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The Basics: Wound Care 101

Wounds occur in many environments from a surgical to diabetic foot ulcers. We’re going to cover the basics of wound care by explaining types of wounds, principles for wound management, types of dressings, and follow up care. 

What are the types of wounds?

An Acute Wound is any surgical wound that heals by primary intention or any traumatic or surgical wound that heals by secondary intention. An acute wound is expected to progress through the phases of normal healing, resulting in the closure of the wound.  Symptoms of acute wounds can include redness around the area and pain or bleeding during dressing changes.

Acute Wounds can be caused from a variety of reasons including: 

  • Penetrating wounds
  • Puncture wounds
  • Surgical wounds and incisions
  • Thermal, chemical or electric burns
  • Bites and stings
  • Gunshot wounds, or other high velocity projectiles that can penetrate the body.
  • Blunt force trauma
  • Abrasions
  • Lacerations
  • Skin tears

A Chronic Wound is a wound that fails to heal over the expected healing time frame and becomes stuck in the inflammatory phase. Chronic wounds can be delayed by factors including medications, poor nutrition, co-morbidities or inappropriate dressing selection. About 2% or 6.5 million people of the US population is estimated to be affected by chronic wounds. 

Chronic Wounds have many causes including:

  • Trauma
  • Burns
  • Skin cancers
  • Infection 
  • Underlying medical conditions such as diabetes

How do I care for a wound?

The basic principles for the management of a wound or laceration that caregivers should use to achieve timely wound healing are:

  • Haemostasis
  • Cleaning the wound
  • Analgesia
  • Skin closure
  • Dressing and follow-up advice

Haemostasis is the process that causes bleeding to stop. In most wounds, haemostasis will be spontaneous. In cases of significant injury or laceration of vessels, steps may need to be taken to reduce bleeding and aid haemostasis. These include pressure, elevation, tourniquet, or suturing.

Cleaning wounds promotes healing and reducing infection. Cleaning a wound with dirty hands increases the risk of infection. Even if your hands appear clean, before doing anything to a wound, wash your hands thoroughly with soap. Rub your hands under water for at least 20 seconds and use soap to remove germs and bacteria that may cause infection in a wound.

Additional steps involved with cleaning the wound include:

  • Disinfecting
  • Debriding
  • Irrigating
  • Administering antibiotics if needed

Analgesia or pain relief is an important part of wound care management because professionals need to reduce the pain and stress their patients experience during treatment, especially for those whose burns require regular wound care procedures. Most physicians are comfortable with prescribing neuropathic agents, NSAIDS, and acetaminophen. Many also use tramadol, anxiolytics, topical agents, and hydrocodone or codeine.

Skin Closure includes three main types:

In primary wound closure, sutures are the standard of care. There are two types of sutures, absorbable and non-absorbable. Non-absorbable sutures are preferred because they provide great tensile strength, and the body’s chemicals will not dissolve them during the natural healing process. Wound closure is not a painless event, and some anesthesia should be provided. 

The sheer number of dressings available makes choosing the correct dressing for clients a difficult proposition. A physician can advise the patient or caregiver on the most appropriate dressing related to the size and depth of the wound. Legacy Medical Sales offers a large variety of dressings, check them out here: https://legacymedicalsales.com/product-category/wound-care/wound-dressings/

Each type listed below needs to be evaluated for use based on its pros and cons:

  • Gauze dressings are made of woven or non-woven materials and come in a wide variety of shapes and sizes. They are cheap and widely available, however they require frequent changing.
  • Transparent Films conform to the wound well and stay in place for up to a week, however they may stick to the wound
  • Foam dressings are comfortable and won’t adhere to the wound, however may require a second dressing to hold it in place
  • Hydrocolloids are waterproof and impermeable to bacteria, but can leave a residue on the wound site
  • Alginates are highly absorbent and can be used when infection is present, but will always require a second dressing
  • Composites are widely available and easy to use, however may be more expensive and difficult to store.

What information is important once wound care treatment has been implemented?

Tetanus prophylaxis is required for any individual not up to date with (or unsure of) their tetanus immunization status. Mortality in the United States resulting from generalized tetanus is 30% overall, 52% in patients older than 60 years, and 13% in patients younger than 60 years.  

Any sutures or adhesive strips should be removed 10-14 days after initial wound closure (or 3-5 days if on the head); tissue adhesive glue will naturally slough off after 1-2 weeks. Remove dressings at the same time as the sutures or adhesive strips. 

Advise the patient to:

  • Seek medical attention for any signs of infection
  • Take simple analgesia (e.g. paracetamol)
  • Keep the wound dry as much as possible, even if wearing a waterproof dressing

As you can see there are several important principles to wound care management that include a variety of products. Each product should be evaluated or prescribed by a physician based on the individual wound, as there is not a “one size fits all” approach to wound healing. Legacy Medical Sales works with medical professionals to provide our clients with the most effective and up to date medical supplies. Need help selecting the right wound care products? Simply call or email us today for a customized consultation at info@legacymedicalsales.com or 1-800-446-7310.