Wound Care and Healing

Health Science Technology

Goals of Wound Care

• Remove necrotic tissue to promote wound healing

• Prevent, eliminate, or control infection

• Absorb drainage (exudate)

• Maintain a moist wound environment

• Protect the wound from further injury

• Protect the surrounding skin from infection and trauma

Stages of Wound Healing

1.Primary Stage= inflammation

2.Secondary Stage= proliferation (granulation)

3. Tertiary Stage= maturation (wound remodeling)

Primary Stage of Wound Healing

• Inflammatory Phase caused by histamine and prostaglandin

• Lasts 4 - 6 days

• Edema leads to a reddened, swollen, and tender wound

• Healing process is controlled by the release of neutrophils and macrophages

Secondary Stage of Wound Healing

• Proliferative or Granulation phase

• Begins 1-4 days after the injury and ends 14-21 days later

• Rapid growth of epithelial cells to produce a protective covering for the wound

• Healthy granulation tissue has a healthy reddish-pink color

Tertiary Stage of Wound Healing

• Maturation, or wound remodeling-

• Begins 14-21 days after the injury and can last up to 2 yrs.

• Scar shrinks and thins and becomes less red

Wound Healing

• In order to accomplish the goals of wound care, a moist wound environment must be maintained

• Wound cannot be too dry or too moist• All wounds require a dressing that is dry on the

air-exposed side to prevent bacterial invasion• Dressing should be secured over the wound and

taped in place using the “window paning” method of taping

Wound Treatments

• If epidermal (surface) injury:

-clean the wound, apply antibacterial ointment and cover

• If bleeding:

-Apply pressure with a gloved hand.

-Elevate affected area above the level of the heart to slow blood flow-bleeding should stop after 10-15 minutes. Cover.

Wound Treatment

• Antibiotics if animal/human bite, or if not cleaned properly

• Sutures if wound is deep or large

• Tegaderm or Hydrogel for elderly in lieu of sutures due to fragile skin.

Types of Dressings

• Wound Vac-

-used for wounds with excess exudate, excess edema, bacterial burden, absence of moisture

• Dry sterile dressing-used for wounds with little to no drainage.

• Wet to dry dressing-used for wounds in granulating phase of healing

Alternative Wound Care Methods

• Maggot Therapy-

Maggot Therapy

• Maggots can effectively:

-Debride (clean) the wound

-Promote wound healing

-Kill bacteria

• Maggot Debridement Therapy (MDT) is indicated for non-healing wounds such as:

-Venous ulcers, diabetic ulcers, etc.

Leech Therapy

-Leeches secrete an anticoagulant that increases blood flow

-They are painless to attach because they secrete an anesthetic

-Used primarily in Eastern medicine, but also in Western medicine.

-Can be used for more than just wounds, ex: psoriasis