Brief overview
- What does wound care mean? All measures for the treatment of open acute and chronic wounds – from first aid to complete wound healing.
- Measures for wound care: Wound cleansing and disinfection, possibly drainage, possibly debridement, possibly maggot therapy, wound closure with plaster, tissue adhesive, suture or staples.
- Wound care: for freshly dressed wounds, avoid contact with dirt and water, do not use commercial soap for wound care, possibly apply wound and healing ointment to support wound healing.
- Risks: Wound infection, formation of unsightly scars, in surgical wound care and debridement: risk of nerve and vascular injury.
Caution.
- Wounds that bleed heavily or persistently should always be treated by a physician. The same applies to heavily soiled wounds and large cuts, bites, burns and lacerations.
- Remember tetanus vaccination protection for fresh injuries! The last tetanus shot should not have been given more than ten years ago.
How does wound care work?
The term wound care covers the cleaning, closing and care of open wounds. Such wounds can be acute injuries (such as cuts) or chronic wounds (such as pressure ulcers in bedridden patients).
Chronic wounds are those that persist for more than two to three weeks.
Primary and secondary wound care
Physicians distinguish between primary and secondary wound care:
Primary wound care
This refers to wound closure within the first six hours after the injury. Sometimes a plaster or tissue adhesive is sufficient for this, for example in the case of wounds on areas of the skin that are exposed to little mechanical stress. In other cases, the wound must be closed using sutures or staples.
Secondary wound care
Therefore, such an injury initially remains open and is cleaned regularly. Only when the wound is clean (usually after several days, but sometimes only after weeks), it is closed with a suture.
Wound care: Moist or dry
In dry wound treatment, open wounds are covered with a sterile, dry dressing. In the case of poorly healing wounds and burns, however, special dressings that keep the wound area moist are more appropriate. This moist wound care (moist wound treatment) is also called modern wound care because specially manufactured materials, newly developed in recent years, are used for it.
You can read more about the various dressings and their application in the article Wound care: Wound dressings.
Initial treatment
The first step in wound care is the initial treatment of the wound. It is important for further treatment and good wound healing.
- mild disinfectant, suitable for open wounds/mucous membranes
- sterile swabs and compresses
- commercially available plasters as well as fixation plasters
- gauze bandages and dressings
- scissors
The initial treatment of a bleeding wound involves stopping the bleeding. You can stop weaker bleeding by applying several sterile compresses to the wound and then wrapping a gauze bandage around the injury with light pressure.
If the bleeding is heavier, after the first wrapping with the gauze bandage, you should also place a bandage pack over the wound and wrap the rest of the gauze bandage tightly around it (pressure bandage). The additional pressure can compress the blood vessels. It is also advisable to elevate the affected body part. If the bleeding cannot be stopped even then, you must call a doctor immediately!
Ligature
Therefore, ligating wounds is now only recommended when life-threatening blood loss is imminent. Furthermore, it should only be performed by medical professionals whenever possible.
In situations where surgical hemostasis is difficult (such as in military medicine), ligation continues to be highly valued.
Superficial wound
Primary wound care is indicated for a superficial injury. This can usually be done by the family doctor or pediatrician:
Deep wound
If the physician determines during the wound assessment that the injury is deep and complex, he or she will proceed with primary wound care as follows:
- First, he must clean and disinfect the wound, as is indicated for superficial injuries.
- Then he can close the wound: Sometimes a special tissue adhesive is sufficient for this. In other cases, he has to suture the wound or staple it with a special stapling device. To ensure that the patient does not experience any pain, the doctor injects a local anesthetic near the wound beforehand.
- In the case of a heavily bleeding wound, the doctor often places a drainage before closing the wound: wound fluid and blood are sucked out of the wound area through a thin plastic tube using negative pressure. The drainage is then removed a few days later.
Chronic or inflamed wound
The doctor first cleans the wound with saline solution and then rinses it. He uses an antiseptic solution for this wound irrigation. In most cases, a so-called debridement is also carried out: the doctor cuts out infected or damaged tissue from the wound edge and from the depth of the wound. This prevents wound infection and stimulates the remaining tissue to heal.
Final wound closure is not performed until there is no (more) infection and the newly formed tissue looks healthy.
Dressing change
If a wound was dressed during initial treatment, the dressing should be changed after 24 to 48 hours at the earliest. For chronic or inflamed wounds, a doctor or nurse should do this. For smaller wounds, you can do it yourself. You can find out what you should bear in mind in the article on wound care: Dressing changes
Wound and healing ointments
After wound care
After the wound has been treated, you should observe a few points in order not to disturb the healing process:
- After wound care, make sure that the wound is not dirty and does not come into contact with water. For showering, you can stick a special waterproof plaster.
- You must not use commercial soaps for wound care.
- If your wound has been stitched, you should see your family doctor or the attending physician after ten to twelve days to have the stitches removed. If the wound is on the face, you can have the stitches removed on the fourth to sixth day.
Wound care: Maggot therapy
For poorly healing wounds, medical professionals sometimes rely on the help of maggots: Fly larvae are introduced into the wound. The maggots that hatch from them eat dead cells and can thus promote wound healing. Read more about this form of therapy in the article Wound Care: Maggot therapy.
Every open wound should be treated professionally. For smaller wounds, you can do this yourself:
Treat lacerations
A laceration is a superficial injury caused by blunt direct force (such as a fall while cycling, skateboarding or climbing). The edges of the wound are often ragged, which can interfere with wound healing. You can prevent this with the right wound care. You can learn more about this in the article Wound care: Laceration.
Care for abrasions
Abrasions – like lacerations – are common injuries in everyday life and sports. They occur when the skin scrapes across a rough surface, such as the asphalt from a bicycle fall. As painful as such abrasions often are, they are usually only very superficial and harmless. Nevertheless, they should be properly cleaned, disinfected and covered. How to do this, you will learn in the article Wound care: abrasion.
Caring for cuts
When is a visit to the doctor necessary?
You should see a doctor promptly for professional wound care in the following cases:
- heavy or unstoppable bleeding
- @ large cuts, bites, burns or lacerations
- heavily contaminated wounds that cannot be cleaned with disinfectant alone
Risks of wound care
The goal of wound care is to reduce the risk of infection and wound healing problems. However, as with almost any medical therapy, things can go wrong. For example, the injury can become infected despite wound treatment. This can be recognized by pain, redness, swelling and pus secretion in the wound area.
In addition, unsightly scars can form in the course of wound healing. In some cases, these grow excessively and even cause pain (hypertrophic scar or scar keloid).
