Wound Free Worry Free
This information has been created to help keep yourself healthy and independent by following these four simple steps below.
You can help by telling a health professional eg doctor or nurse if the following happens: increased pain, swelling, redness around the wound.
Helping It Heal...What You Can Do
What The Dressing Will Do
Remember
New technology enables the dressings to remain on the wound for several days. A slight smell is normal and expected when the dressing is changed.
The scientific evidence is now conclusive that the best way to heal a wound is not to allow it to dry and create
a crust. The human body is composed of many cells and a lot of water. Cells manage to perform their functions in a more constructive manner within a fluid environment. The consequence of this knowledge is the production of dressings and devices to aid the body in healing a wound within a balanced moist environment. The health clinician caring for your wound will assess relevant aspects and plan the appropriate care.
An understanding of the wounds needs is obtained through a thorough assessment of the wounded patient. Assessment requires the clinician to ask many questions pertaining to past medical and surgical history together with current medication history. This information is then added to the assessment of the wound tissue and surrounding skin in order to establish the correct diagnosis and reveal all factors that may inhibit or delay healing.
When the clinician is satisfied that a thorough history has been obtained a treatment regime is planned. Planning involves setting both short and long-term goals. The longer term is complete healing but in the short term, goals may include the removal of any dead tissue or promoting the healthy new growth of tissue.
Products have been developed to achieve these goals and your wound clinician will advise you of the dressings needed to heal the wound.
Dressings are generally classified according to their function so you may require dressings to:
Some dressings come in forms that adhere to the skin in order to be waterproof and some are not waterproof. Your health clinician will inform you about what you need to do to keep your dressings in good order and dry if necessary. If no adhesive/waterproof dressing is used then you will require some form of tape or bandage to hold the dressing in the correct place and prevent slippage and ensure that it stays dry during shower or other daily activities.
There are many forms of bandages available. Some bandages are used to hold the dressings in place and some are used to assist in reducing swelling of the tissue surrounding the wound. It is important that when a health professional applies a dressing or a bandage to your wound they explain the purpose of these so that you are completely informed and have an understanding of the short term treatment aims.
The more you know about what is happening, the better prepared you'll be to take care of yourself.
Any wound from amputation or other surgery is at risk of becoming infected because the skin opening can allow germs or dirt to enter the bloodstream. Infections can cause tenderness or pain, fever, redness, swelling and/or discharge. These infections can lead to further complications or surgery or even death if not treated properly.
If you suspect you are getting an infection, do something. Act quickly, before a small irritation becomes a serious problem.
The best way to handle an infection is to prevent it:
You may have a wound that you are very capable of managing yourself. Sometimes, however, a wound needs professional management from a doctor or nurse. These wounds can include leg ulcers, lacerations and skin tears or wounds that have not healed properly after an operation.
One pair must last a lifetime - take good care of them and they will look after you
With the rising incidence of diabetes, it is essential that everyone has a greater understanding of what constitutes good foot care. People suffering from diabetes have greater risks of sustaining injuries to their feet and these wounds may take much longer than normal to heal and be associated with more complications.
Suggestions for good foot care include:
If a wound on the foot fails to improve within one week it is suggested that further advice is sought from a health specialist or podiatrist. Often the non-healing wound may be the first sign that diabetes is present.
Wounds on feet require 'off-loading' or protection against further pressure, management of the ooze so that the skin does not become soft and soggy and reduction of bacterial counts via antimicrobial dressing.
Antiseptics may be used to assist in cleaning the skin of foot wounds and then antimicrobial dressings such as iodine, silver, tea tree oil, enzymes or honey dressings may assist in managing any bacteria contained within the wound.
Regular dressings and trying not to put any increased pressure on the wound are necessary to successfully heal the wound in a reasonable time frame.
What is moist wound healing?
Active dressings, what are they and why do we use them?
ALGINATES ANTIMICROBIALS FILMS FOAMS HYDROCOLLOIDS HYDROGELS are the names of dressing products that can be described as "active" dressings because they interact with the wound bed in providing a "moist" environment, conducive to optimum healing. This article will provide a brief overview of these active dressings and why moist wound healing has become a preferred approach when managing most chronic wounds rather than encouraging the wound to dry out and form a scab.
* Moist wound healing is not recommended when there is dry dead tissue with insufficient blood flow to the affected body part to support inflammation and wound healing; and in palliative care where healing is not a realistic goal and necrotic tissue provides protection of deeper vascular structures.
The principles of moist wound healing came about from research conducted in the' 40s where it was found that wounds actually closed faster by covering the wound and keeping the area moist. The moist environment stimulated activity in the wound bed allowing cells to repair the injured tissue and remove wound debris.
The growth of new skin was found to be faster and more efficient in a moist environment when compared to leaving a scab to dry out. It is more difficult and a slower process for cells to repair skin under a dry hard scab. This is only until the outer skin layers eventually shed.
The scab itself can become a problem if left open. It can be knocked, traumatized and at times serve as a focus for bacteria (bacteria may have been multiplying under the scab and the inflammatory process can start over). Dressings can be used to prevent dehydration of the wound surface and gently absorb fluid or offer protection for fragile new skin until it regains strength.
