- A case study of the initial treatment of a suspected ‘hard...
A case study of the initial treatment of a suspected ‘hard to heal’ wound
For several decades, health care professionals
have been under increasing financial and political pressure to
optimise care and above all minimise costs. Chronic wound
management is estimated to cost the NHS £1bn a year (Harding, 1998)
and as longevity increases and medical, nursing and pharmaceutical
knowledge and care develop, this figure will inevitably rise.
Venous leg ulcers, diabetic foot ulcers and pressure ulcers account
for more than 90% of what are defined as chronic wounds (Mustoe,
O'Shaughnessy, Kloeters, 2006). Clearly, some of this enormous sum
could be invested elsewhere if those dealing with wounds were
better informed about current wound management research and had
access to a wide range of dressings.
For the individual, chronic wounds can be
physically debilitating and painful, but the psychological effects
are equally detrimental, disruption in self-image and
self-consciousness about odour and visible dressings. It was for
this reason that I chose to study the holistic care of someone who
had sustained a wound that would, in all likelihood, be chronic and
'hard to heal'.
After four weeks, the ulcer on Mrs S' leg did seem
to be decreasing in size and depth, although it was a slow process,
Annie was pleased that her leg appeared to be healing. Mr and Mrs S
also appeared to be more confident about managing Annie's diabetes
and felt empowered by knowing more about the condition and the fact
that they could, through their actions, improve Annie's health.
In retrospect, Mr S said that he wished he had
sought help sooner after the fall. One might suggest that his
generation are more reluctant than most to 'bother' the doctor and
are more stoic whereas a younger person is less tolerant of
diminished quality of health and comfort. In the future, he
realised the importance of early intervention when a diabetic
person is developing health problems. Annie did still find the
compression stockings hot and uncomfortable to wear but was aware
of the fact they would help her leg heal and reduce the oedema in