The concept of wound management is a relatively new one in the Caribbean.  With our growing elderly and diabetic populations, it is an area that we must focus on both for improved patient outcomes and cost-effectiveness.

Medical Outreach offers a comprehensive approach to quality wound management including full educational and consulting services. 

We offer one of the most complete sets of educational offerings available to address all aspects of wound care.  Our current modules include:

Basic Wound Healing – These modules are the basis for staff education in wound management.  We treat these modules on two levels – basic for all staff members, and advanced for those who will form part of the Wound Management Team.  The basic sessions are one-day classes while the advanced group receives a full week-long workshop with plenty of hands-on experience. 

The modules include:

• Anatomy and Physiology – Normal Wound Healing
  This module includes the basic anatomy and physiology of the skin along with a thorough explanation of the normal wound healing process.  If this basic process is not understood in detail, it is impossible to recommend appropriate interventions. 
  
  
• Factors Affecting the Healing Process
  We discuss the many factors that can adversely affect the normal healing process including inappropriate dressing materials/cleaning techniques, nutrition, mobility, and underlying disease.
  
  
• Wound Assessment and Documentation
  Each wound has parameters that need to be assessed in a systematic way.  We practice wound measurement, identification of granulation tissue vs necrotic tissue, the peri-wound skin, and various other elements.  We also present meaningful documentation methods that go beyond “the wound looks good” or “dressing change completed” so that each staff member is aware of their responsibility to accurately describe what they see.
  
  
• Lower Extremity Ulcers
  The majority of chronic wounds that we see are ulcerations of the lower extremities.  Since each type of these wounds requires different treatment plans, it is crucial to differentiate between them.  Within this module, we discuss the differential characteristics and treatments for venous stasis, arterial, and diabetic ulcerations.
  
  
• All Dressed Up – Product Selection
  This is an introduction to the various categories of wound products appropriate for practicing advanced moist wound healing.  It explains the characteristics of the different products and provides guidelines for selecting the “right” dressing for the “right” wound.  The use of Hyperbaric Oxygen Therapy is also discussed.
  
  
• Acute Surgical Wounds
  Acute and/or surgical wounds differ from chronic wounds.  Within this module, we discuss the various physiological differences and discuss important considerations for dealing with acute wounds, from dressing selection to the important of recognizing the changes for the diabetic surgical patient.
  
  
• Emergency / Trauma Wound Management
  Emergency and Accident Departments are constantly seeing both acute and chronic wounds.  We discuss the implications of moist wound healing from their perspective as well as address burns, lacerations, and crush injuries.  The concept of Hyperbaric Oxygen Therapy is also discussed.

We can also provide V.A.C. Therapy training and certification as well as our comprehensive PUP Program (pressure ulcer prevention).

Wound Management Concepts – These advanced level modules are designed for the beginning Wound Management Team and are certainly not intended solely for nursing staff.  Taking a multi-disciplinary approach from the outset helps to insure that all the pieces of the puzzle come together for the Program.

• Putting It All Together – The Assessment and Evaluation
  Within this module we put together all the knowledge gathered from the basic wound care course, put it together, and assess and evaluate actual wound care patients.  We discover a systematic method for looking at all the factors that could be affecting this patient’s ability to heal his/her wound.  We evaluate any recommendations for referrals (i.e. physical therapy, nutrition) and establish a treatment plan with both short-term and long-term goals.
  
  
• Establishing a Wound Management Team
  This offering is designed as the basis of a multi-disciplinary approach to wound management.  It is intended for physicians, surgeons, nurses, nutritionists, physical and occupational therapist, chiropodists, materials management, administration, and any other interested parties.  We discuss determining the organization of the team, developing protocols and guidelines, identifying needed referral parties, and many other aspects of establishing the team to deal with both in-patient and out-patient wound management patients.  We also take a look at the community resources that may be involved.
  
  
• Product Formulary Development
  Product Formulary development goes hand-in-hand with the basic dressing selection module and are usually presented together.  With the myriad of advanced wound products on the market today, it is helpful to have some guidance in determining the best products to have available for your particular circumstances.  Through this process, we help you weed out the unnecessary items and focus on what is truly a necessity.  We can guide you to various suppliers of these items and help to negotiate the best pricing possible for your group.
  
  
• Becoming an Instrument of Change – Implementing The Team
  Wound Management is a relatively new concept and requires individual, group, and societal changes.  Changes can be difficult without knowing proven methods for obtaining group consensus and enthusiasm.  Medical Outreach has implemented these changes in numerous environments and has the tools to help bring about change in the most positive manner.  We will discuss these methods and tailor them to your situation.

Best Practices in Wound Management do exist.  They are based upon current scientific evidence and form the basis of all our educational offerings.  As clinicians and health care providers, we have the obligation to work towards implementing best practices within our own area.  Our advanced consulting services can help your facility work through all the necessary steps for the initiation of:

• Best Practices in Wound Bed Preparation
• Best Practices for Venous Ulcerations
• Best Practices for Diabetic Foot Ulcers
• Best Practices for Pressure Ulcers

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