The Danger Of Wounds That Don't Heal

By Peruji Perumal Malaysian Nanban writer Peruji Perumal shares with Bernama his interview with Dr Harikrishna K.Ragavan Nair, the head of the Diabetic Foot Care Clinic at Hospital Kuala Lumpur and the president of the Malaysian Society of Wound Care Professionals (MSWCP). KUALA LUMPUR, Feb 23 (Bernama) -- Almost every second a diabetic's foot is amputated somewhere in the world. For the diabetic, the wounds that don't heal are a real threat to their limbs and ultimately their lives. As they are no ordinary wounds, diabetics need proper wound care says the head of the Diabetic Foot Care Clinic at Hospital Kuala Lumpur Dr Harikrishna K. Ragavan Nair. Malaysia's current population is 31.7 million and 17.5 percent of the population is diabetic, and this is an alarming matter says Dr Harikrishna who is also the president of the Malaysian Society of Wound Care Professionals (MSWCP). Because diabetes is becoming a pandemic, diabetic wounds or ulcers should not be taken lightly. If the patient turns up for treatment late, it will be tough to save his/her limbs. DIABETIC WOUND CARE IS A DYNAMIC FIELD First and foremost wound care is a dynamic field. However, Dr Harikrishna stresses that if the underlying causes of the wound are not addressed, it will impede wound healing. The underlying causes include one's dietary habits. Wounds open the door to outside bacteria. Acute wound becomes chronic wound. Hence, the assessment of the wound is one of the main tenets of wound care and management. For Dr Harikrishna most diabetic wounds can be treated unlike cancerous wounds where the treatment is usually not to heal but to reduce the odour, bleeding, pain, control infection and prevent complications from setting in. Nonetheless, it has to be emphasized that wound care management is not a one-man job. It is a collaborative effort by medical officers, specialists, surgeons, nurses, foot care specialists and para-medics. Wound healing calls for passion and commitment of those involved, he says showing the picture of the hideous wounds of his patients in his handphone. Seeing thousands of patients on wheel chairs lining up for wound dressing and amputees in despair over the years, he views effective treatment of the wounds being a number one priority. Hence, Dr Harikrishna who is currently doing PhD in wound care tries out both conventional and new therapies in treating diabetic wounds. COMPLEMENTARY TREATMENT The conventional treatment include heterogenic dressings/grafts, debridement, antibiotic theraphy and management like offloading the diabetic foot ulcers using therapeutic footware. There is also another option being tried out, the Maggot Debridement Therapy (MDT). Dr Harikrishna is also a consultant in Maggot Debridement Therapy (MDT), which involves the use of maggots to heal wounds. The size of the wounds will determine the number of maggots to be used in the treatment. The founder of this therapy is William Baer from the United States' Johns Hopkins University. The Institute of Medical Research (IMR) here sterilises the maggots used for the treatment. "Historically, maggots have been known to help heal wounds. It has no side effects. The treatment is safe and sound," said Dr Harikrishna. This treatment is effective in healing wounds infected by antibiotic resistant bacteria. Dr Harikrishna has also talked about the role of honey in healing wounds. Manuka honey has been well received in the field of wound care and has been used extensively to treat wounds. Honey heals wounds naturally and has multiple attributes such as antimicrobial properties. "We have to prevent the legs of Malaysians being subject to the surgeon's knife," he said pointing to the serious efforts taken to heal diabetic wounds. ------------------------------------------------------------------------------- SIDE BAR CREATING AWARENESS ON WOUND CARE Malaysian Society of Wound Care Professionals (MSWCP), registered in 2011, is the voice of the wound care professionals and champions the interests people in wound care. MSWCP organises seminars and conferences from time to time and has earmarked October 18 as wound care day. MSWCP is promoting public education on wound care to increase awareness. It has created discussion platforms. MSWCP is currently propagating this message: "You are the cure. It means the patients should play a more proactive role in taking charge of the wound". -- BERNAMA