Diabetes wound healing begins with proper treatment.
In Part 3, I told you of the six steps in wound treatment:
Prevention, inspection, and cleansing have been covered in the earlier parts of this wound care resource. It's now time for treatment.
The road to wound healing requires more than the dressing itself. When choosing a wound treatment, one must first look at the whole person, not just the wound. In addition to the issues your health care professional takes into consideration is a person's nutritional status—normal or near normal blood sugar levels and adequate nutrition, including enough protein, vitamins and minerals, which includes vitamin C, E, and zinc.
To provide direct wound care, one must:
- Treat underlying problems. For example, if poor fitting shoes cause the wound, stop wearing those shoes, and wear appropriate shoes. If a wound is caused by being immobile, treatment involves moving more often, and pressure relief devices. If it's an infection, treat with antibiotics.
- Cleanse the wound. Many times this just includes gently cleansing with soap and water, or a physiologic saline (salt) solution one came make at home, putting 8 teaspoons of table salt in one gallon of distilled water. This can then be boiled, and cooled to room temperature before using. How often the wound needs cleansing depends on the wound itself, the type of dressing, and how often the dressing needs to be changes.
- Treat the wound. This is the wound dressing itself. You may have been told to leave a wound open to air dry. Wound healing is best promoted when the wound bed is kept moist, but not wet. There are many types of wound dressings made from various products that protect the wound and help them heal. Some of these products are:
The type of treatment usually changes as the wound gets better or if the would is not healing.
- Alginates—made from seaweed, which help absorb wound drainage
- Foam, which helps clean healing wounds that don't have a lot of drainage
- Hydrocolloid—helpful in dry wounds and those with minimal drainage
- Transparent films for clean, dry wounds, and also for a dressing over other types of dressing (i.e. foam) to secure the dressing, and also used to protect from friction
- Topical agents—There are several types of agents available by prescription that have been shown to promote wound healing. There are also over-the-counter treatments such as Vitaman A & D ointment, antacids, and sugar. It is recommended not to use hydrogen peroxide, povidine iodine solutions, or acetic acid. Dakin's solution (sodium hypochlorite solution), which I mentioned in part 3, is not generally recommended either. Use only under the supervision of a health care professional.
- Compression—if the wound is on a lower extremity, compression therapy may be needed to help circulation
- Other—there are other products and procedures such as hyperbaric oxygen and wound vacuum devices that are used with some of the dressings above.
Wound dressings protect the wound by keeping the wound clean and protecting it from contamination. Some dressings help decrease friction, and some add padding to protect the wound from trauma.
Even if a wound has closed, it takes time for the area to regain strength. Sometimes a dressing is recommended at this stage to protect the wound. Pressure relief is also still important at this time.
Prevention includes protecting the wound from further damage, while healing as well as protecting once it heals. Also, prevention includes all the steps to manage diabetes, including the foot care basics. Your goal is to prevent wounds. Prevention is an ongoing process.
I hope I have given you enough information to see that wound treatment is not simple. As a person with diabetes, you need to know that prevention is the best treatment. And, if you have a wound, contact your health care provider immediately! This article is not intended to teach you to take care of wounds on your own, but to better understand wounds, wound treatment, and wound healing. You should not be treating wounds yourself, but under the care of a health care provider.
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NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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