We are keeping our office open to make sure our patients with infection, injuries and pain are cared for in our clean, uncrowded office instead of having to go to an Urgent Care or ER where they run the risk of being exposed to COVID-19.

Why don't we leave wounds open to air?

Moist is better than dry

Diabetic foot wounds and ulcers heal best when kept moist. If allowed to air out, wounds will scab over. The body will then have to work twice as hard to lift up the scab and heal underneath. The scab is basically a biological bandaid, which is fine for kids and most adults. However for patients with diabetes who already have impaired healing, the scab will slow down the healing process, and harbor bacteria which can become a source of infection. That is why wound care clinicians recommend some type of topical cream or ointment that has antibacterial properties, and to keep the wound covered essentially 24/7.

What is maceration?

Understandably the rationale behind letting wounds air out is due to concern for a white appearance around the wound called maceration. This happens drainage from the wound gets the surrounding skin wet. This is normal, as wounds may drain more in the early stages of healing, and that drainage will decrease over the next few weeks as the wound starts healing and become less inflamed. It is recommended to increase the frequency of the dressing change to prevent maceration, even up to three times a day if needed. If you need supplies, your doctor can order supplies to be shipped to you depending on your insurance. It is also important to see your doctor regularly for debridement, as a buildup of debris and bacteria called bioburden can develop on top of the wound. This looks like a gelatinous yellow-red layer, that should be removed regularly to prevent infection.

Author
Dr Haywan Chiu, DPM Haywan Chiu

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