KUALA LUMPUR (June 17, 2012): All public hospitals will be required to form dedicated wound care teams to cut down the risk of diabetics losing limbs due to untreated infections and gangrene.
The first phase is already well on its way with more than half of 55 hospitals already forming their own wound care teams.
Another 75 hospitals are expected to have full-fledged teams by January under the second phase, Malaysian Society of Wound Care Professionals president Dr. Harikrishna K.R Nair told theSun.
Dr Harikrishna, who is is the sole wound care specialist in the country said this is in line with a Health Ministry's aim to enhance healthcare in the field of wound care and amputation prevention.
With more than 3.4 million diabetics in Malaysia, he said, caring for wounds has become ever more important, especially due to complications from a diabetic foot.
"It is difficult to categorise how many amputations are performed as a result of poor wound care.
"It is difficult to categorise how many amputations are performed as a result of poor wound care.
"At the moment, we see about 25% of all diabetics developing foot-related complications, of which between 5% to 10% may face the risk of amputation," he said.
Diabetes is widely recognised as a catalyst to multiple health problems such as organ failure and the loss of feeling in the lower extremities (usually feet and toes) due to nerve damage.
The World Health Organisation estimates that one foot is amputated every 30 seconds – an alarming figure which is made all the more serious as 85% of all amputations would have been preventable with proper wound care.
Dr Harikrishna said rates of amputation are higher in the outskirt areas of the country as there is a delay in referring patients with serious, infected wounds to a tertiary centre, like Hospital Kuala Lumpur (HKL), where he heads the diabetic foot care clinic.
"We are disappointed when they are referred too late. The single most important thing in wound care in the primary stage (clinics, general physicians) is to know what can be done at that level, and when to refer to a tertiary centre. That way, limbs may be saved," he said.
Dr Harikrishna added that at HKL,a pioneer study is being conducted on the use of an algorithm which standardises and streamlines the proper management of a wound, in addition to nationwide training workshops conducted with the hospital's wound care teams.
"We are hoping to create wound care professionals who are sufficiently trained, who are able to competently and safely manage wounds – we don't want patients to lose their limbs," said Dr Harikrishna, who is spearheading both the study and the workshops.
"Many medical staff are already doing wound care, but do not specialise in it. What we are trying to do is to increase their expertise in the field in order to enable them to competently use advanced environmental dressings such as silver dressings or composite dressings, as well as employ the correct wound therapy methods on the right patient," he said.
Silver dressings are dressings embedded with silver to treat infected wounds which are particularly resistant to antibiotics.
The formation of wound care committees would be the precursor to having wound care divisions or departments within public hospitals, which would be more in line with the global trend.
"Almost all major hospitals worldwide have dedicated wound care departments, and even wound care paramedics," Dr Harikrishna said.
He added that establishing such departments would require budget allocations, which would hopefully be possible by 2014.
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