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Acta Vulnologica 2006 September;4(3):135-44


language: Italian

Clinical methodology in wound care. The scientific basis for the correct local therapy

Somà K. 1, Furlini S. 2

1 Servizio Cure Domiciliari ASL 7 Volpiano, Torino 2 Medico di Medicina Generale ASL 7, Volpiano, Torino


Defining a Chronic Cutaneous Lesion (CCL) is the first step in arriving at the correct diagnosis and therapy. It is a known fact that uncoordinated medical interventions performed by nurses and doctors often leads to the mismanagement of local therapy, thus prolonging the length of illness. An integrated clinical approach improves the quality of care and reduces the time and costs of care through careful planning of the course of action and the appropriate knowledge of the therapy involved. The patent is involved in preparing the therapeutic plan, agreeing to comply with it to the best of his/her ability. Choosing the best course of treatment together, therefore, increases the probability that it will be followed until the end. Providing treatment is simply “Creating and maintaining the best conditions so that the complex process of tissue repair can start and continue without hindrance until the wound is healed”, as taught by Thomas S. The method that we are proposing derives from a careful review of literature on the topic. Using Falanga’s Wound Bed Preparation (WBP) Score, we can arrive at an objective assessment of the actual condition of the wound and specifically “how prepared the wound is for healing”. This Score can be used to objectively assess our course of action. The most suitable therapy is chosen based on using the WBP to analyze the anatomy of the wound and determine the specific requirements of the wound. After a period of treatment, the wound Score is reassessed so that we can define the most appropriate course of action to take or not. It is our responsibility at this point to re-review the flowchart to identify any possible alternatives for the local therapy. The purpose of this proposal is thus to standardize our methodology of approach to CCL, by involving the patient as an active participant in his/her own therapy.

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