How do I assess and manage chronic wounds that are slow to heal or have complex underlying conditions?

Do you have availability of a wound clinic? Have they evaluated the patient for underlying vascular issues or osteomyelitis?

Remove all dressing material. Measure wound length, width and depth, check for any tunneling, note color, amount, and odor of any drainage. Assess skin surrounding, assess patients nutritional status, mobility, any pressure relieving measures. Any change in dressing needs

ask the wound care specialist to assess the wound. More than likely, she will ask the MD to write an order for a Vac ( if the wound specialist is an NP she can write the order )then you would do vac wound care and the patient can start to get ready for dc. Insurance pays for the vac and the visiting nurse to do vac wound care every 2-3 days