Wound Care for the Vascular Surgeon: Review of Currently Available Products and How They Affect the Biochemistry of Wound Healing in Clinical Practice

Abstract

The role of Vascular Surgeons in the care of chronic wounds can range from a “hands off” approach after the main arterial or venous pathology is addressed to an active one in determining the optimal dressings, antimicrobials, and adjunctive therapies. With multiple options for wound care products, choosing the best local treatment and overall management strategy is difficult. The rise of Wound Care Centers has further fragmented care and the role of the Vascular Surgeon can be marginalized. However, the Vascular Surgeon is in a key position to consider the essential patient clinical factors; if combined with understanding of the spectrum of wound care products, overall patient care can be optimized. Here we review the biochemistry of wound healing and how the currently available wound care products fit into each phase of the healing process. The DIME methodology (debridement, infection control, moisture balance, and wound edge preparation) is used as a framework to connect wound care products with their clinical effects. Product and prescribing information are summarized along with cost information to assist in best clinical decision making. Clinical case studies are presented that illustrate how changes in products and surgical interventions can improve wound healing.