Saving you time, saving you money, putting the patient first - The Ambulatory Wound Care Phenomenon
AbstractThe ambulatory wound care concept is an accepted and growing phenomenon worldwide. As the aging population grows so the number of patients with chronic diseases increases. Each and every chronic disease is associated with a wound manifestation of one type or another. Thus diabetic patients present with diabetic foot ulcers; those with chronic venous insufficiency present with venous leg ulcers; hypertensive patients present with arterial ulcers; elderly patients on corticosteroid drugs, blood thinners and other immunosuppressive drugs are prone to injuries, abrasions and differing wounds; and the list goes on... The level of sophistication of treatment has increases in tandem with the level of understanding of the background pathophysiologic events surrounding the genesis of these wounds. Thus too, the success of ambulatory wound care has increased exponentially. The advantages in terms of cost are enormous to the patient and the insurer; the lessening impact on lifestyle of the patient on ambulatory treatment who continues to work and contribute to society is incalculable; the decreased exposure to hospital acquired infections inevitable in long-stay hospital patients is also a significant factor in successful wound management outcome. This is of special importance in the patient treated for post-operative sepsis who is separated from the potential source of further infection. For these reasons and numerous others patients and insurers worldwide are turning to ambulatory wound care as a new efficient service for healing complex wounds. South African insurers are lagging behind somewhat in recognition of this service as an essential health care segment, but the trend is starting to change with some medical aids giving consideration to the service as part of a proscribed minimum benefit working in tandem with the treatment of chronic disease. This paper introduces a few typical cases of ambulatory wound care. They have been selected, not on the basis of any dramatic unusual response to sophisticated treatment, but rather as examples of typical cases that are treated in these facilities on a daily basis. We have included two cases demonstrating complete healing and comparative costs incurred and two more cases demonstrating comparative costs (ambulatory vs hospital) ongoing treatment costs of wounds in the process of healing.
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