AOCPMR 2024 Mid-Year Meeting-The "ABCs" of Chronic Wound Care and Why Lymphatics Are Critical to Wound Care

Video Transcription

Video Summary

The video presentation covers advanced insights into wound care, emphasizing the critical roles of arterial, venous, and lymphatic systems in diagnosis and treatment. A novel device, Ability2—developed by vascular medicine experts—uses AI to rapidly assess posterior tibial artery waveforms and perform plasmography, offering accurate, efficient evaluation of limb ischemia and venous obstruction, potentially replacing time-consuming ABIs and TBIs.<br /><br />The discussion highlights lymphatic function’s underestimated importance in wound healing, noting that 80-90% of interstitial fluid returns via lymphatics, requiring a paradigm shift in medical education and practice. Dermal lymphatic stasis contributes to chronic wound non-healing by promoting inflammation and endothelial dysfunction. Near-infrared fluorescence imaging demonstrates real-time lymphangion contractility, opening new therapeutic possibilities.<br /><br />Biofilm management is emphasized as a unifying factor in chronic wounds, with hypochlorous acid solutions (such as VOSH) and acetic acid used twice daily to control infection and inflammation without systemic antibiotics. Compression therapy, especially multilayer and circumferential micro-MLD garments, reduces edema and enhances lymphatic flow, improving healing outcomes. Nutritional support including vitamin A, B6, B12, folate, C, and D is integral to supporting endothelial health.<br /><br />Cases illustrate effective use of ultrasonic debridement, negative pressure wound therapy, and ovine foregut grafts for complex wounds. Challenges include accurate diagnosis, recognizing venous lymphedema, and differentiating wounds from malignancies. The presentation advocates treating wound care like a cancer center, focusing on timely diagnosis, correct treatment, and reducing recurrence.<br /><br />Overall, innovations in diagnostics, targeted biofilm mitigation, optimization of lymphatic function, and holistic patient care represent the future of wound management to improve limb salvage and patient quality of life.

Keywords

Dr. John Lavelle

exercise for health

back pain management

physical medicine and rehabilitation

psychogenic back pain

nervous system sensitivity

strength training

mobility exercises

functional movements

health promotion

wound care

arterial system

venous system

lymphatic system

Ability2 device

AI in vascular medicine

limb ischemia diagnosis

biofilm management

compression therapy

nutritional support in wound healing