Wound Management
Wound Management
Wound Management
Objectives
Provide
education to all staff of 3east on wound care management Provide education to all staff on appropriate dressing selection
Successful wound healing is largely dependent on the patient. Expensive dressings will do little to improve healing if the patient does not also have:
A good blood supply to deliver essential wound repair components to the wound site e.g oxygen, nutrients (such as protein, vitamins and minerals) and essential wound repair cells (such as monocytes/macrophages, neutrophils, fibroblasts, monocytes/macrophages, neutrophils, myofibroblasts and growth factors) Adverse influences impeding wound healing being controlled odema, odema, infection, disease, malnourishment etc.
Principles of Management
Understand the clinical significance of our actions in promoting or hindering wound healing i.e. the need to be knowledgeable about normal wound healing physiology. Systematically determine the cause of a wound by history taking and requesting relevant clinical investigations. Medical management of the cause of the wound is complimenting topical management Acknowledge patient variables with potential to delay healing. Systematically determine the objective of management Routinely use non-irritating, pH friendly, cleansing solutions nonUse effective cleansing/debriding techniques dependent on cleansing/debriding wound/patient type. Always promote prevention of wounds Objectively evaluate wound progress/deterioration
synthesis
Epidermis
Does not have a blood supply Contains 4 distinct cell types
Keratinocytes (produces keratin which helps waterproof the skin) Melanocytes (produces melanin which is a skin pigment) Langerhans & Granstein cells (involved in immunity)
Contains four or five cell layers. High friction areas (palms & soles) have five layers
Stratum
Dermis
Is
composed of connective tissue containing many nerve endings, hair follicles, glands and blood vessels. Is thick on the soles of feet and on the palms of the hand, but is thin on the eyelids, penis & scrotum.
Subcutaneous Layer
Main
constituent is adipose tissue, nerve fibres, arteries, veins and sweat glands.
thickness wound edges are approximated (brought together) shortly after the primary wound has been created e.g. Clean surgical wounds with no tissue loss.
is when closure of grossly contaminated wounds e.g. Animal bites is delayed (4-5 days) to allow time for host (4inflammatory and immune responses (neutrophils & macrophages) to reduce the risk of infection.
Lightly exudating superficial wounds Moderately exudating superficial wounds Heavily exudating superficial wounds Very heavily exudating superficial wounds
Dry Necrotic Wounds Excoriated Skin Treatment Cavity wound- moderately exudating woundCavity wound- Heavily exudating woundCavity Wound- Very heavily exudating Wound Fragile Skin Critically Colonised wounds
Phase
Wound Assessment
Wound Management