Wound Care

Principles

In modern wound care, suitable wound dressings are used to create a moist wound environment, which is intended to optimize the healing process. Drying of the wound and scab formation are avoided as much as possible, as this delays healing. Infections should be avoided as much as possible by applying appropriate hygiene measures.

General procedure

The wound is first cleaned, then disinfected, and finally closed with a suitable dressing. 1. hygiene measures

  • Wash hands and disinfect if possible (hand disinfection).
  • Put on gloves

2. stop bleeding 3. clean the wound: Due to the risk of infection, clean the wound:

  • If possible, the wound is cleaned with Ringer’s solution. Physiological saline can also be used as a second choice. If no sterile solution is available, running lukewarm drinking water or another drinkable liquid is used if possible.
  • Wound cleansing wipes impregnated with disinfectant are also available in stores.
  • Remove impurities with sterile tweezers.

4. wound disinfection:

  • Wound disinfection is necessary especially in the first care and contaminated wounds, for example, stab wounds, abrasions and bites. In the course of wound healing, the wound does not need to be disinfected, especially in chronic wounds.

5. close the wound:

  • The wound is closed with a suitable dressing that allows a moist wound environment. The drying of the wound and the formation of scabs should be avoided. Larger wounds must be sutured.

6. further procedure:

  • Minor injuries: Observation of the wound or the healing process or the healing process.
  • Major injuries: Immobilize injured part of the body, if possible elevate and transfer the patient as soon as possible to the doctor

To the doctor

  • Persistent bleeding
  • Deep or large wounds
  • Severe burns or those larger than the palm of a hand
  • Signs of infection
  • Disturbances of sensitivity and motor function
  • Pulsatile bleeding
  • Bite wounds risk of tetanus
  • If the tetanus vaccination is not refreshed.
  • Wounds over joints
  • Do not pull out objects in the wound (e.g. nails)!
  • Injuries with gaping wound edges
  • Wounds on the face, v.a ears, lips and eyelids
  • Wounds on the genitals
  • In case of possible injury to the nerves, for example, deep wounds on the hand.
  • Children under 2 years and the elderly

Chronic wounds

In chronic wounds, the elimination of factors that impede wound healing is particularly important, these include:

  • Surgical removal of dead tissue and sloughing (debridement).
  • Treatment of malnutrition conditions
  • Remedy of circulatory disorders
  • Optimal treatment of underlying diseases
  • Clarification, whether the wound healing interfering drugs are administered
  • Treatment of infections
  • Use of wound dressings appropriate to the stage of the wound.

Moist wound care

In the majority of wounds, with hydroactive wound dressings, such as hydrocolloid dressings and hydrogels. Moist conditions promote cell growth, formation of new blood vessels and fibrinolysis.

Desiccating wound care

Using textile compresses, such as gauze compresses. For minor everyday wounds, small cuts and abrasions possible. However, moist wound care is also preferred here.

What signs indicate infection of the wound?

  • Inflammation: redness, swelling, warmth, functional limitation, pain.
  • Malodor, pus
  • Swelling and tenderness of the lymph nodes.
  • Red-blue lines along the lymphatic vessels on the skin
  • Fever and chills

Risk factors for infection:

  • Bite wounds
  • Certain occupational groups, e.g., health care workers, butchers, farmers
  • Wounds that contain foreign bodies
  • Chronic diseases, such as diabetes, immunodeficiency, anemia, circulatory disorders.
  • Drugs that affect the immune system

To note

Since when rendering first aid is first and foremost also to think about their own safety, gloves should be worn during wound care necessarily. They also protect the patient from the transmission of germs. Because many people have latex allergies, vinyl or nitrile gloves are preferred. All wounds are at risk for infection with the tetanus toxin tetanus.

Things to know

Because blood washes impurities from the wound, the risk of infection is much less for wounds that bleed profusely than for those that bleed only slightly. Cold water should not be used to rinse wounds, as this would cause the vessels to contract and reduce blood flow, which in turn would have a negative effect on wound healing.