Debridement is the process of removing necrotic or dead tissue that occurs during wound healing. This tissue inhibits the body’s ability to recover and develop new tissue during the healing process. This makes debridement critical in preparing a wound for quick and efficient healing.

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Offloading refers to removing pressure from the affected appendage. Offloading is achieved through a variety of methods including:

Shoes/socks that disperse pressure points

Wheelchair, scooter, or any device to minimize weight on the foot

Removable cast

Total contact cast

Half-shoes

All of these offloading methods are effective. The best option for any patient will be decided by the clinician and patient together.

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Compression Therapy involves the use of specialized stockings to reduce swelling and increase blood flow in lower limbs. Compression stockings attempt to apply gentle pressure and strengthen vein support. The stockings slowly stretch out vein walls which in turn helps eliminate swelling.

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Infection control is a critical element of any wound treatment. It can only be effective if both patient and care providers are dedicated to the proper infection control practices. Proper clinical infection control practices require the existence of an official Infection Control Program which should include:

Proper hand hygiene

Use of gloves, gowns, mask and face/eye shields when necessary

Safe injection practices

Proper handling of contaminated material.

Patient best practices should include:

Keeping draining wounds covered with clean/dry bandages

Keeping hands clean with soap and alcohol-based gels

Maintaining good general hygiene includes regular bathing

Not sharing items that can come in contact with the wound such as towels, clothing, bedding, bar soap, razors, etc.

Avoiding skin to skin contact with other individuals

There are many other precautions that could be detailed but following good hygienic practices will eliminate the majority of infection risks.

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Poor circulation is a primary contributor to complications with wound healing. Restoring blood flow to areas showing signs of reduced circulation is critical to proper wound care and to avoid amputation.

There are various ways patients can assist in restoring blood flow:

Stop tobacco use

Maintain a healthy weight

Control blood glucose levels

Control blood pressure

Eat a diet low in sodium and added sugar

Keep physically active; if restricted by limited mobility or chronic pain, seek additional options from your care provider

In severe cases, your provider may recommend surgical treatments. In any case, early diagnosis is key to patient success.

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When caring for wounds, clinicians have a wealth of options for bandages and dressings. These options are considered superior to the basic gauze and tape and are referred to as Advanced Wound Dressings. Advanced dressings reduce heal times and decrease risk of infection, thereby reducing drainage.

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Skin substitutes have been used to aid in wound closure for centuries. They also help to control wound pain and replace the skin functions to promote proper wound healing. Skin substitutes come in two varieties, temporary and permanent. Temporary substitutes function as a wound covering and primarily serve to protect a wound from bacteria and additional trauma while providing a moist, clean and healthy environment for wound healing. Permanent substitutes are used to fully replace all layers of the skin and are most common with severe burns.

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Negative pressure wound therapy also known as “NPWT” is an option for treating burns, various types of ulcers and other chronic wounds. NPWT uses a dressing that creates a seal over the wound and around tubing which is attached to a pump which will draw out fluid and infection from a wound to help it heal. NPWT is a great option for some, but not all, patients. Based on your wound and medical situation, your provider will decide if you are a good candidate for this method of wound treatment.

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A common treatment for diabetic foot ulcers relies on the application of a hard cast to relieve pressure on the areas of the foot that are most prone to ulceration. This technique is most commonly referred to as Total Contact Casting and is an option that may be presented by a provider post-diagnosis.