Managing the complicated vascular wound & Pain management in complex wounds

Managing the complicated vascular wound

What makes a wound complicated? Any non-healing wound can be described as complicated, but some are more complicated than others! Complicated wounds are usually found on patients with complex medical problems. Often complicated wound aetiology is multifactorial, but outcomes are significantly worse with underlying vascular disease. Medical optimisation and risk factor modification is required to treat the rest of the individual too.

Vascular disease covers many of the common wounds such as arterial ulceration, venous leg ulcers, mixed arterial-venous ulceration and diabetic foot disease. Vascular surgeons aim to optimise the arterial supply through revascularisation procedures such as angioplasty, endarterectomy and bypass, and reduce venous hypertension through superficial venous ablation, deep venous stenting and extrinsic compression.

Revascularisation is only one stage of the process however and optimisation of healing conditions also requires sepsis source control through debridement and amputation, and wound -management strategies to optimise function as well as ensure healing.

Pain management in complex wounds

There are many pharmacological and non-pharmacological management strategies for wound pain. Good pain management improves the patient experience, enhances compliance, and contributes to wound healing. In this session we will look at the ‘pain pathway’ and how we can use a variety of management approaches to interrupt the pathway or boost our endogenous pain reductions mechanisms.