WOUND CARE

Asst. Prof. Rochie C. Cagara

WOUND
▪ It is an injury to the body (as from violence,
accident, or surgery) that typically involves
laceration or breaking of a membrane (such
as the skin) and usually, damage to
underlying tissues.
CLASSIFICATION OF
WOUNDS
A. Open wound – it involves a break in the
skin that leaves the internal tissue exposed
and allows the blood and other fluids to be
lost from the body and allows entrance of
microorganisms.
B. Closed wound - tissue damage and
bleeding occur under the surface of the
skin. Bleeding is purely internal.
OPEN WOUND
▪ Incised – a clean cut from a sharp edge, such as broken glass or a
knife, that causes an incision.
▪ Laceration – a crushing or ripping forces results in a rough tears on
the tissues.
▪ Abrasion – a superficial wound in which the top layers of the skin are
scraped off, leaving a raw tender area.
▪ Punctured - a wound with a small entry site, but with a deep track of
internal damage.
▪ Gunshot – is physical trauma due to a bullet from a firearm. Damage
may include bleeding, broken bones, organ damage, infection of
the wound, or loss of the ability to move part of the body. The entry
point may be small but the exit point may be large and ragged.
▪ Avulsion – a forceful tearing away or separation of tissues from the
casualty or patient’s body.
▪ Pressure ulcer - (also known as pressure sores or bedsores) are
injuries to the skin and underlying tissue, primarily caused by
prolonged pressure on the skin.
CLOSED WOUND
1. Contusion– (bruise) a blunt blow or punch
and rupture of the blood vessels (capillaries)
beneath the skin.
2. Blisters - a fluid-filled elevation of the
epidermis often caused by burns or constant
rubbing.
TYPES OF BLEEDING IN
WOUNDS
▪ Arterial bleeding – bright red due to high
oxygen content. Blood spurts from the wound in
time of heart beat. A severed main artery may
jet blood several feet high and rapidly reduces
the volume of circulating blood.
▪ Venous bleeding – the blood is dark red in
color due to the deoxygenated blood in the
veins. Bleeding is less profuse than arterial
bleeding.
▪ Capillary bleeding - this type occurs at the
site of all wounds. Blood loss is usually slight.
SEVERE EXTERNAL
BLEEDING
OBJECTIVES OF TREATMENT
▪ To control the bleeding.
▪ To prevent and minimize the effects of shock.
▪ To minimize the risk of infection(s).
▪ To arrange for the urgent transport of the
casualty to the nearest hospital.
SEVERE EXTERNAL
BLEEDING
FIRST AID
1. Remove or cut clothing to expose the wound. Watch
for sharp objects such as glasses that may injure you.
2. Apply direct pressure over the wound, with your
fingers or palms, preferably over a sterile dressing
or clean pad. Note: Use the cleanest material or cloth
available if there is no sterile dressing.
If you can not apply direct pressure, for example, an
object is protruding, just press down firmly on either
side. Do not attempt to remove or pull the object.
 SEVERE EXTERNAL
BLEEDING
FIRST
3. Raise
AID
and support an injured limb above the level of the
casualty’s heart.
4. Lay the casualty down. This will reduce blood flow to
the site of injury and minimize shock.
5. Leaving any original pad in place, apply another sterile
(if available) dressing on top and secure with a bandage
firmly, but not so tightly as to impede the circulation. If
blood still seeps through, add another dressing on top
and secure it with a bandage.
If there is a protruding foreign body, build up padding
on either side of the object and apply bandage without
pressing the object down.
SEVERE EXTERNAL
BLEEDING
FIRST AID
6. Secure
and support the injured part with
bandaging.
7. Do the following:
a) Dial for an ambulance.
b) Treat for shock.
c) Check the dressing for seepage.
d) Check for circulation beyond the bandage
APPLICATION OF INDIRECT
PRESSURE
▪ This may be applied if it is impossible to apply direct
pressure, or if direct pressure is insufficient to staunch
bleeding from a limb.
a) Indirect pressure may be applied to a pressure point
above the bleeding artery, where the main artery runs
lose to the bone.
b) First identify the artery by feeling for pulsation and
then apply pressure until the blood supply to the limb is
greatly reduced.
c) Tourniquet application. Hourly release of tourniquet
for 10 minutes.
 APPLICATION OF INDIRECT
PRESSURE
PRESSURE POINTS:
▪ Brachial pressure point – runs along the inner
side of the upper arm.
▪ Femoral pressure point – where femoral artery
crosses pelvic bone in the center of the groin
crease.
