Wound Management: Wound care treatment chart

 

The wound care treatment chart should be saved to your gallery as from birthday to Deathday, wounds may surprisingly catch you anytime. Why surprisingly catch you? Is it a virus or an infection that will catch you? No! Then?

You have to wait a little for the answer to this question. Just a few more lines will get you the answer. Stay connected! Before jumping to the wound management, first, let’s have a detailed overview of ‘wounds and their types‘.

 

What is a wound?

A wound refers to a non-intact skin condition followed by physical trauma. It may affect the skin and any body tissues (muscles, bones, ligaments, tendons) as well. Remember! Skin wounds, whether small or big, are clearly visible.

What are the causes of wounds?

As the definition shows, physical trauma may cause a wound. The etiology further includes;

• Blunt Injuries: When a blunt object hits the body, examples include Road Traffic Accident, Falls, Physical abuse, Athletic injuries, and Bite injuries (animal or human bites).
• Surgical insult: Wounds that are caused due to the surgical procedure.
• Penetrating trauma: When skin is pierced by a foreign object which then creates a wound.
• Burn injury: These injuries may include any burn incident, including thermal, radiation, electrical, and cold injuries.

Classification of the wound

There are many factors that outline wound classification. They can be classified according to the etiology, duration of the wound healing, integrity of the skin, wound severity, and depth of the wound.

Wound classification on the basis of etiology

1. Blunt Wound – caused by blunt injuries
2. Surgical Wound – caused by surgical procedures
3. Penetrating Wound – caused by penetrating injuries
4. Burn Wound – caused by burn injuries

Wound classification on the basis of duration of wound healing

1. Acute Wounds: These wounds usually heal faster – immediately or in some days. Examples of acute wounds include surgical or traumatic wounds.
2. Chronic Wounds: These wounds include recurring wounds. Such wounds may take 1 month to 4 months to heal. Chronic wounds result from various underlying conditions like compromised blood supply, increased pressure on the tissues, and others. Examples include pressure ulcers and diabetic foot ulcers.

Wound classification on the basis of the integrity of the skin

1. Open Wounds: It refers to compromised skin integrity where the underlying structures (skin layers, muscles, bones, etc.) are exposed. Moreover, it is further classified into different types based on the object causing the wound. For example, laceration wounds, incised wounds, and puncture wounds are all open wounds.
2. Closed Wounds: The wounds with intact skin, where underlying tissues are traumatized, are referred to as closed wounds. There are a few types of close wounds that are taken seriously same as open wounds. Bruises and blood tumors are examples of closed wounds.

Wound classification on the basis of wound severity

1. Simple Wounds: Traumatized skin without skin layer loss or tissue damage.
2. Complex Wounds: Wounds caused by crush or burn injuries further containing a foreign body.

Wound classification on the basis of the depth of the wound

1. Superficial Wounds: In these wounds, the superficial skin layer ‘epidermis’ is impacted. So, it may require replacement. True superficial wounds heal faster and there is no bleeding stage. Abrasions are an example of superficial wound.
2. Partial-Thickness Wounds: In the case of partial-thickness wounds, all the epidermis and some parts of the dermis layer are involved (affected). However, these wounds bleed and if they are not dressed in time, scar formation occurs followed by blood clotting. The epidermis regenerates and hence the dead tissues are replaced. Such wounds take longer to heal and healing duration mainly depends on the type of treatment given.
3. Full-Thickness Wounds: In a full-thickness wound, both skin layers – the epidermis and dermis are affected. The underlying structures, e.g., muscles, fat layer, bones, and tendons can be affected as well. In some cases, it is not possible to suture a full-thickness wound, so, the wound will heal naturally. Regeneration of the epidermis will eventually lead to a completely healed wound. Although, healing time is long (several months).

Wounds Healing

After the wound is caused, the body’s natural repairing system is activated and the healing of the wound starts. Wound repair begins immediately after the wound is caused. This will continue for a long period (months to years). The pathophysiology of the wound repair process constitutes of 3 stages;

1. Inflammatory stage (Lasts 2 to 5 days – Clotting and further injury prevention)
2. Proliferative Stage (Lasts 3 weeks or longer – Repairing of wounded tissues)
3. Maturation & Remodelling stage (Lasts a year or longer – Restoring structural and functional integrity)

Moreover, there are 3 types of wound healing;

1. Primary Closure (Aseptic wound and minor tissue damage)
2. Secondary Closure (An infective wound)
3. Tertiary Closure (Contaminated wounds)

 

Wound Management | Wound care treatment chart

 

Wound management guidelines vary from hospital to hospital and also vary based on wound types. However, general guidelines are as follows;

1. Healthcare professionals should follow a multidisciplinary approach to wound care.
2. Assess the patient when he/she presents with a wound and then keeps monitoring the wound healing from time to time.
3. Think about the psychological effects of a wound—particularly important in the context of pediatric care given the development of knowledge and the pain linked to the wound and dressing changes.
4. Define the wound care goals and possible treatment outcomes.
5. Don’t insult the delicate wound environment.
6. Aseptic wound management is recommended to maintain bacterial balance.
7. A moist wound environment is a critical need for proper wound healing, so healthcare professionals need to maintain it.
8. Monitor wound temperature and keep it constant while avoiding cold solutions and wound exposures.
9. Keep the wound pH either acidic or neutral.
10. If a wound is draining, let it be.
11. Remove dead space around the wound, but don’t do tight dressing.
12. After the assessment is done, decide which dressing is appropriate and how to apply it. Take clinical decisions based on EBP.
13. Begin with proper adjunctive wound therapies including compression, off-loading orthotics, and others.

The wound care treatment chart for acute wounds includes the standard procedure for managing acute wounds.

The wound care treatment chart for chronic wounds lists both wound assessment and management.

 

Take Away!

Wound management is a usual clinical practice and healthcare professionals should learn standard protocols. The wound care practices across different regions differ, but you can professionally handle it following standard protocols.