WOUND MANAGEMENT
ACUTE WOUND –
ACUTE WOUND is a surgical wound that heals by the primary
intention or any traumatic or surgical wound that heals by
secondary intention .
An acute wound is expected to progress through the phages of
normal healing , resulting in the closure of the wound
Chronic wound -
Chronic wound is a wound that fails to progress healing or
respond to treatment over the normal expected healing time
( 4 weeks ) and become ‘’ stuck ‘’ in the inflammatory phase .
This pathological inflammation is due to a postponed , incomplete
or uncoordinated healing process .
Wound healing is dealed in presence of intrinsic and extrinsic factor
intrinsic factor incuding medication , poor nutrition , co- morbidities
or inappropriate dressing selection .
TYPES
Primary intention -
The wound edges are held together by artificial means such as
sutures , staples tapes or tissues . there is minimal tissue loss and
wounds heals with minimal scarring .
,Delayed primary intention –
When the wound is infected or requires more through intensive
cleaning or debridement prior to primary closure usually 3-7 days
later. May be used for traumatic wounds or contaminated surgical
wounds .
Secondary intention –
spontaneous wound healing occurs through a process of
granulation , contraction and epithelialization . results in scar
formation and used as a method of healing for pressure inures ,
ulcers , or dehisced wounds .
skin graft –
removal or partial or full thickness segment of epidermis and dermis
from its blood supply and transplanting it to another site to speed up
healing and reduce the infection .
flap –
the surgical relocation of skin and underlying structure to repair a
wound . flaps are named according to their tissue components and
may include as anastomosis of blood supply to vessels attached to
or at the affected site .
wound healing –
wound healing is a complex sequences of events that can be
broadly divided in 2 stages :-
,HAEMOSTASIS-
Haemostasis is a rapid response to physical injury and is necessary
to control bleeding . it involves the following components :-
1) Vasoconstriction
2) Platelet response
3) Biochemical response
TISSUE REPAIR AND REGENERATION –
Tissue repair and regeneration involve 3 phases
1) Inflammation phase ( 0-4 days )-
The body normal response to injury this phase activates
vasodilation leading to increased blood flow causing heat .
redness , pain , swelling and loss of function .
2) Reconstriction phase (2-24 days )-
The time when the wound is healing . the body makes new
blood vessel , which cover the surface of the wound . this
phase includes reconstruction and epithelialization . the
wound will become smaller as it heals .
3) Maturation phase (24 days – 1 year ) –
The final phase of healing . when scar tissue is formed . the
wound is still at a risk
Wound bed clinical appearance
1)granulating –
When a healthy red tissue is observed and is deposited
during the repair process . it presents as pinkish /red
coloured moist tissue and comprises of newely formed
, collagen , elastin and capillary network .this tissue is well
vascularized and bleed easily .
2)EPithelialising –
Is the process by which the wound surface is covered by
new epithelium , this begins when the wound has filled
with granulation tissue .
The tissue is pink , almost white and only occurs on the top
of healthy granulation tissue .
3)sloughly-
The presence of devitalized yellowish tissue is observed and is
formed by an accumulation of dead cells. Must not be
confused with the presence of pus.
4)Neurotic –
Necrotic describes a wound containing dead tissue . the
wound may appear hard , dry and black . deadconnective
tissue may appear gray . the presence of dead tissue in a
wound presents healing .
4) Hyper granulation –
Hyper granulation is observed when granulation tissue
grows above the wound margin . this occurs when the
proliferative phase of healing is prolonged usually as a
result of bacterial inbalance or irritant forces .
WOUND EDGES
The edges of the wound are assessed for-
Colour –
ACUTE WOUND –
ACUTE WOUND is a surgical wound that heals by the primary
intention or any traumatic or surgical wound that heals by
secondary intention .
An acute wound is expected to progress through the phages of
normal healing , resulting in the closure of the wound
Chronic wound -
Chronic wound is a wound that fails to progress healing or
respond to treatment over the normal expected healing time
( 4 weeks ) and become ‘’ stuck ‘’ in the inflammatory phase .
This pathological inflammation is due to a postponed , incomplete
or uncoordinated healing process .
Wound healing is dealed in presence of intrinsic and extrinsic factor
intrinsic factor incuding medication , poor nutrition , co- morbidities
or inappropriate dressing selection .
TYPES
Primary intention -
The wound edges are held together by artificial means such as
sutures , staples tapes or tissues . there is minimal tissue loss and
wounds heals with minimal scarring .
,Delayed primary intention –
When the wound is infected or requires more through intensive
cleaning or debridement prior to primary closure usually 3-7 days
later. May be used for traumatic wounds or contaminated surgical
wounds .
Secondary intention –
spontaneous wound healing occurs through a process of
granulation , contraction and epithelialization . results in scar
formation and used as a method of healing for pressure inures ,
ulcers , or dehisced wounds .
skin graft –
removal or partial or full thickness segment of epidermis and dermis
from its blood supply and transplanting it to another site to speed up
healing and reduce the infection .
flap –
the surgical relocation of skin and underlying structure to repair a
wound . flaps are named according to their tissue components and
may include as anastomosis of blood supply to vessels attached to
or at the affected site .
wound healing –
wound healing is a complex sequences of events that can be
broadly divided in 2 stages :-
,HAEMOSTASIS-
Haemostasis is a rapid response to physical injury and is necessary
to control bleeding . it involves the following components :-
1) Vasoconstriction
2) Platelet response
3) Biochemical response
TISSUE REPAIR AND REGENERATION –
Tissue repair and regeneration involve 3 phases
1) Inflammation phase ( 0-4 days )-
The body normal response to injury this phase activates
vasodilation leading to increased blood flow causing heat .
redness , pain , swelling and loss of function .
2) Reconstriction phase (2-24 days )-
The time when the wound is healing . the body makes new
blood vessel , which cover the surface of the wound . this
phase includes reconstruction and epithelialization . the
wound will become smaller as it heals .
3) Maturation phase (24 days – 1 year ) –
The final phase of healing . when scar tissue is formed . the
wound is still at a risk
Wound bed clinical appearance
1)granulating –
When a healthy red tissue is observed and is deposited
during the repair process . it presents as pinkish /red
coloured moist tissue and comprises of newely formed
, collagen , elastin and capillary network .this tissue is well
vascularized and bleed easily .
2)EPithelialising –
Is the process by which the wound surface is covered by
new epithelium , this begins when the wound has filled
with granulation tissue .
The tissue is pink , almost white and only occurs on the top
of healthy granulation tissue .
3)sloughly-
The presence of devitalized yellowish tissue is observed and is
formed by an accumulation of dead cells. Must not be
confused with the presence of pus.
4)Neurotic –
Necrotic describes a wound containing dead tissue . the
wound may appear hard , dry and black . deadconnective
tissue may appear gray . the presence of dead tissue in a
wound presents healing .
4) Hyper granulation –
Hyper granulation is observed when granulation tissue
grows above the wound margin . this occurs when the
proliferative phase of healing is prolonged usually as a
result of bacterial inbalance or irritant forces .
WOUND EDGES
The edges of the wound are assessed for-
Colour –
