Approach to Complex Wound Management and Adjunct Therapy

ABSTRACT

The ageing of our population and rise in chronic diseases has resulted in the complex profile of the patients in the community. Complex wounds such as diabetic foot ulcers, infected pressure ulcers and other complications of non-healing wounds are common encounters in the primary health settings. The challenges of these complex wounds lie in its multi-factorial nature of the person, the wound and the environment. This requires a team approach to care within the limited resources boundary. As part of the care continuum, it is essential for primary care physicians to be familiarized with the approach to care of complex wounds and the adjunct therapy. This article seeks to provide a broad framework using the systematic assessment framework via T.I.M.E (Tissue, Inflammation/Infection, Moisture imbalance, Epithelial edge of wound) for wound bed preparation to guide primary care physicians/clinicians in their approach to complex wounds. It also highlighted the complexities of chronic wound management pertaining to the person, the wound and the environment as well as the recent advances adjunct therapy in chronic wound care. In addition, it seeks to enable primary care physician and wound clinicians to translate wound-healing principles into effective management strategies to provide better clinical care to our patients.