Wound Care Its Definition ,Facts ,Wound Healing And Management

Definition of wounds. 

Wound. A wound is any break in the skin that can vary from a superficial to a full thickness wound.

 A partial thickness wound is confined to loss of the epidermis and partial loss of the dermis; whereas

 a full thickness wound has a total loss of the epidermis and dermis and can involve the deeper

 subcutaneous and muscle tissues and/or bone.Wound care is provided in a variety of patient 

care settings including acute care, subacute care, long-term care, outpatient clinics, and in the home.

Acute wound.: 

Acute wounds occur suddenly and are commonly due to trauma or 

surgery, which triggers blood clotting and a wound repair process that leads to wound closure 

within 2-4 weeks. 

Chronic wound.

A chronic wound is a one that does not does not proceed through an 

orderly and timely repair process requiring more than 4 weeks to heal such as vascular wounds 

and pressure wounds .

Surgical wound:

. A surgical wound that heals in an orderly and expected fashion may be 

considered an acute wound. Surgical wounds heal by primary closure or are left open for delayed 

primary closure or healing by secondary closure. Primary closure facilitates the fastest healing. 

However, infected wounds should not be primarily closed.

WOUND CARE FACTS: 

The skin is a barrier to the outside world protecting the body from infection, radiation, and extremes of temperature.

There are many types of wounds that can damage the skin including abrasions, lacerations, rupture injuries, punctures, and penetrating wounds.

Many wounds are superficial requiring local first aid including cleansing and dressing.

Some wounds are deeper and need medical attention to prevent infection and loss of function, due to damage to underlying structures like bone, muscle, tendon, arteries and nerves.

The purpose of medical care for wounds is to prevent complications and preserve function. While important, cosmetic results are not the primary consideration for wound repair.

Animal and human bites should always be seen by a medical professional because of the high rate of infection.

It is important to know a person'stetanus immunization status (for example, has the person had a tetanus shot or booster vaccine in the last 5 years?) so that it can be updated with a tetanus booster if needed.

TYPES OF WOUND HEALING : 

FIRST INTENTION HEALING-partial thickness wounds. - a clean incision is made with primary closure, minimal scarring. -expected when the edges of clean surgical incisions are sutured together, tissue loss is minimal or absent if the wound is not contaminated with microorganism. -e.g.-abrasion or skin tear.

SECOND INTENTION HEALING-granulation -accompanies traumatic open wounds with tissues loss or wounds with a high microorganisms count. -go though a process involving scar tissue formation a heal slowly because of the volume of tissue needed to fill the defect. -e.g.-contaminated surgical wound, pressure ulcer. 

COMPLICATION OF WOUND HEALING : 

1. HEMORRRHAGE -risk of hemorrhage is greatest during the ist 48 hours after surgery. -emergency pressure dressing to the wound and monitor vital signs.

2. INFECTION -surgical infection is apparently 2-11 days post operatively. 

WOUND MANAGEMENT

. DRESSINGS - material applied to wound with or without medication, to give protection and assist in healing. -what are the purposes? To protect the wound from mechanical injury Splint or immobilized the wound. Absorbs dressing Prevent contamination from bloody discharges.

DRY TO DRY DRESSINGS -used primarily for wounds closing by primary intention is good protection, absorption & provide pressure to the wound surface when drainage dries. - when remove can cause pain and disruption of granulation tissue.

WET TO DRY DRESSINGS -used for untidy or infected wounds that must be debrided and closed by secondary intention.How can it be done? -gauze saturated with sterile saline or antimicrobial sol’n. is packed into the wound, the wet dressing are then covered by dry dressings.When to changed? -when it becomes dry.

WET TO WET DRESSINGS -used on clean open wounds or on granulating surfaces.Provide a more physiologic environment (warmth moisture) which can enhance the local healing processes and assure greater patient comfort. surrounding tissues can become ulcerated. high risk for infection.