Alliance of Wound Care Stakeholders Issues Position Statement To Help Health Systems Avoid
Unintended Consequences for Wound Patients Amid COVID-19 Pandemic Response
March 24, 2020 – The Alliance of Wound Care Stakeholders developed a position statement to help health systems and providers avoid unintended consequences for wound patients amid the realities of the COVID-19 pandemic: “Wound Care is an Essential – Not Elective – Service that Prevents Hospital Admissions and ED Visits Among a Fragile Cohort of Patients at High-Risk of COVID-19.”
The COVID-19 pandemic is driving significant change in the U.S. healthcare system, disrupting wound care best practice and leaving large numbers of wound patients without care. As hospitals and health systems are directed to halt all elective and “non-essential” services as part of COVID-19 response, a concerning number have categorized wound care services and procedures as “non-essential” - leaving a fragile cohort of patients at risk.
“The Alliance is concerned that this decision will result in unintended negative consequences that will cause a gradual influx of patients to the emergency department. Nonhealing wounds, left untreated and unmanaged, can result in significant medical issues including infection, sepsis, the need for limb amputation, and even death. As a
result, many procedures provided by wound clinics are essential – not elective – to protect the health of patients and prevent an escalation of their disease. Individuals with chronic wounds commonly have other chronic conditions – typically type 2 diabetes, hypertension, venous insufficiency, peripheral arterial disease, and/or chronic kidney disease. This cohort of fragile patients is at increased risk of mortality from COVID-19 and also high risk for increased morbidity and mortality - loss of limb or life - if access to wound care is abruptly discontinued.”
“Across the country, wound care providers are working to ensure that the health of our patients is protected during the COVID-19 crisis. We are adopting aggressive infection control and social distancing precautionary measures at our sites and with our staff. While wound care providers are working to limit clinic visits and move as many patients as practical to telehealth, office visits or home health follow-up where appropriate, wound clinics must be able to provide those urgently needed wound care procedures that are infection-sparing, limb-saving and
life-saving. These procedures are essential, not “elective,” and ultimately will reduce wound patients’ potential for needing other hospital services such as operative intervention or amputation.”
“Address the COVID-19 pandemic while avoiding unintended consequences for wound patients: Leave clinics open to manage complex wounds in clinically complex medical patients who are at risk for limb loss, hospital admission, amputation or infections. Hospital administrations should take into consideration input from providers when making these decisions and deploy appropriate triage criteria when reducing essential clinical services.
Enabling continuity of care for these wound patients will improve outcomes while unburdening emergency departments, operating rooms, hospital staff and hospital beds for the COVID-19 crisis. Keeping these patients out of the ED and out of hospital beds can in turn limit exposures and curb COVID-19 infection among this fragile population.
Read the Alliance’s full statement, and see its pandemic response resources specifically for wound care.
The Alliance represents 20+ medical specialty societies and clinical associations whose members treat patients with wounds.