A Sustainable and Meaningful Approach Toward Self-Treat Wound Care

This letter is a comment on the SAGE Open Nursing article “How Diabetic Foot Ulcer Patients Can Self-Treat Wound Care: An Integrative Literature Review” (Manalu et al., 2024). This article reviews current evidence on diabetic foot ulcer (DFU) patients’ self-treatment. The need for DFU patients to be skilled in cleaning and applying medication and dressings was highlighted. While these critical components are noteworthy, I would like to elaborate on the social consideration as one of the sustainability factors for self-treat wound care.

The self-treat wound care initiative is a good start toward improving the quality of life for patients with DFU. However, they may face social burdens associated with self-care wound care (Hanlon et al., 2024), which can influence their social activities, such as attending cultural festivals and family events. Wound odor, for example, can prove to be socially challenging and distressing and affect patients’ well-being and quality of life (Gethin et al., 2023). With this in mind, nurses can assist patients in developing a detailed care plan, such as using an affordable ostomy pouch to treat fungating wounds (Luo et al., 2022). Additionally, patients may experience mobility and discomfort issues that restrict their social engagements, which can lead to social isolation and low self-esteem. If this is the case, nurses can offer patients additional emotional support, which is highly regarded by them (Janke et al., 2023). To enhance patient engagement and treatment concordance, nurses must recognize that wound care should be patient-centered rather than clinician-centered (Moore & Coggins, 2021). This suggests that nurses might consider interactive and hybrid delivery methods, including face-to-face, written, phone, and online wound care teaching for patients (Huang et al., 2023).

The next consideration is to capitalize on the patient's social circle. For example, nurses may need frequent communication with the patient's family. This is an important step toward promoting patient and family engagement and sharing information transparently. The implementation of home wound care training for patients and their caregivers also has the potential to enhance the quality of life of patients and their families (Huang et al., 2023), which is particularly true in rural or developing regions, where access to essential medical care is not always readily available (Manalu et al., 2024). It is also fundamental to recognize the value of community support. For example, the Leg Club, a community-based organization in the United Kingdom, provides evidence-based care that is founded on empathy, education, and social and peer support (Lindsay, 2004). It helps to foster social interaction, empowers the individual, and enables patients to achieve a successful and sustainable recovery (Frasier et al., 2024).

In summary, Manalu et al. (2024) were indeed accurate in their assertion that a comprehensive wound care strategy must include strategies that address the underlying social factors that influence patients’ ability to engage in self-treat wound care. We need to strive for strategies that combine personalized and practical support and leverage the patient’s social network, which covers both family and community salient contributions. These considerations will contribute to an increased level of compassion and understanding regarding the social issues, concerns, and expectations that patients may have. Additionally, they will reinforce the motivation for patients to engage in meaningful self-care and ensure the sustainability of self-treat wound care.