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Wound care
A practical review

Outlines
I. Theoretical review

1. Definition of dressing
2. 3. 4. 5. 6. Purpose of dressing Types of healing process Factors affecting healing process Definition and types of antiseptic solutions Types of dressing

II. Nursing clinical skills ( procedure and checklist)


1. Preparing a dressing car & dressing list 2. Apply a sterile dry dressing 3. Apply a wet to moist dressing 4. Irrigating a wound 5. Packing wound & obtain a wound culture 6. Suture removal

III. Review questions.

Definition: Dressing is a process of cleaning and covering the wound to protect it from infection and help it to heal as soon as possible by healthy way.

Purpose: To promote wound healing by primary intention. To prevent infection. To assess the healing process. To protect the wound from mechanical trauma. T provide opportunity to assess the wound.

Types of wound healing: The major types of wound healing are classified as primary secondary and tertiary .

Primary intention. Wounds with minimal tissue loss such as clean


surgical incision heal by primary intention where the edges od the wound approximated or lightly pulled together, granulation tissues is not visible and scarring is usually minimal.

Secondary intention. Wounds with full thickness tissue loss such


as deep lacerations, burns and pressure ulcers, they heal by secondary intention . The open wound gradually fills with granulation tissues and scarring is more prevalent.

Tertiary intention. Healing by tertiary intention happens when


there is a delay between injury and wound closure and there is a deeper and wider scar.

Factors affecting wound haling There are systemic factors and individual factors Systemic factors: A. Nutrition. Nutrition is essential for optimal healing as nutritional deficiencies may retard wound healing by inhibiting collagen synthesis and by reducing the activity of the cells that are important to wound healing. Vitamin A,C,E ,protein such as Arginine, zinc and water are especially important in wound healing. B. Circulation and oxygenation. Circulation to the involved wound and oxygenation of the tissues greatly influence wound healing; impaired blood supply affect healing process C.Immune system; drugs and therapies can affect immune system such as immunosuppressive drugs such as corticosteroid delay wound healing. Individual factors

Definition : An antiseptic is a chemical agent used to reduce the number of micro organisms on skin and mucous membrane without causing danger or irritation. Uses o anti septic solution: 1. Retard barcterial growth on living organisms. 2. Hand washing as skin preparation before invasive procedure, to pack or irrigate wounds. 3. Skin and wound care.

Type of antiseptic solutions: Agent Povidone-iodine soudium hypochloride chlorohexidine gluconate acetic acid hydrogen peroxide(3%) alcohol hexachlorophene Kills Bacteria Bacteria,yeasts Gram positive organisms Pseudomonas Decomposes necrotic tissue Bacteria Bacteria Uses Skin decontamination, wound packing and irrigation. Wound irrigation and packing Skin scrubs and irrigation Cleaning, packing, irrigating wound Irrigate wound, cleans pus and necrotic tissue Skin preparation before injection. Hand washing skin preparation

normal saline 0.9% tincture of iodine glycerin magnesium Bacteria

keep a clean wound and washing Used to clean closed wound Used for deep septic wound.