Afsaneh Alavi - Local Wound Care for Dermatologists

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With the aging of the population, impending epidemic of chronic diseases such as diabetes, and natural and man-made disasters, there is a huge need for knowledge of wound care. Individuals with chronic wounds may suffer from social isolation, disfiguring bandages, cost, pain, odor, and many disabilities. Clinicians familiar with local wound care significantly improve the quality of life of these patients. In fact, most people classify wounds as dermatological issues since it is skin-related. Dermatologists play a pivotal role in wound healing, both diagnosis and the management. Chronic wounds are also a major financial burden. The cost of wound care in the United States is estimated at $5$7 billion per year and is increasing at an annual rate of 10%. The chronicity and recurrence make the venous ulcers a big healthcare system cost estimated to be $3 billion per year in the United States. Diabetes is a serious, lifelong condition that is the sixth leading cause of death in North America. Lifetime risk of diabetic foot ulcers in individuals with diabetes is as high as 25%. Foot ulcers precede 85% of lower limb amputations. Evidence showed that 80% of limb amputations in diabetics are preventable.

The interdisciplinary team approach and collaboration are required for quality care for the complex wounds. Unfortunately, the dermatology educational curriculum in all levels contains very little material regarding wound care. Dermatologists dealing with wounds in their routine practice either as a sign of systemic disease or ulceration from dermatological conditions usually educate themselves. Most dermatologists are familiar with wound diagnosis and differential diagnosis of wounds as part of their training, but the wound care management is an unmet need.

Over the past 20 years, our knowledge of wound healing dramatically increased from growth factors to cellular and acellular skin substitutes. There is a need for a great emphasis on quality wound care and teaching medical students, residents, and dermatology colleagues.

This book will be an invaluable resource for clinicians and particularly dermatologist in regards to local wound care. The knowledge of wound care is rapidly expanding, but well-organized basic foundations are required to interpret the new evidence.

The clinicians should have a broad differential diagnoses and think out of the box when it comes to wounds. Wounds can have many unusual and atypical etiologies.

More than 5000 wound products and devices are available in the United States only, but there is no need to know all these products. What clinicians require to know are the main basic categories of products, their availabilities, and estimated cost to make informed decision. It is empirical to be familiar with the main types of dressings and bandages, not the commercial brand names. It is beneficial to make yourself familiar with the main components of the dressings in order to recognize or prevent contact dermatitis.

In this time of technological advancement, an online book can be handy on any device and provide general information regarding local wound care for you whether you are involved in the research or clinical practice.

Thanks are due to all authors and contributors of this book for volunteering their time and sharing their expertise to shed light on this important topic in dermatology and to the staff at Springer for supporting the publication of this book.

I would like to thank my family that without them I was not here today. Thanks to my mentors, Professors Gary Sibbald and Robert Kirsner and also to Professor Howard Maibach for his guidance throughout this project.

Afsaneh Alavi