- Definition of wound: A wound is break or disruption in the normal integrity of the skin & tissues. Or A breach in the anatomical continuity of any living tissue due to any violence (such as injury & trauma).
- Classification of wounds:
- According to visibility
- Closed wound
- Open wounds are-
- *Laceration wounds
- *Abrasion wounds
- *Avulsion wounds
- *Puncture wounds
- According to duration:
- Acute wound:
- Laceration wounds
- Abrasion wounds
- Avulsion wounds
- Puncture wounds
- Crush/ avulsion
- Damage to internal organs
- War wounds and gunshot injuries
- *Special Injury (injuries to fat, muscle, bone, artery, vein)
- Chronic wound
- *Pressure sore
- According to cause:
- *Intentional wounds
- *Unintentional wounds
- According to cleanliness
- *Clean wound
- *Clean- contaminated wounds
- *Contaminated wounds
- *Dirty and infected wounds
- According to thickness of skin loss:
- *Superficial epidermal
- *Full thickness
- Purpose of wound care:
- To protect the wound from contamination of microorganism.
- To promote wound granulation and healing
- To support or splint the wound and healing
- To support or splint the wound site
- To promote terminal insulation to the wound surface
- To provide for maintenance of high humidity between the wound and dressing.
- Clean the wound or keep it clean
- Control the bleeding by putting direct pressure on the wound.
- Keep the wound moist and therefore enhance epithelization
- To promote physical, psychological and aesthetic comfort.
What is wound healing?
Wound healing is a mechanism where the body attempts to restore the integrity of the injured part.
Factors influencing healing of a wound:
- Site of the wound
- Structures are involved
***Mechanism of wounding
- Crush avulsion
**Loss of tissues
**Other local factors
- Vascular insufficiency
- Previous venous Pressure
- Malnutrition or vitamin or Mineral deficiencies
- Disease (Eg Diabetes Mellitus)
- Medications (Eg Steroids)
- Immune deficiencies (Chemotherapy, AIDS)
Nutrients that enhance wound healing:
“Pyridoxine, riboflavin, thiamine
- Inflammatory phase.
- Proliferative phase.
- Remodeling phase.
Types of wound dressing:
Open dressing: The antimicrobial cream is applied with a gloved hand the wound is left open to the air without gauze dressing. The cream is reapplied if needed
“Increase visibility of the wound
“Freedom for joint mobility
“Increased chance of hypothermia.
Closed dressing: In closed method, gauzed dressing is impregnated antimicrobial cream and applied to the wound.
“Decrease in evaporative fluid and heat loss from wound surface.
“Gauze dressing aids in debridement.
”Wound assessment is limited.
Procedure of applying a wet to damp dressing:
- Articles: Dressing trolley with-
- Dressing pack
- Sterile bandage in a bin
- Sterile dressing pads in a bin
- Sterile Vaseline gauze.
- Silver sulpha diazene1%
- Sterile normal saline
- Chaetae forceps
- Adhesive tape and scissors.
- Sterile scissors
- Receptacle for waste
- Explain procedure to patient.
- Instruct patient to have a shower bath.
- Administer analgesics about 20 minutes Before procedure as per physician’s Instructions.
- Provide privacy and give psychological support to paint.
- Regular temperature of the room at24 degree Centigrade [80 degree Fahrenheit] and Humidity at 40-50% if possible.
- Put on mask and cap.
- Scrub hands and don sterile gown, gloves and goggles if available.
- Clean and debride the wound using sterile scissors and forceps. Trim loose Escher and separate devitalize skin.
- Inspect wound and surround area
- Apply topical medications over the wound.
- If closed method is used for dressing, cover the wound with Vaseline gauze and place sterile dressing pad.
- Apply bandage over the dressing pad.
- Wash reusable articles to be sent for autoclaving.
- Discard gloves and gown and wash hands.
- Record procedure and note the odor, color, size, amount of exudates, signs of epithelialization and any changes from previous dressing.