Compromised wounds: costly and a system-wide problem

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Study reveals this often preventable issue plagues people with diabetes, in particular

August 29, 2013—People with diabetes admitted to hospitals are nearly six times more likely than other patients to have wounds that don’t heal properly, reports the Canadian Institute for Health Information (CIHI).

In fact, diabetes doubles the risk of infections after operations
and makes patients nearly 40 times more likely than other patients to develop wounds due to poor blood circulation.

This chronic illness was linked to more than 2,000 foot amputations in 2011–2012, many of which could have been avoided if proper wound care management and prevention had been in place.

CIHI’s unique study looked at persistent or “compromised” wounds—not only those infected or otherwise not healing, but also bed sores—among Canadians in hospitals, receiving home care and in long-term care during that same period.

“Compromised wounds are a burden to our health system,” said Kathleen Morris, CIHI’s Director of Health System Analysis and Emerging Issues. “They can be extremely painful and cause mobility problems and distress for patients.”

While any Canadian can be subject to a poorly healing wound, Compromised Wounds in Canada highlights the increased risks associated with chronic illnesses such as diabetes. It also reveals clear opportunities to reduce the frequency of occurrence.

A widespread issue

The study shows that no health care setting is immune to the problem. Among the provinces and territories examined for each sector of care, it found compromised wounds in

  • 30% of patients in hospital-based continuing care;
  • 10% of residents in long-term care; and
  • 7% of patients receiving home care.

The lowest rate for wounds in 2011–2012 was 4% in acute care (the only sector for which data was available from all Canadian hospitals). During that period, more than 117,000 people in acute care were identified as having a compromised wound.

The scope of the problem may be even bigger, as wounds in the early stages of healing are not always properly identified and recorded in a patient’s health record.

Many wounds are preventable

Clinicians and health care planners are increasingly recognizing wounds as a quality of care, clinical and policy issue. In fact, Canada’s premiers noted diabetic feet as a priority in 2012.

Measures to improve wound prevention and management include turning bed-ridden patients frequently to prevent pressure ulcers, regular foot check-ups for diabetic patients and surgical site infection reduction.

“No matter the cause, comprehensive assessment by an interprofessional team, identification of risk factors, effective monitoring and appropriate prevention strategies and referral are critical,” said Karen Campbell, registered nurse and researcher for the Lawson Research Institute of St. Joseph’s Health Care, London, and faculty member of the Master’s of Clinical Science in Wound Healing at Western University. “Early recognition and improved reporting of wounds, particularly bed sores, would certainly help lead to improved wound management—and better quality of life for many patients.”

 

 

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