SLR - December 2023 - Cukelj
Title: Effects of home-based chronic wound care training for patients and caregivers: A systematic reviewReference: Huang, Y, Hu, J, Xie, T, et al. Effects of home-based chronic wound care training for patients and caregivers: A systematic review. Int Wound J. 2023; 20(9): 3802-3820. doi:10.1111/iwj.14219
Level of Evidence: 3
Reviewed By: Richard Cukelj
Residency Program: University Hospitals, Cleveland OH
Podiatric Relevance: Chronic wounds plague a significant portion the patient population commonly treated by podiatric physicians and surgeons. The treatment of these wounds can frequently take weeks or months to resolve. Even when seen weekly, the treating physician only spends a minuscule amount of time with the patient when compared to patient caregivers. This study aims to better understand the effect of education of patients and caregivers on the outcomes of those with chronic wounds.
Methods: The study screened multiple databases to find studies involving participants with chronic wounds and their caregivers. 790 studies were retrieved, 16 met inclusion criteria based on MESH phrasing of specific wound-related terms. These included studies were analyzed and outcomes of chronic wound management were compared between those who had formal wound management education or training with those who did not. This training could be from any level or provider or in any location such as a home, clinic, one on one, or in a group setting. Outcomes were then measured based on wound healing, self-care behavior, wound knowledge, quality of life, anxiety/depression, and HbA1c.
Results: Those educated performed leg exercises 32% more often. Anxiety and Depression both decreased with education. Quality of life improved as well. All demonstrated improved knowledge of wound care practices by the patients and caregivers. All reported improvement in wound self-care behavior. Of the 2 studies that looked at HbA1c, both showed improvement at 3-month follow-up. Regarding wound healing, all evaluated studies showed improvement in wound grade/stage and reduction in wound size when compared to nonintervention groups.
Conclusions: This study demonstrates that by including patients and their loved ones/caregivers in education of the treatment of their chronic wounds you can greatly improve their understanding, behaviors, and outcomes. Through simple methods of education including pamphlets, online videos, and handouts you can drastically change the trajectory of a wound and a patient’s outlook on their involvement in their healing process. The creation of educational materials and resources for patients require an upfront time investment, but once in place takes minimal effort to distribute to patients. Although there have been significant advancements in wound care treatment modalities they can be further amplified through the education of the patients they are treating, and through this education, patients are given a sense of responsibility and control over their own outcomes which can reduce healing times, providing a tangible return on the time invested.