Wound Care

Wound healing

Wound healing refers to a living organism's replacement of destroyed or damaged tissue by newly produced tissue. wound healing is depicted in a discrete timeline of physical attributes constituting the post-trauma repairing process. In undamaged skin, the epidermis and dermis form a protective barrier against the external environment.

When the barrier is broken, a regulated sequence of biochemical events is set into motion to repair the damage. This process is divided into predictable phases: blood clotting , inflammation, tissue growth , and tissue remodeling. Blood clotting may be considered to be part of the inflammation stage instead of a separate stage.

Wound care encourages and speeds wound healing via cleaning and protection from re injury or infection. Depending on each patient's needs, it can range from the simplest first aid to entire nursing specialties such as wound, ostomy, and continence nursing and burn center care.


Most common types of non-healing wounds:

  • Diabetic foot wounds/ulcers
  • Puncture wounds
  • Pressure sores
  • Surgically created wounds


Highest risk of non-healing wounds:

  • Patients with Rheumatoid arthritis, lupus (SLE)
  • Dialysis and transplant patients
  • Patients with venous insufficiency who develop swelling in the legs and feet
  • Poor circulation in feet and legs


Classification of Wound Dressing:

  • Passive

Examples:
Gauze, wool dressings, and plaster

Advantages:
Protect the wound from foreign contamination, stops bleeding, covers the wound, absorb exudate, and provide cushion

Disadvantages:
Requires frequent changing, becomes adherent, causes reskin damage and causes pain.


  • Interactive

Examples:
Hydro-gels, films, foams, sponges, and sprays

Advantages:
Offer moist environment at the wound site, promotes re-epithelialization, act as a barrier against infection, good mechanical properties, and enhance water vapor transmission

Disadvantages:
Limited antibacterial activity


  • Skin substitutes

Examples:
Accellular xenografts, Autografts, and allografts

Advantages:
Replace damaged skin, less vascularized wound bed required, reduce scar formation, and increases dermal component of healed wound

Disadvantages:
Host rejection, possibilities of infection transmission, and limited life-span at the wound site.


  • Bio-active

Examples:
Pectin, chitosan, alginate, silk fibroin, elastn, etc.

Advantages:
Biocompatible, patient compliant, biodegradable, used as delivery system of bioactive materials, and skin and environmentally friendly.

Disadvantages:
No obvious disadvantages