to follow the steps to prevent devitalized tissue. The ‘D’ can go even further to mean debridement or the removal of unhealthy or sloughed cells. The wound bed must not contain necrotic or “dead” tissue for it to heal properly. There are several methods to debride wounds and/or keep them void of necrotic tissue. The easiest and first step would be auto-debridement. Simply keeping a wound covered and moist will allow your body to heal and grow a nice layer of skin.
- ‘I’ is for infection. The wound needs to be cleansed and protected from becoming soiled. The dressing chosen should help prevent infection by providing a barrier from the outside environment. Sometimes an antimicrobial dressing is needed to help get rid of an infection already in place. It is also possible that oral antibiotics may be needed. Regular assessment of the wound is needed to identify signs and symptoms of infection so that they can be quickly addressed.
- ‘M’ is for moisture and probably the most important one of all. Too much moisture can cause maceration and skin breakdown and promote infection, while too little moisture can create necrotic tissue formation. Moist wound healing is the best environment, but it should be like the hard, packed sand on the edge of the ocean. If a dressing sticks to the wound upon removal, it is too dry, and moisture may need to be added. If the skin around is macerated and weeping, either a more absorbent dressing is needed or more frequent dressing changes. Sometimes you may need to switch back and forth to find the right balance.
- ‘E’ is for wound edges. The edges should migrate in, causing the wound dimensions to lessen as the wound heals. Regular measurement of the length (head to toe) and width (side to side) is the definitive way to tell if this is happening. If you are following all these steps and the wound is not growing smaller, it may have stalled, and a wound specialist should be consulted to see if there are any products to stimulate that cell growth.
In summary, following these 4 steps should promote a healthy, healing wound. If further evaluation or treatment is needed, contact one of the many local wound care centers. The larger centers are staffed with a podiatrist, vascular and general surgeon, wound care nurse (WOCN), and in some cases, a hyperbaric oxygen therapy chamber.
Take the steps necessary to prevent falls, learn about the signs of an acute vs. chronic wound, and use the resources available to help you stay healthy, vibrant, and living the active life you deserve!
If you or someone you care about needs additional support to help cope, The Option Group is here to help. Please contact our professional care management team for assistance.
About The Option Group: Founded in 2010, The Option Group’s compassionate team of experienced Certified Life Care Managers serves families, their loved ones, medical professionals, and professional family advisors in Maryland, Pennsylvania, and Delaware. The firm understands the challenges of caring for an individual who needs assistance due to aging, dementia, disability, or serious illness. Their skilled providers possess over 100 years of combined experience navigating the healthcare maze and accessing hundreds of quality resources. The Option Group helps families spend quality time with their loved ones, providing clear choices that lead to better care. For more information, visit www.theoptiongroup.net or call 410-667-0266 (MD) or 717-287-9900 / 610-885-8899 (PA) / or 302-858-6449 (DE).