Critical paths for wound care.

Critical paths and clinical algorithms are an adjunct for quality management of an average person's health problems. A critical path attempts to achieve continuous quality improvement by aligning actions of the care team. Critical paths are difficult to construct for chronically ill patients with comorbidities. Therefore, clinicians are challenged to consider key elements of critical paths: describing normalcy, identifying variances, creating differential diagnoses, handling individual responses to care, managing continuity of care, communicating among team members, discerning chronic disease dilemmas, and developing a common pathway model. Continuity of care and cost effectiveness can be the result of close attention to aspects of critical pathways. Medicine is frequently described as art blended with science. Nowhere is the art of medicine more apparent than in the management of wounds. The challenge of wound care has taxed the ingenuity of countless caregivers from the days when therapeutic armaments consisted of only salves, balms, and poultices to the present plethora of high-tech therapies. Unfortunately, the treatment of patients with wounds for the most part has been relegated to a little-appreciated segment of an equally unappreciated and "unattractive" category of chronic disease.