Recently as part of a post marketing surveillance project for a specific dressing product, I had to record the dressings used on a wound over time. I’ve provided just a little example of what I found. This is just the diary of one wound, and doesn’t include all of the treatments days for this one wound:
Dear DiaryYou probably look at this and think, “That doesn’t happen in MY wound center! We don’t make club sandwich dressings and we don’t change plans every week!” But, I am pretty sure you DO, based on registry data.
For more than 10 years, we’ve had a way to select dressings more consistently and appropriately, but no one has wanted to use it. When we started that project, we looked at the likelihood that the specific dressings chosen complied with the surgical dressing policy (e.g. putting an absorbent dressing on a wound documented as having moderate to high drainage). Care to guess what the likelihood was that a patient in a wound center was treated with a dressing appropriate to the wound characteristics documented in the chart? If you guessed that the dressing “matched” the wound characteristics about 50% of the time, you were right.
What are the implications of this?
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
Let’s think about this – what are dressings supposed to do? Do they make wounds heal? I say NO! After my early years of consistent disappointments in results that generally did not match the confident claims of the various product reps, I gradually came to understand that dressings only support our learned attempts to manage fluctuations in a microenvironment as we focus primarily on the long list of underlying anatomic and physiologic issues that are “in the way” of that body’s inherent ability to heal itself. Products in most cases, DO NOT make wounds heal. PERIOD. My low-cost repertoire of dressing types has narrowed down to less than ten over the years of trial and error and thinking outside of the box (of ultra-expensive products). There, I feel better now!