Wound Care

Chronic and minor wounds are very common both to the young and to the old, in acute settings as well as in community settings. They may come in terms of pressure sores, foot or leg ulcers or wounds caused by an injury on any part of the body or due to a surgical operation.A wound may develop due to varying factors which include an injury of a malfunction of the skin.

When the veracity and protective function of the skin is violated, many different types of cells normally enter a simple wound and causes it to make an inflammatory response. This brings about signs of redness on the wound, severe pain and swelling. In some cases it causes temperature rise and a fever.During this process, the human body aims to have homeostasis restored. The probability of being infected by a wound normally depends on several factors like the hydration state of one’s body, quality of nutrition observed and the existing individual medical conditions.It may also depend on some extrinsic factors that are connected with pre operation, intra operation and post operation care in case the patient has ever undergone surgery. Due to these varying factors, it is usually difficult to foretell which wound is likely to become infected. In regard to this, healthcare practitioners should take the prevention of wound infection as a chief management objective.

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Surgical wounds are a major category of wound infections. These are a very dangerous category of wounds that are acquired from the hospital when one undergoes an operation. If not well taken care of, they may lead to death. Delay in the patient’s recovery and the consequent increase in the length of hospitalization also brings about economic consequences.

Wounds are caused by the presence of pathogens, which are minute and micro organisms. Most micro organisms are very small in size, below 0.1mm in diameter. They are not visible with a naked eye but can only be seen when one uses a microscope. They can be classified into various groups which include harmful bacteria, viruses, protozoa and fungi.The first step in wound care is the recognition of wound infection. The provocative response made by wounds is a protective mechanism whose aim is to counterbalance and kill any toxic agents that are present at the spot of an injury and to restore the homeostasis of tissues.One can easily find out an infection from the indicators which give typical signs such as pain, heat, arythena and cellulitus on the affected part of the body.

A wound may also give out a discharge which may be sticky and discolored in nature.In other cases, the tissue within the wound and at the wound margins becomes discolored. This may be due to clotted blood or pus that is being produced by the wound. This could cause much disorder.Upon diagnosis and confirmation of a wound infection, suitable management procedures should be considered. Priority should be given to reducing the danger of cross infection. Medical practitioners should treat the infected person as a whole and should not deal with the infection alone.

Management strategies should therefore be based on data that is derived from the holistic evaluation of the individual needs of the patient. For a medical specialist to treat the wound, he should look at the patient as a whole person and not just a single part of the body.The main objective for making any treatment is to reduce the bacterial burden that is found within the margins of the wound and not to eradicate it. Antibiotic therapy is the major method of wound management that is used to reduce the bacterial load hence bringing quick healing.Generic products have also been found to be effective in the reduction of the bacterial burden in and around the wound. They include compounds that contain silver or iodine.

When administered to the patient, they fight other infectious micro organisms which may affect the patient.Antibiotics, which are basically chemical substance that are produced by a micro organism, have the capability to selectively slow down the growth of other micro organisms or even to kill them.Systemic antibiotics are therefore necessary for the management of the wounds that are clinically infected, although the choice of which antibiotic to used is not apparent all the time.To identify the most appropriate micro organisms for a certain patient, the concerned parties should carry out an all-inclusive assessment process and also consider the patient’s characteristics. They should do also carry out micro biological investigations on the patient and also try to identify the nature and the location of the wound, so as to treat it with due regard.Wound infections affect the patient in both economical as well as human terms and should therefore not be underestimated.

Medical practitioners should learn how to identify and manage the signs, symptoms and consequences of wounds which are clinically infected.The main principles for the management of a patient who is infection with a wound include a holistic treatment of the patient as a whole. After the recognition of the evident signs of irritation and notion of an increased bacterial burden as well as clinical infection, the medical practitioner may take reliable wound swabs.Interpretation of culture reports is very important in the management of wound infections. This enables the concerned parties to give the right treatment and hence yielding the desired results for the treatment of the infection.During the actual treatment, one should consider the causative organisms which are mostly harmful micro organisms. If properly handled, these micro organisms normally reduce under treatment and hence the infection gets easy to heal.Antibiotic sensitivities should also be considered.

Among the various wound management products that are available, the medical practitioner should consider which one is the most suitable and appropriate for the particular patient. The position and nature of the wound should also be put into consideration.In wound care management, the medical practitioner should try to minimize the risk of cross infection. They should highly avoid the risk of any complications that could be incurred on the patient in the process of wound infection treatment and wound care management.It is very important that the patient and the immediate family members as well as other care takers be educated on how to take care of the patient and on different methods of home care and treatment.

Since the doctor is not always around, the care takers should have basic knowledge on wound care management as well as the proper nutritious knowledge.The incidence of wound infections will only be reduced over time if all practitioners keep these principles in mind when dealing with patients and plan interventions based on appropriate assessment techniquesA major type of dressing for wounds is activated charcoal dressings. This works by the filtration and the prohibition of the release of malodorous chemical compounds and by the absorption of bacteria.In order to prevent the release of bad smells, the dressing should be close fitting and should be properly sealed around the wound. It should be large enough so that it covers the whole wound.However, this can be quite difficult to achieve especially if the wound is in a discomfited position or is irregular in shape. Some dressings integrate silver and since silver is a known antimicrobial, bad smell from the wound may be easy to control and reduce.

The dressings should be applied directly to the wound so as to get maximum benefit from the silver.Topical issue confronting adult health care nursesAdult health care nurses are confronted by a number of problems in the course of their day to day activities of taking tare of their patients. To begin with, nursing a patient who has a wound infection can be very distressing for the adult health care nurse who is involved.It may leave them feelings hopeless because of not being able to deal with the presented symptoms adequately. For example a patient may have excessive exudate and the nurse may be unable to deal effectively with any bad smell coming from the wound. This may have a bad impact on the patient as well as the nurse, which may lead to the latter feeling frustrated and inadequate.Adult health care nurses may find it hard to avoid showing their feelings after seeing a wound infection.

This is because facial expressions and body language usually show signs of shock, disgust or horror. This can cause the patient and his immediate family or care takers great concern as well as anguish.Health care nurses should be given support so as to be able to discuss their own worries and feelings. This can help a lot as it can enable them to continue providing proper care to the patient. This support can be obtained from colleagues or through clinical supervision.The nurses also suffer from mistreatments as at times they have to bear the stress that the patients under their care pass on to them.

If the patient is in great pain, they tend to share their anguish with the nurse and some become harsh and ruthless, hence bringing suffering to the nurse.During wound care management, the health care nurse may be a victim of circumstances and find himself not coping well with other family members and care takers of the patient. Some may despise the efforts he may be putting into the process hence causing a lot of discouragement.Due to the great work they do in the process of heath care management, adult health care nurses should be encouraged and given as much support as possible. This will help them put more effort and willingness into the service as they enjoy their work as well as a condusive environment.

Medical practitioners and family members should work hand in hand with the health care nurses so as to bring a good outcome in the care management practice and also provide the nurses with a good and caring working environment. This is also very beneficial to the patient.BibliographyExudates Management: A Patient-Centered Approach. From Journal Of Wound Care, Vol. 17, no 6, June 2008http://rn.modernmedicine.com/rnweb/CE+Library/CE-Wound-basics-Types-treatment-and-care/ArticleStandard/Article/detail/535258Assessing and managing wound pain during dressing changes – from Nursing & Residential Care, July 2008, Vol 10, No 07



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