Wound Bed Preparation 2021

Abstract

Wound Bed Preparation is a paradigm to optimize chronic wound treatment. This holistic approach examines the treatment of the cause and patient-centered concerns to determine if a wound is healable, a maintenance wound, or nonhealable (palliative). For healable wounds (with adequate blood supply and a cause that can be corrected), moisture balance is indicated along with active debridement and control of local infection or abnormal inflammation. In maintenance and nonhealable wounds, the emphasis changes to patient comfort, relieving pain, controlling odor, preventing infection by decreasing bacteria on the wound surface, conservative debridement of slough, and moisture management including exudate control. In this fourth revision, the authors have reformulated the model into 10 statements. This article will focus on the literature in the last 5 years or new interpretations of older literature. This process is designed to facilitate knowledge translation in the clinical setting and improve patient outcomes at a lower cost to the healthcare system. GENERAL PURPOSE To present the 2021 update of the Wound Bed Preparation paradigm. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will: 1. Apply wound assessment strategies. 2. Identify patient concerns about wound care. 3. Select management options for healable, nonhealable, and maintenance wounds.

A ‘game of dressings’: Strategies for wound management in primary health care

“…12 The peri-wound tissue is also assessed regarding maceration (reflecting the excess of exudate), skin integrity (erosions, skin-stripping), induration, oedema, erythema/cellulitis/ folliculitis, callous, xerosis, atopic eczema and hyperkeratosis and should be addressed in the treatment plan. 12,20 The DIME framework (Figure 2 15,24 ) incorporates the same principles of TIME, adding concepts regarding healability of wounds and the need to address the cause and other factors related to wound management into the enabler; D stands for debridement (surgical, sharp, autolytic, enzymatic, larval or biological and mechanical), I for inflammation/infection, M for moisture and E for edge. 15,24 Strategy number 4: Provide the treatment plan…”

Saudi Honey: A Promising Therapeutic Agent for Treating Wound Infections

“…There is therefore a need for an urgent and effective therapeutic plan to facilitate wound management and limit potential complications [1]. Wound bed preparation (WBP), a recommended protocol based on clinical practice guidelines, is applied to remove non-viable tissue from a wound, manage exudate, and prevent the establishment of infections [11]. To achieve successful WBP, chronic wounds need to be cleaned with high-pressure water to debride them, as there is no evidence-based recommendation that the use of chemical solutions, such as decylenamidopropyl betaine, leads to better outcomes [11].…”

“…Wound bed preparation (WBP), a recommended protocol based on clinical practice guidelines, is applied to remove non-viable tissue from a wound, manage exudate, and prevent the establishment of infections [11]. To achieve successful WBP, chronic wounds need to be cleaned with high-pressure water to debride them, as there is no evidence-based recommendation that the use of chemical solutions, such as decylenamidopropyl betaine, leads to better outcomes [11]. Moreover, maintaining a moist wound environment with hydrogels is important to accelerate epithelialization and prevent any further damage by blisters [12].…”

Hospital Bed for Diabetes Care: An Invention to Support Professional and Hygienic Nursing Practice

“…Wound care is one form of nursing care to support cell growth, so that wounds heal and avoid infection. The wound care process begins with assessment, washing the wound, preparing the wound bed, dressing [1] [2]. Based on the observations of researchers at the wound care clinic, the time required to perform wound care is in the range of 30-120 minutes.…”