The traditional goal of wound care is to heal or prepare for surgical closure, but techniques and procedures used to heal a wound can be painful or uncomfortable and very costly. It is inappropriate to ignore wounds or declare them untreatable in patients at the end of life. Palliative wound care requires a different mindset than traditional wound care, yet is based on the same fundamental scientific principles. The concept of palliation for chronic wounds is a relatively new concept within the past ten years. Palliation recognizes and accepts non-healing endpoints as appropriate care and uses non-healing strategies to comfort patients and improve quality of life. This presentation provides a framework for understanding and providing palliative care for wounds at the end of life.
How Prevalent are Wounds at the End of Life?
Types of Wounds at EOL
Wound Location in Hospice Patients
Who Gets Wounds?
The Big Four
Eight P’s of Ischemic (Arterial) Ulcers
Arterial Insufficiency (PAD)
Palliation of Arterial Disease
Assessing a Wound for Palliation
Pressure Injuries in Palliative Care
How do We Approach Wounds at the End of Life?
Palliative Wound Care Goals
Part I. What is Palliative Wound Care?
Palliative Wound Care
Can Wounds be Treated at End of Life?
When Odor is a Problem
Review of Cincinnati Program
Medicated Hydrogel Gauze
Wound Dressing in Place
Cincinnati Hospice Results
Test Case 1
Test Case 2
Test Case 3
Test Case 4
Test Case 5
Test Case 6
Test Case 7
Test Case 8
Test Case 9
Dr. Aletha Tippett received her BS in chemical engineering from the University of Missouri in 1975 and her MD from the University of Cincinnati in 1997. Dr. Tippett has done wound care for 20 years and has treated over 15,000 wounds. Her main areas of focus in wound care are limb salvage and pressure ulcer prevention and treatment and she brings a bio-engineering approach to these. She has been honored with numerous awards in the healthcare community and is a published author and international speaker and teacher on wound care topics. She is president of the Hope of Healing Foundation, dedicated to limb salvage and novel wound therapies. She is a member of the International Biotherapy Society and is an active "biotherapist", using maggots and leeches in her wound care practice. Dr. Tippett is also active in hospice and is a certified hospice medical director for Brookdale Hospice in Dayton, Ohio. Disclosure: Aletha W. Tippett, BSChE, MD, ABFP, ABHPM, AAPM, WCC, CWS has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
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