It is finally spring, and admittedly, I have become very impatient. I want my colorful flowers, and I want them right now.
Two weeks ago, I planted six different types of seeds of my favorite perennials and annuals. Yes, I could have cheated and simply visited a nearby nursery to buy several hearty seedlings, but I did not. I know that there is something very rewarding and magical about watching my tiny nasturtiums push through the soft soil as they reach toward the sun.
There are lessons in taking a small seed through its germination toward a blossoming flower. Any amateur gardener knows the essentials of avoiding frost conditions, preparing the soil, ensuring adequate soil drainage, and recognizing the need for fertilizer. Moreover, the appropriateness of choosing the locale of sunlight is key, especially for those species that prefer partial shade.
I hope that you can sense the parallels in our toils in wound care.
Regardless of etiology, an initial wound assessment involves attention to multiple factors including, but not limited to, vascular conditions, wound bioburden, the need for offloading, moist wound bed status, and optimization of nutrition. Some patients with underlying chronic venous insufficiency require direct wound care, but also reinforcement of learned lessons. Our patients are advised to recognize the importance of edema reduction in the mitigation of recurrent venous ulcers, skin breakdown, and/or cellulitic infection. Other patients with chronic wounds, stalled by an inflammatory milieu, may need to undergo selective debridement to remove the “weeds” so that healthier “rootlets” may thrive.
By adhering to best practices and following basic tenets in the management of chronic wounds, our healing goals may reach their fruition (pun intended).
May we continue caring for our patients with the eager, hopeful anticipation of the avid gardeners. May our patients have the patience and the fortitude to reach toward the sun.
Until next time.
Monique Abner, MD, CWSP, is affiliated with Wound Healing & Hyperbaric Medicine, part of Tower Health Medical Group, in Wyomissing, PA. Dr. Abner's professional affiliations include the American Board of Wound Management, the American Society of Plastic Surgery, Diplomate of the American Board of Plastic Surgeons, member of the Undersea and Hyperbaric Medical Society, and member of the Association for the Advancement of Wound Care.