Question

Wound care: stages, drainage, complications, dressing types, shear/friction?

Answer 1

Stages of wound care

Hemostasis Phase

Hemostasis is the process of the wound being closed by clotting. Hemostasis starts when blood leaks out of the body. The first step of hemostasis is when blood vessels constrict to restrict the blood flow. Next, platelets stick together in order to seal the break in the wall of the blood vessel

Inflammation is the second stage of wound healing and begins right after the injury when the injured blood vessels leak transudate causing localized swelling. Inflammation both controls bleeding and prevents infection.

The proliferative phase of wound healing is when the wound is rebuilt with new tissue made up of collagen and extracellular matrix. In the proliferative phase, the wound contracts as new tissues are built. In addition, a new network of blood vessels must be constructed so that the granulation tissue can be healthy and receive sufficient oxygen and nutrients

The maturation phase is when collagen is remodeled from type III to type I and the wound fully closes. The cells that had been used to repair the wound but which are no longer needed are removed by apoptosis, or programmed cell death

Wound care drainage

1. Sanguineous wound drainage is the fresh bloody exudate which appears when skin is breached, whether from surgery, injury, or other cause. Sanguineous bloody drainage is bright red and somewhat thick in consistency, some compare to the consistency of syrup. This is seen in inflammatory phase of wound healing

2. Serous drainage is mostly clear or slightly yellow thin plasma that is just a bit thicker than water. It can be seen in venous ulceration and also in partial-thickness wounds. It is one of the normal types of wound drainage and often appears in the first 48 to 72 hours.

3. seropurulent drainage is done when a sign that the wound is becoming colonized and treatment changes are needed is observed.Seropurulent wound drainage can appear in a variety of colors including pink, grey, yellow, tan, brown, green, or white.

4. Purulent drainage is not a characteristic of normal healthy wound healing. These purulent types of wound drainage are commonly called "pus" and often have a foul or unpleasant smell.

Complications of wound care

1. Infection is the most common complication. The most common infections seen are of Staphylococcus, Streptococcus, and Pseudomonas.

2. Osteomyelitis occurs when bone is exposed to germs during injury

3. Gangrene occurs when loss of blood supply to a particular area

4. Periwound dermatitis- Periwound is the tissue surrounding a wound. When not properly cared for, dermatitis may occur, turning the periwound area red, swollen, and sore, sometimes with small blisters.

5. Periwood edema which occurs the tissue surrounding the wound. Edema can also cause small vessels to compress, decreasing blood flow to parts of the body.

6. Wound dehiscence

7. Hematomas

Wound care dressing types

1. cloth- Most commonly used as a first layer of protection.

2. Foam-  They’re extremely soft and usually very absorbent, depending on the brand. Foam dressings help to protect the wound while it’s healing and maintains a healthy moisture balance. Used for foul smelling odours

3. Transparent - It is used when to closely monitor healing of a specific wound is required. So, transparent dressings are often used on larger, more complicated wounds.

4. Hydrocolloid- are a non-breathable, self-adhesive dressing. They work by creating moist conditions to help speed up healing time and are made out of a flexible material for increased comfort.

5. Hydrogel- used for dry wounds. It adds moisture to the wound. This process helps increase patient comfort levels while simultaneously reducing pain caused by dead tissue. In some hydrogel products, a cooling gel is used for extra comfort.

wound care shear

Shear is a combination of upwards and downwards friction which causes cell deformation and cell death. It is dangerous because a shear wound develops from the inside and goes outwards and by the time it is detected the wound is at an advanced stage already. The wound in such a scenario is ragged and uneven in shape and healing is prolonged as well.