Page 169 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

144 Chapter 6. Treatment

Summary

As noted in other chapters, chronic wounds may cause
financial, emotional and psychological strain for the patient.
However, it is not just the wound that can cause these prob-
lems- it may also be the treatment for their wound. This
chapter explores some of the psychological issues related to
the treatment for chronic wounds, detailing three particular
areas of treatment. Firstly, the stresses and strains of dressing
change are explored. This highlights how the pain and stress
may be associated with the dressing regime and, how, changing
to an appropriate dressing choice may reduce both pain and
stress. In such a way it may be possible to improve healing
by reducing the stress associated with inappropriate dressing
technique. Secondly, compression therapy will be explored
and how concordance with this may be low and thereby reduc-
ing the effectiveness of the treatment. Techniques to improve
concordance with treatment will also be explored. Finally, the
pain and stress of Negative Pressure Wound Therapy (NPWT)
will be outlined and how this may change across the course of
treatment- emphasising the need to assess psychological vari-
ables throughout the course of any health related intervention.

Introduction

Although many wounds have the potential to become chronic,
certain medical conditions are commonly associated with
non-healing wounds. These conditions include DFU, chronic
venous ulcers, arterial ulcers and pressure ulcers. These pose
a significant treatment challenge for the healthcare profes-
sional and can result in significant issues for the patient
given not only the chronic nature of the wound but also the
frequent, and often painful, treatment. The principles of the
management of chronic wounds include effective debride-
ment, stimulating the intrinsic process of wound healing and
using appropriate dressing techniques until the wound bed
is ready for wound closure. Each of these elements has the
potential to cause significant issues for the patient.