Question: 4.1- Discuss and evaluate your approach to the management of wounds classified as healing, non-healing or maintenance. Comment on the differences in approaches to care between these classifications. Our approach to wound management was far from optimal in our own context. After reading the article by Sibbald et al (1) and attending the presentations during the first residential weekend, our approach at the Family Medicine Clinic at St. Mary's Hospital needs to change. We did not classify wounds as healable, maintainable, or non-healable. We have always considered injuries in our practice to be curable, despite system constraints or patient preferences. In the following lines, I will define and summarize the methods to use for initial wound management and how to best integrate them into our site. The first goal we must set is to determine its ability to heal. To determine whether a wound is healable, a maintenance wound or a non-healable wound. The first consideration is whether the wound has adequate vascular supply which can be assessed by.1. Peripheral impulses2. Ankle Brachial Pressure Index (ABPI)3. Sound Doppler examination4. Toe pressure5. AngiographyOnce the vascular component has been assessed, we get a clear idea of ​​the main organic factor limiting wound healing. We can then build on this information by assessing the patient's healing cofactors. This step is essential in order to maximize the vascular network that the patient has. These cofactors are:1. Systemic diseases (diabetes, immunosuppression, skin disease)2. Nutrition/Diet (Low protein diet, vitamin deficiencies)3. Medications (corticosteroids, immunosuppressive drugs and ...... middle of paper ...... are expressed by most treating doctors if the best treatment is not possible. Most of these wounds are unfortunately sent to a community nurse for a dressing change without the patient returns to the treating physician to assess treatment for “maintenance wound” Treatment of non-healable wounds When a wound is determined to be non-healable, as described by Sibbald et al (1). ), it should not be treated with wet treatment and should be kept dry to reduce the risk of infection compromising the limb. It is also important to consider the patient's preferences and try to control their pain. , its discomfort in activities of daily living and the odor of its wound may produce. In this case, special attention should be paid to infection prevention and control. Some charcoal dressings would be useful in the care of our non-healing wounds at St. Mary's Hospital..