APPLICATION OF TOURNIQUET
TOURNIQUE
T
APPLICATIO
N
DRESSING
Definition
▪ It is a piece of material placed on wound to help control
bleeding and/or cover the wound to protect it from
contamination, thereby reducing the risk of infection.
GENERAL RULES FOR
APPLYING DRESSINGS
1. The dressing pad should always extend well
beyond the wound’s edges.
2. Place dressings directly on a wound. Do not slide
them from the side.
3. If blood seeps through, do not remove but instead
apply another dressing over the top.
4. If there is only one sterile dressing, use this to cover
the wound and use another clean material as top
dressings.
TYPES OF DRESSINGS
▪ Hydrocolloid dressings can
be used on burns, wounds
that are emitting liquid,
necrotic wounds, pressure
ulcers, and venous ulcers.
These are non-breathable
dressings that are
self-adhesive and require no
taping. It creates a moist
condition and helps in
healing
TYPES OF DRESSINGS
▪ Hydrogel can be used
for a range of wounds
that are leaking little or
no fluid, and are painful
or necrotic wounds, or
are pressure ulcers or
donor sites. Hydrogel
can also be used for
second-degree burns
and infected wounds.
TYPES OF DRESSINGS
▪ Alginate dressings are
made to offer effective
protection for wounds
that have high amounts
of drainage, and burns,
venous ulcers, packing
wounds, and higher
state pressure ulcers.
These dressings
absorb excess liquid
and create a gel that
helps to heal the
wound or burn more
quickly.
TYPES OF DRESSINGS
▪ Collagen dressings can
be used for chronic
wounds or stalled
wounds, pressure sores,
transplant sites, surgical
wounds, ulcers, burns,
or injuries with a large
surface area. These
dressings act as a
scaffolding for new cells
to grow and can be
highly effective when it
comes to healing.
TYPES OF DRESSINGS
▪ For wounds of varying
degrees of severity, foam
dressings can work
incredibly well, as well as for
injuries that exhibit odours.
Foam dressings absorb
exudates from the wound’s
surface, creating an
environment that promotes
faster healing.
TYPES OF DRESSINGS
▪ Transparent
dressings are useful for
when medical
professionals or carers
want to monitor wound
healing, as these
dressings cover the
wound with a clear film.
These make identifying
potential complications
much easier, such as by
making infections easier
to spot at an earlier time.
TYPES OF DRESSINGS
▪ Cloth dressings are the
most commonly used
dressings, often used to
protect open wounds or
areas of broken skin. They
are suitable for minor
injuries such as grazes, cuts
or areas of delicate skin.
These dressings come in all
shapes and sizes, from small
coverings for fingers to
larger ones for
wounds across wider areas
of the body.
CLEANING AND DRESSING
OF WOUNDS: STEPS
1. Assess the wound in terms of the following: site, the
size of the wound, type of wound and the type of
bleeding.
2. Plan for appropriate action:
▪ Stop the bleeding and prevent shock
▪ Clean the wound and apply dressing
▪ Refer the patient to the nearest health facility
CLEANING AND DRESSING
OF WOUNDS: STEPS
3. Wash hands
4. Prepare the equipment and supplies for wound care
▪ Soap and water for dirty wound
▪ Hydrogen peroxide for infected wound
▪ Betadine cleanser and/or antiseptic or other antiseptic
recommended by the institution.
▪ Sterile gauze
▪ Plaster
▪ Clean gloves
▪ Working forceps
▪ Picking forcep (sterile) needed in the hospital setting
CLEANING AND DRESSING OF
WOUNDS: STEPS
5. Implementation
▪ Assemble the equipment at the bedside or on table or on the
floor.
▪ Put the gloves on.
▪ In the community setting, may ask the patient to wash the wound
with soap and water.
▪ Clean the wound from the center to the outer portion, until it
becomes clean, using the available wound cleansing agent. For
old dirty wound, may use hydrogen peroxide and betadine
cleansing solution for fresh wounds. Repeat as necessary.
▪ Dry and apply betadine antiseptic.
▪ Apply sterile dressing directly over the wound.
▪ Secure the dressing with an adhesive tape or plaster.
CLEANING AND DRESSING
OF WOUNDS: STEPS
6. After care
7. Wash hands
8. Documentation
▪ Site
▪ Type
▪ Size
▪ Type of bleeding
▪ Cleansing agent and antiseptic used
▪ Response of the patient.
▪ Signature
▪ Thank you for listening!