Wound Care: An Essential Service During the COVID-19 Pandemic?

By Emily Behse (RN, IIWCC, MClSc-WH)

The coronavirus disease 2019 (COVID-19) pandemic has forced the healthcare system to adopt a new approach to the delivery of medical services. This includes the creation and revision of new and existing protocols to accommodate for the growing impact of the disease. The popular term “essential” has emerged from these changes to define whether a particular service is given priority for implementation, in an attempt to avoid overwhelming the healthcare system and depleting the available resources.1

Beyond the disruption to the general field of healthcare, wound care has a unique place amongst the affected specialty services. The allocation of resources has changed to supply “essential” care, which is a vague label when it comes to the individual needs of patients. Unfortunately, amongst various locations, wound care has been labeled as a nonessential service.2In reality wound care has been found to reduce morbidity and mortality, and contribute to a decline in hospital admissions and length-of-stay for traditionally comorbid patients.3,4 Individuals with wounds are often amongst the most vulnerable of the population living with chronic conditions, such as diabetes, kidney disease, and lung disease. In addition, they have a break in the protective barrier function of the skin, thus increasing the possibility for infection and the life-threatening complications of COVID-19.

Wound care specialists have been called to support the frontline workers for the management of COVID-19 patients where nursing resources are worn thin. However, chronic wounds compose a large portion of the healthcare system and complete cessation of professional wound care can cause these wounds to progress to the point of irreversible systemic damage, resulting in severe complications.3 Therefore, the advanced knowledge and skills of the wound care specialist are crucial in preventing such complications, as well as fostering hospital admissions due to wound complications (e.g., infection). This requires wound management plans that offer maximal effectiveness and strong knowledge on the dressing regimens that provide the optimal wound environment for healing while decreasing the risk of exposure to COVID-19 through proper containment of wound exudate.5

Consequently, wound care should not be mislabeled as an elective service. Because once a wound has been installed the only way to heal it and avoid further complications is by treating it faster and appropriately. Wound care specialists need to be involved in the changing policies, procedures, and platforms for delivering healthcare services during the COVID-19 pandemic. Incorporating the unique assets that a wound care specialist offers to the interprofessional team has the ability not only to heal wounds and save limbs but also to prevent severe wound complications and subsequently to save lives.

References

1. Bondini CM, Sage S, Wilson BP, Hall MR, Wallis EAR. Modified telehealth for care of chronic wounds during the Coronavirus disease 2019 pandemic: A rapid literature review of alternative care modalities. International wound journal. 2020;17(6):1960-1967. doi:10.1111/iwj.13488

2. Oropalla A. Coronavirus disease 2019 (COVID-19): Issues related to wound care and telehealth management. UpToDate, 2020. Retrieved from https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-issues-related-to-wound-care-and-telehealth-management#H3881646380

3. Hsieh MW, Lee C, Ou S, Kuo Y. Telemedicine algorithm for chronic wound care during COVID‐19. International wound journal. 2020;17(5):1535-1537. doi:10.1111/iwj.13409

4. Bekeny JC, Zolper EG, Steinberg JS, et al. Ensuring quality care in the COVID-19 era: Applying the donabedian model to tertiary wound care center practices. Journal of the American Podiatric Medical Association. 2020. doi:10.7547/20-080

5. Gefen A, Ousey K. Safe and effective wound care during the COVID-19 pandemic. Journal of wound care. 2020;29(11):622-623. doi:10.12968/jowc.2020.29.11.622

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