Wound Care - All You Need to Know

Introduction

A wound occurs in the body due to an accidental injury or during a surgical procedure when an incision or a cut is made. This damages the integrity of the skin and causes pain and bleeding through the injured tissues. A wound assessment must be done to decide found wrong choice of word management for the same. Proper wound healing is essential to relieve the discomfort and allow the healthy cells to grow and approximate the wound margins.

What Are the Types of Wounds?

The wounds can be classified into different types depending on the cause. It includes:

1. Pressure Ulcers: This refers to the injury of the skin or soft tissue over a bony prominence and is painful. It occurs due to prolonged pressure in that area. For example, the bed sores that occur on the buttock region.

2. Venous Ulcers: A defect within the valves of the veins that causes backflow of blood and accumulates within the lower leg. When left untreated for a long time, these veins lead to a venous ulcer.

3. Arterial Wounds: When the arteries are narrowed or obstructed, it leads to poor blood flow to the area supplied by that artery and causes an arterial wound.

4. Diabetic Foot Wounds: Patients with diabetes develop a complication called neuropathy, wherein the nerve sensation at the extremities is damaged. So, when the toe gets an infection, the patient cannot feel the pain which, in the long run, leads to an ulcer formation.

5. Moisture-Associated Skin Damage: A prolonged exposure of the skin to moisture like urine, sweat, and wound drainage leads to inflammation and erosion of the skin surface.

The wounds can also be classified as open or closed wounds. An open wound damages the external skin surface, exposing the underlying structures. On the other hand, closed wounds damage the internal structures without exposing them outside. The open wound can further be divided into:

• Abrasion: The scraping of the skin against a hard or rough surface is called abrasion. Very minimal bleeding occurs and causes only superficial injuries.

• Laceration: It refers to a deep cut into the skin using a sharp instrument like a knife, blade, or machinery. Extensive bleeding occurs in cases of deep lacerations.

• Puncture: It is a deep wound caused by a needle, nail, or bullet. Bleeding is very less.

• Avulsion: It is a forcible skin tearing that exposes the underlying muscles, tendons, and tissue. The avulsion wounds bleed rapidly.

How to Assess a Wound?

A complete wound assessment is required to start with wound care. The following are the factors to be considered for assessing a wound:

1. Location: The location provides information about the possible causes of the wound. The possible causes for wounds in the legs can be a pressure ulcer (on the buttocks) or a venous ulcer (lower leg).

2. Depth of Tissue Damage: Depending on the depth to which the wound is extending, it can be a partial thickness or a full-thickness wound. This information will help the doctor decide the treatment plan and the healing duration.

3. Type of Wound Tissue: The tissue overlying the wound can be vital or non-vital. Vital tissues give an appearance of red or light pink that indicates healing. The non-vital tissues can be black, brown, or yellow in color. When vital tissues start to appear in a wound, it shows that the wound is healing.

4. Size of the Wound: The length and depth of the wound are measured to know the size of the wound and to monitor the wound's progress at regular intervals.

5. Wound Edges: The outer edge of the wounds helps in determining the cause of the wound. It also helps to know how long the wound has been present and also its healing progress. For example, a healing wound has a sloping edge.

6. Infection: The presence of infection is identified when the wound shows signs of pain, swelling, discharge, redness, and a bad odor. The infection, if not fully removed, will delay the healing process.

7. Pain: The intensity of the pain also provides information regarding the type of wound. Wounds like abrasion do not have much pain, whereas, in avulsion, extreme pain and bleeding are present.

How to Care for a Wound?

The doctor recommends the following instructions to take care of a wound.

• First, the bleeding must be stopped by applying pressure over the wound and enhancing the blood clot to occur.

• Gently clean the wound and remove the dirt and debris attached to it. Water can be used in cleaning a wound.

• In cases of road accidents where the wound comes in contact with the soil, a tetanus injection is given. Tetanus shot helps to prevent the growth of bacteria in the body. When the wound is deep enough, it must be consulted with a doctor and surgically treated under local anesthesia.

• Sutures are placed after surgery to approximate the wound edges, which are removed after a week. If the wound is causing too much pain, the doctor prescribes medications to relieve the pain.

• Since pain causes the blood vessels to constrict and delays the healing process, it must be controlled by consuming painkillers.

• Compression stockings can be used in case of venous insufficiency to promote blood flow and improve healing. The doctor will prescribe antibiotics to reduce infection and speed up the healing.

Include food rich in vitamin C, such as citrus fruits, tomatoes, bell peppers, and green leafy vegetables. Apply an ointment or cream over the affected area and cover it with an adhesive bandage. The bandage must be changed daily to keep the wound clean and promote the growth of healthy tissues. After complete healing has taken place, apply sunscreen to the skin over the wound to avoid discoloration and for the scar to fade away faster.

What Are the Home Remedies Available to Care for a Wound?

Home remedies are useful only for minor wounds that do not involve much of the deeper tissues. Some of them are the use of turmeric, aloe vera, coconut oil, and garlic. Turmeric possesses antimicrobial and anti-inflammatory properties that work great for the healing of minor wounds. Aloe vera contains glucomannan (a dietary fiber), increasing collagen production in wounds. Collagen is important in forming healthy tissues; hence aloe vera helps reduce infection and improve healing. Coconut oil has an antimicrobial component called monolaurin and helps in a speedy recovery. Similarly, garlic contains an antimicrobial compound called allicin that reduces the infection rate.

What Are the Reasons for Delayed Healing of a Wound?

The following are the reasons that slow down the healing process.

• Older Adults: Wounds in older people tend to heal slower than younger ones.

• Medications: Patients under certain medications like Aspirin (blood thinners) have delayed healing due to the slow rate of blood clotting.

• Bleeding: Continuous bleeding from the wound prevents healing and has to be consulted with a doctor.

• Smoking: The blood vessels constrict in smokers, so the healing is delayed. Hence, smoking must be avoided at least till complete recovery of the wound.

• Dryness: The wounds exposed to air for a long time tend to heal slowly. So a moist environment is created by applying ointments regularly.

• Medical Conditions: Certain conditions like diabetes cause delayed healing. Hence appropriate measures are taken to take good care of the wound.

Conclusion

The wound must be managed properly with a thorough assessment and consultation with the doctor if necessary. Minor wounds can be managed at home, but deep wounds need to be checked by a doctor and treated surgically. Successful wound care is obtained by having a knowledge of the barriers that slow the healing and effectively maintaining the hygiene of the wound area.