Dressings are selected on the basis of their action to match the goal of care. These dressings have been described as "intelligent" implying that little thought is needed when applying it to a wound. This assumption could not be further from the truth. Wound healing is a complex process and the wound is only the end result or a symptom of deeper problems that have caused the development of a wound in the first instance.
ALGINATES are highly absorbing biodegradable fibrous material derived from brown seaweed that interacts with wound surface to produce a gel-like substance to aid gentle removal when saturated. Alginates have been used in the food industry for many years and are available in flat sheets to lie over the wound bed or in a "rope" to pack into a wound cavity. Alginates have been added to other types of dressings like gels and hydrocolloids to aid extra absorbency within the dressings. The main function of the alginate is to absorb exudates, gently fill a cavity while healing and can stop bleeding once applied.
Some of the names of alginates are kaltostat, sorbsan, algoderm, algisite m, tegaderm alginate, sorbalgon, melgisorb, curasorb, seasorb, calcicare.
Active dressings promote moist wound healing. There are several groups of active dressings that provide a moist environment for the wound. They are: hydrocolloids, hydrogels, films, foams and antimicrobials.
Coping with wound odour can be extremely challenging and have a profound negative effect on the patient, and their family at a time when more support is needed. Wound odour can diminish appetite and activity and when masked with sprays or fragrances can set up an ongoing reminder of the negative wound experience.
Wound odours need to be clearly evaluated as either those coming directly from the wound or the odour of the wound fluid mixed with dressing material which may disappear after the dressing change.
If the odour is present after wound cleaning then it is most likely an infection or dead tissue. Some specific bacteria have characteristic odours such as sweet or ammonia-like, other bacteria can create foul odours due to tissue breakdown.
In identifying the cause of the malodour three main areas can be examined:
In order to control the odour there are three main areas to address:
Delayed Healing or Chronic Wounds
When managing wound care in the community there are two types of wounds that can occur, acute wounds that usually heal within 2-4 weeks, or chronic wounds that are delayed in healing and stay around from 6 weeks or so to several years.
There are many factors that may delay wound healing. If the person with the wound does not have effective blood circulation, or if there is a recurrent infection, there could also be an underlying disease that hasn't been detected or controlled well. This will also cause a delay in wound healing.
It is extremely important to speak to a health professional if you have a wound that's not healing within an expected time frame as it could be a result of many different things.
Consider why the healing may be delayed. It is more appropriate to consider the "whole" person rather than just what to put over the "hole".
There has been a revolution in wound management products since the early 90's so you may hear all sorts of solutions and remedies about what is the best thing to cover the wound. The important point is always to find out what caused the wound in the first place and why it may not be following the predicted path to healing.
Once that is sorted out then choosing a dressing that suits the conditions of the wound is the next step. Sometimes the wound conditions can change so the dressing choice needs to change as well. Seek professional help to get on the right track, because it could also be an inappropriate dressing that is causing a delay in healing. The modern dressings are complex and will interact with the wound bed so clear guidance is needed.
There are many things that can cause delayed wound healing. In diabetes, a blood sugar reading over 8mmols/L will affect the healing capacity. If the body is trying to repair tissue then nutrition is very important. Skin hygiene or just keeping the wound clean by changing bandages and dressings when they are wet is necessary to avoid an infection.
If these things are taken care of and the wound is still not healing then it is important to seek professional help to investigate why the healing is delayed.
Nutrition
Protein intake is important because it provides the building blocks for tissue repair. Protein sources can be found in meats, fish, nuts, lentils or in a nutritional supplement. If a wound is not continuing to show signs of healing, and there is weight loss from a hospital stay or trauma, then a nutritional supplement may be needed to help the recovery.
A good multivitamin and at least 1,000 mg a day of Vitamin C may help speed up the healing process. A GP can arrange for a blood test to see if a supplement or extra iron is needed to aid wound repair, or refer a dietician to help with meal plans. Alternatively, making an effort to eat well could have a surprising result.
Hygiene
The wound must be kept clean at all times to control bacteria and promote healing. In acute wounds, inflammation is normal for a few days but if this continues then it can lead to infection. Increasing pain, excess fluid from the wound, redness, swelling, odour from the wound or a temperature are all symptoms of an infection. Seek medical advice as antibiotics may be needed to fight the infection.
Protection
Protecting the wound is imperative so securing the dressings is important and ensuring it is the right size for the wound. Keeping the area dry is also worthwhile and keeping the wound bed undisturbed so it has a chance to heal is just as important as changing it often enough. Seek help or make an effort to protect the dressing under the shower. Some dressings are waterproof but it doesn't take much to have the water leak in.
Once the wound has healed then providing protection with a barrier cream or moisturizer is also worthwhile because the area will be fragile and take a while to recover and regain strength again.
The elderly or frail or those without sensation, it may be worthwhile providing a protective sleeve to prevent reoccurring injury.
Wound management is complex particularly if the healing is delayed and the wound has become "chronic". By understanding the nature and cause of the wound and eliminating the things that can be controlled, for example, hygiene, diet, protection then healing can be achieved.
If the wound is not healing then consider what your doctor could do to help investigate or assist with those things that cannot be easily controlled.
