Proper wound management is important for preventing infections and promoting healing. The National Health Service (NHS) provides lots of guidelines on handling various types of wounds and on selecting the most appropriate dressings.
Types of Wounds
- Cuts and Grazes: These are common injuries where the skin is torn or scraped.
- Surgical Wounds: Incisions made during medical procedures.
- Chronic Wounds: Wounds that fail to heal in an expected timeframe, such as pressure sores, infected wounds and venous leg ulcers.
General Principles of Wound Management
- Hand Hygiene: Always wash hands thoroughly with soap and water before and after touching a wound.
- Assessing the Wound: Carefully consider the wound’s size, depth, and condition to help decide the most appropriate treatment.
- Cleaning the Wound: Use clean water to gently rinse the wound, removing any debris. Avoid using antiseptics like iodine or hydrogen peroxide, as they can damage healthy tissue and delay healing.
- Stopping the Bleeding: Apply gentle pressure with a clean cloth or bandage to stop bleeding. Elevate or lift up the injured area if possible.
- Applying a Dressing: After cleaning, cover the wound with an appropriate dressing to protect it from infection and promote healing.
NHS Information on Wounds and Wound Dressings
This is quite a large topic.
Cuts & Grazes – NHS Information on Cuts & Grazes
Surgical Wounds – NHS Information on Caring for Surgical Wounds at Home which provides helpful guidance after an operation.
Chronic Wounds – Patients with diabetic foot ulcers, pressure ulcers, venous leg ulcers and infected wounds should carefully follow the advice of their doctor or nurse.
Selecting the Right Dressing
Choosing the correct dressing depends on the wound type, its location, and the amount of exudate (fluid) being produced. Common types of dressings include:
- Hydrocolloid Dressings: These are self-adhesive, waterproof dressings that create a moist environment over the damaged tissue, promoting faster healing. They’re suitable for uninfected wounds producing light to moderate fluid or exudate.
- Alginate Dressings: Made from seaweed, these dressings are highly absorbent and ideal for wounds that are producing more significant amounts of fluid or exudate. They also help with blood clotting, making them quite useful dressings for bleeding wounds.
- Foam Dressings: These provide some cushioning and are suitable for wounds producing moderate to heavy amounts of fluid or exudate. They help maintain a moist environment and protect the wound from external contaminants.
- Hydrogel Dressings: These dressings help wounds heal by keeping them moist. They are made mostly of water and a gel-like substance that hydrates dry wounds, softens dead tissue, and promotes healing. The moisture creates a suitable environment for new skin cells to grow. Hydrogel dressings also provide a cooling effect, which helps soothe pain, especially in burns or pressure ulcers. They don’t stick to the wound, making them gentle during removal. These dressings are best for dry, painful, or necrotic wounds but are less effective on heavily leaking wounds. They should be changed regularly to keep the area clean and promote recovery.
Steps to Change a Dressing
- Preparation:
- Clean the surface where you will place the new dressing using sanitizing wipes or warm water with detergent.
- Gather all necessary supplies, such as new dressings, gloves, and disposal bags.
- Hand Hygiene:
- Wash your hands thoroughly with soap and water for at least 20 seconds, ensuring all areas, including between fingers, are cleaned. Dry them with a clean towel or kitchen roll.
- Removing the Old Dressing:
- Carefully peel off the old dressing without touching the wound. If it sticks, moisten it with saline solution to ease removal.
- Cleaning the Wound:
- Gently rinse the wound with clean water to remove any debris. Pat the surrounding skin dry with a clean towel.
- Applying the New Dressing:
- Place the appropriate dressing over the wound, ensuring it covers the entire area. Secure it in place using medical tape or as directed.
- Disposal:
- Dispose of the old dressing and any used materials in a sealed plastic bag before placing them in the bin.
Signs of Infection
Monitor the wound for signs of infection, which include:
- Increased Redness and Swelling: The area around the wound becomes more inflamed.
- Pus Formation: Yellow or green discharge may be present.
- Fever: A high temperature indicates the body is fighting an infection.
- Unpleasant Odor: A foul smell emanating from the wound.
If any of these symptoms occur, seek medical advice promptly.
Special Considerations for Surgical Wounds
Surgical wounds require specific care:
- Initial Dressing: Keep the original dressing in place for at least 48 hours, unless advised otherwise by healthcare professionals.
- Keeping the Wound Dry: Avoid getting the wound wet during the initial healing phase to prevent infection.
- Monitoring: Regularly check for signs of infection and consult healthcare providers if concerns arise.
Managing Chronic Wounds
Chronic wounds, such as venous leg ulcers, require ongoing care:
- Cleaning and Debridement: Remove dead tissue and clean the wound to promote healing.
- Compression Therapy: For venous ulcers, compression bandages or stockings help improve blood flow and aid healing.
- Regular Monitoring: Frequent assessments by healthcare professionals ensure appropriate treatment adjustments.
Preventing Wound Complications
- Nutrition: Maintain a balanced diet rich in vitamins and minerals especially Vitamin C and Zinc to support healing.
- Avoid Smoking: Smoking impairs blood flow, delaying wound healing.
- Manage Chronic Conditions: Conditions like diabetes can affect healing so manage blood sugar levels well to help prevent delays in recovery
- Regularly monitor the wound for signs of infection: watch for increased redness or pus. Seek medical advice if the wound doesn’t heal or if it shows signs of infection to avoid further complications.