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
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.