Question

Explain how to properly diagnose skin wounds in frail elders, including how to distinguish between a colonization and infection.

Describe the type of skin wound you selected.

Explain how you would treat and/or dress this wound based on guidelines for treatment.

Explain factors that might contribute to the development of the skin wound you selected. Include strategies for the prevention and improvement of this type of wound.

Answer 1

SKIN WOUND:

A skin wound is a type of injury to the skin due to torn, cut,puncture,blunt force traume and contusion.

FACTORS CAUSING SKIN WOUNDS:

1. Skin Oxygenation
2. Infection
3. Age
4. Sex Hormones
5. Stress
6. diabetes
7. Obesity
8. Smoking
9. Alcholism
10. Nutrition

DIFFRENCE BETWEEN INFECTION AND COLONIZATION:

Infection:An infection means that germs are in or on the body and make you sick, which results in signs and symptoms such as fever, pus from a wound, a high white blood cell count, or pneumonia.

Colonization:Germs can also be in or on the body, but not make you sick. This is called colonization.

TYPES OF SKIN WOUNDS:

The five types of Skin wounds are

1. Abrasion,
2. Avulsion,
3. Incision,
4. Laceration,
5. Puncture

• An abrasion is a wound caused by friction when a body scrapes across a rough surface.
• An avulsion is characterized by a flap.
• An incision is a cut with clean edges.
• A laceration is a cut with jagged edges.
• A puncture is a wound where something passes through or becomes impaled in the skin.

DIAGNOSIS:

Consider the following before diagnosis of skin wound

• Type of Injury
• Cause of Injury
• Depth of injury
• Bleeding which is not reducing with direct pressure

MANAGEMENT:

• The overall treatment depends on the type, cause, and depth of the wound, and whether other structures beyond the skin (dermis) are involved.

  Treatment of recent lacerations involves examining, cleaning, and closing the wound. Minor wounds, like bruises, will heal on their own, with skin discoloration usually disappearing in 1–2 weeks

  Cleaning

  Evidence to support the cleaning of wounds before closure is scant. For simple lacerations, cleaning can be accomplished using a number of different solutions, including tap water and sterile saline solution Infection rates may be lower with the use of tap water in regions where water quality is high. Cleaning of a wound is also known as 'wound toilet'.

  Closure

  If a person presents to a healthcare center within 6 hours of a laceration they are typically closed immediately after evaluating and cleaning the wound. After this point in time, however, there is a theoretical concern of increased risks of infection if closed immediately. Thus some healthcare providers may delay closure while others may be willing to immediately close up to 24 hours after the injury. Using clean non-sterile gloves is equivalent to using sterile gloves during wound closure.^[6]

  If closure of a wound is decided upon a number of techniques can be used. These include bandages, a cyanoacrylate glue, staples, and sutures. Absorbable sutures have the benefit over non absorbable sutures of not requiring removal. They are often preferred in children Buffering the pH of lidocaine makes the injection less painful.

  Adhesive glue and sutures have comparable cosmetic outcomes for minor lacerations <5 cm in adults and children. The use of adhesive glue involves considerably less time for the doctor and less pain for the person. The wound opens at a slightly higher rate but there is less redness. The risk for infections (1.1%) is the same for both. Adhesive glue should not be used in areas of high tension or repetitive movements, such as joints or the posterior trunk.

  Dressings

  In the case of clean surgical wounds, there is no evidence that the use of topical antibiotics reduces infection rates in comparison with non-antibiotic ointment or no ointment at all Antibiotic ointments can irritate the skin, slow healing, and greatly increase the risk of developing contact dermatitis and antibiotic resistance. Because of this, they should only be used when a person shows signs of infection and not as a preventative.

  The effectiveness of dressings and creams containing silver to prevent infection or improve healing is not currently supported by evidence
• PREVENTION OF SKIN WOUNDS:

1. Skin assessment
2. Skin Inspection
3. Regular skin care
4. Prevention of Moisture
5. Prevention of In continence
6. Good Nutrition
7. Second hourly position changing
8. Use of Pressure-redistributing equipment
9. Stoppage of smoking, alcholism
10. Regular excersice
11. avoidance of stress
12. Control of Diabetes