Wound Management

BN Year 1Semester 2, 2014

Hongyan Lu

Session Content

• Wound classification

• Factors affecting wound healing

• Basic wound assessment

• Wound care products

Classification of wound

Can be base on:

• Mechanism of injury

• Time that takes for a wound to heal

Mechanism of Injury

• Intentional wound - surgery for diagnosis, cure, exploration, e.g. incision - Treatment – intravenous cannula, epidural insertion, e.g. puncture

• Unintentional wound- accidents – road accident, sports, victim of crimes, etc. - poor care – skin tear, pressure areas/sores- allergies – blisters- Treatment complications – skin damages due to radiotherapy and chemotherapy

Time taken for wound healing

• Acute wound - wounds that heal by first intention

• Chronic wound - wounds that heal by secondary intention and tertiary intention

Factors affecting wound healing• Patient factors – age, nutritional status, past medical conditions,

current health concerns, knowledge and self-care ability, screening for possible infectious status – multidrug-resistant organisms

• Health professionals: standard precautions such as hand hygiene,

use of Personal Protective Equipment (PPE), wound care knowledge, assessment and skills, communication, monitoring effectiveness of treatment

• • Environment – isolation protocols, environment cleaning such as

linen management, blood and body fluid spill management, sharps

Wound assessment

• Location• Physical examination - any dressing in situ - size/depth: any skin and tissue loss - discharge/exudate/drainage – colour, amount, odour - colour of the wound tissue - presence of stitches and staples and any other foreign body - surrounding skin • Most importantly, what does the patient feel about the

wound?

Wound care products

• Cleaning agents – 0.9% NaCl (normal saline); tap water• Change of dressing (COD) - what do dressings do for a wound? - if there is a need for changing dressings - Dressing types 1) occlusive and adhesive dressing products: e.g. transparent dressings 2) non-adhesive absorbent dressing 3) microfoam 4) fixation: tape, tubigrib, etc

References:

•Crisp, J., & Taylor, C. (2013). Potter and Perry’s fundamentals of Nursing (4th ed.). Chatswood, NSW, Australian: Elsevier.

•Dempsey, J., Hillege, S., & Hill, R. (2014). Fundamentals of nursing and midwifery: A person-centred approach to care (2nd ed.) (Australian and New Zealand edition). Sydney, NSW, Australia: Lippincott Williams & Wilkins Pty Ltd.

•Fernandez, R., Griffiths, R., & Ussia, C. (2006). Water for wound cleansing. Journal of Athletic Training, 41(2), 196–197. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472650/

•Mölnlycke Health Care. (n.d.) Wound care dressings. Retrieved from http://www.molnlycke.com/wound-care-dressings/#confirm

•Smith&Nephew New Zealand. (n.d.). Product types. Retrieved from : http://www.smith-nephew.com/new-zealand/healthcare/products/product-types/

•Waitemata District Health Board. (n.d.). Wound assessment chart.