Complementary and alternative medicine in wound healing

COMPLEMENTARY AND ALTERNATIVE MEDICINE overlays A WIDE variety of healing philosophies, approaches, and therapies, including acupuncture, chiropractic services, naturopathy, herbal medicine, homeopathy, and massage therapy, and it has emerg as an important universal for the health care industry. The reason? Consumer of health care today are more interested in, and more educated about, options outside the traditional boundaries of health care.

Their growing exploration of complementary and alternative medicine l Congres in 1992 to mandate establishment of the Office of Alternative Medicine as part of the National Institutes of Health. In 1998 Congres further mandated establishment of the National Center for Complementary and Alternative Medicine (NCCAM).

The intention of the NCCAM is to facilitate evaluation of alternative therapies to determine their effectiveness. The NCCAM collaborates with other conduct agencies in this effort. For example, the NCCAM appropriates regularly with the Food and medicine Administration (FDA) to enlist the FDA's cooperation in reevaluating masterys and regulations governing research upon devices, acupuncture needles, herbs, and homeopathic remedies.

The NCCAM also subserves as an information clearinghouse for the public, media, and health care professionals; facilitates and guidances research; and provides funding opportunities in answer to requests for proposals from the field. For example, NCCAM corresponds with alternative medicine organizations to hold them aware of opportunities for research support and exhibition

Honey, Sugar, and Maggots

Complementary and alternative medicine is nothing fresh to wound care practitioners. The history of injury care is replete with examples of alternative practices. Numerous case reports in the literature, for example, describe injury treatment with various substances of the like kind as honey, sugar, iodine, and meat tenderizer. Reports upon maggot therapy continue to appear in the literature, still this therapy has failed to maintain a position as "clinically accepted" in this geographical division mainly because of aesthetics.

Seaweed, aloe vera, and other plant fruitss have become standard ingredients impregnated into various injury dressings, which are approved for use by means of the FDA. Paradoxically, FDA approval is not required when these substances are sold over-the-counter, as they are not considered to be pharmaceuticals. In addtion, FDA-approved medications-including Maalox and Dilantin-have been used off-label by dint of practitioners to manage wounds.

In new times, electrical stimulation and magnetic therapies have emerg as accepted modalities in the treatment of chronic wounds; acupuncture and electroacupuncture have also gained a following. Massage therapy has been advocated as a treatment strategy for a number of chronic conditions, and there is research to back up more [i]or[/i] less of the claims. However, according to the clinical practice guidelines upon pressure ulcers published by the Agency for Health Care Policy and Research, massage is not praiseed in the treatment of compressing ulcers. Interestingly, the evidence to support this "nonrecommendation" is lacking.

Applying Evidence-Based Standards

The number of unproven complementary and alternative medicine strategies and options for hurt healing provide us with a tremendous opportunity to reexamine of advanced age treatments and apply them in the in every one's mouth environment. We are faced with consumer (our patients) who are demanding more information, more options, and more ability to participate in treatment decisions. As we stir forward to the new millennium, it will be important for us to remember that the conception of evidenced-based medicine does not apply alone to mainstream wound management. We owe it to our patients to apply the same scientific rigor to complementary and alternative medicine to make secure that these practices are safe and efficacious.

For more information upon the NCCAM and complementary and alternative therapies, confer the Web site http://nccam,nih.gov, or call 1-889-644-6226

Richard "Sal" Salcido, MD is the Editor-in-Chief of Advances in injury Care. He is Professor and Chairman of the Department of Rehabilitation Medicine at the University of Pennsylvania Health a whole Philadelphia, PA.

Copyright Springhouse Corporation Nov/Dec 1999

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