What it is
Advanced wound care therapies are treatments used in addition to basic wound care, such as cleaning, dressings and offloading pressure. They are typically discussed when a wound has not progressed as expected or has a complicated cause.
Negative pressure wound therapy (NPWT), or wound vac therapy, uses a sealed dressing connected to a small pump that gently draws fluid away from the wound area. It is a well-established therapy. Skin substitutes and bioengineered tissue are materials made from human, animal or lab-grown components that are placed on a wound as a covering or scaffold. Amniotic and placental grafts are made from donated birth tissue that is processed and applied to a wound.
Regulation differs by therapy. Wound vacs are regulated medical devices. Skin substitutes and amniotic or placental grafts vary in FDA status, and many are regulated as minimally manipulated human tissue rather than as FDA-approved drugs. Coverage also differs by product and payer, so it is reasonable to ask which specific product is being used. For further reading on amniotic products specifically, see amnioticdoctors.com, which is a separate resource and not affiliated with WoundKare.
How it’s traditionally been approached
Wound care has traditionally started with the basics: finding the underlying cause, keeping the wound clean, choosing suitable dressings, managing pressure, and addressing circulation, nutrition and blood sugar where relevant. Many wounds are managed this way without advanced therapies.
When a wound is slow to change, clinicians have commonly looked at whether something is getting in the way of healing, such as infection, poor blood flow, ongoing pressure or other health conditions. Debridement, which is the removal of non-healthy tissue, is often part of a specialist's approach.
Advanced therapies have usually been considered after a clinician has evaluated the wound and the person's overall health. Which option, if any, is appropriate is a decision made by a licensed clinician after an evaluation, and approaches vary between providers and between patients.
How the right wound care specialist may help
A wound care specialist may help by looking at the whole picture: what caused the wound, how deep it is, how it is staged or classified, what may be slowing healing, and whether other health factors are involved. A first visit generally includes a review of your history, an examination and measurement of the wound, and a conversation about next steps.
If advanced therapies come up, a specialist may explain what a wound vac, skin substitute or graft involves, what the experience of using it is like, and why it might or might not fit your situation. They may also coordinate with other professionals, such as vascular, diabetes or infectious disease clinicians.
Questions worth asking a licensed provider include: What is causing my wound, and how is it staged? What are my treatment options, including basic care? If a skin substitute or graft is suggested, which product is it and what is its FDA status? How long might healing take? What will insurance cover? No provider can promise a particular result, but clear answers can help you make informed choices.
The whole-person view
Healing involves the whole person. Long-term stress, poor sleep, pain, and the strain of frequent appointments or limited mobility can affect how people feel and cope, and body and mind influence each other. Living with a slow-healing wound can also bring worry, frustration or low mood.
Some people find body-based support helpful for stress, such as the approaches offered through Somatic Experiences, while others value talk therapy through Therapists.plus. These are optional complements to medical care, not replacements for it, and every approach has a place depending on what works for you.
Somatic Experiences: trauma and emotional healing →Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- Only a licensed clinician can decide whether an advanced wound therapy is appropriate, after an evaluation of your wound and overall health.
- Seek medical care promptly for signs of infection, including spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills, or if a wound is rapidly worsening.
- Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, signs of sepsis, or a deep or severely contaminated wound, such as from a serious accident. If you are in emotional crisis, call or text 988.
- Skin substitutes and amniotic or placental grafts vary in FDA status and insurance coverage, so ask which product is used and what is covered. Results are never guaranteed.
Skin substitutes and amniotic/placental grafts vary in FDA status and coverage — ask which product is used. See amnioticdoctors.com for more on amniotic products specifically.
Wound care specialists
We’re welcoming founding wound care specialists for advanced wound therapies now. Get matched or list your practice.
Frequently asked questions
What is advanced wound care?
Advanced wound care refers to therapies used beyond standard dressings and basic care, such as negative pressure wound therapy, skin substitutes, amniotic or placental grafts and bioengineered tissue. A licensed clinician decides whether any of these are appropriate after evaluating the wound and the person's health. They may be considered when a wound is complex or slow to heal.
How does wound vac therapy work?
Wound vac therapy, or negative pressure wound therapy, uses a sealed dressing connected to a small pump that applies gentle suction to the wound area. It is a well-established therapy that specialists may use to help manage fluid and support the wound environment. Whether it suits a particular wound is a decision for a licensed provider.
What is a skin substitute for a wound?
A skin substitute is a material made from human, animal or lab-grown components that is placed on a wound as a covering or scaffold. Products differ widely in how they are made and regulated, and their FDA status varies. Ask your provider which product is proposed and what is known about it.
Are amniotic grafts for wound healing FDA-approved?
It depends on the product, and many amniotic or placental grafts are regulated as minimally manipulated human tissue rather than as FDA-approved drugs. Ask your provider about the specific product's regulatory status. You can also read more about amniotic products at amnioticdoctors.com, an independent resource.
Will insurance cover advanced wound therapies?
Coverage differs by therapy, product, payer and individual situation, so there is no single answer. Wound vacs and skin substitutes or grafts may be treated differently by insurers, and prior authorization or specific criteria may apply. Ask your provider's office and your insurer what applies to your wound before treatment.
When should I see a wound care specialist?
Consider seeing a wound care specialist if a wound is not improving, keeps returning, or is linked to conditions like diabetes or circulation problems. Seek care promptly for any sign of infection, such as spreading redness, pus, foul odor, fever or increasing pain, and call 911 or go to the ER for heavy bleeding or a deep or severely contaminated wound.
Educational resource. WoundKare shares general information and connects people with independent wound care specialists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.