WOUND DRESSING
Wound, any break in the external or internal
surfaces of the body involving a separation
of tissue, and caused by external injury or
force. Wounds are classified as incised, or
cut, if they are produced by a sharp
instrument or object; puncture, if the
instrument is pointed and narrow; lacerated,
if accompanied by a tearing of the tissue;
contused, if a substantial amount of tissue is
bruised; penetrating, if the wound passes
completely through a part of the body; and
subcutaneous, if it involves deep destruction
of tissue with a relatively small opening, or
none at all, in the surface. Septic, or
infected, wounds are those in which the area
is contaminated by bacteria, which can
cause suppuration or shedding of tissue.
WOUND
CLASSIFICATION OF WOUNDS
1.Mechanism of injury
a) Incision- open wound;
painful;deep;shallow
b) Contusion-closed wound, skin appears
ecchymotic (bruised).
c) Abrasion-open wound involving the
skin; painful
d) Puncture-open wound which
penetrates the skin and underlying
tissues.
e) laceration-made by object that tears
tissues
f) Penetrating wounds-open wound that
penetrates the skin and the underlying
tissues.
2. According to depth
a) Partial thickness- confined to the skin
b) Full-thickness- involving the dermis,
epidermis, subcutaneous tissues and
possibly muscle and bone.
Decubitus ulcer
Gunshot wound
Stab wound
Lacerating wound
3. Degree of contamination
a) Clean-an aseptically made wound, that
does
not enter the alimentary, respiratory or
genito-urinary tracts.
b) Clean contaminated-are surgical wounds
in which the alimentary, respiratory and
genitals or urinary tract has been entered.
c) Contaminated- wounds exposed to
excessive amounts of bacteria
d) Dirty or infected-wounds containing
dead tissues and with evidence of clinical
infection (purulent discharged).
TYPES OF WOUND DRAINAGE
1. Serous-clean, watery
2. Purulent- thick, yellow, green, tan or
brown.
3. Serosanguineous-pale, red, watery
mixture of serous and sanguineous.
4. Sanguineous- bright red, indicative of
active bleeding.
PHASES OF WOUND HEALING
1. INFLAMMATORY PHASE-starts
immediately after injury and lasts 3-6 days or
4-6 days.
2 major processes occur during this phase
HEMOSTATIS AND PHAGOCYTOSIS
Hemostatis- blood vessels constrict, platelets
aggregates and bleeding stops, scabs forms,
preventing entry of infectious organisms.
Inflammation-increase blood flow, to wound
resulting localized redness and edema,
attracts WBC and wound growth factors.
WBC arrive-clear debris from wound.
2. PROLIFERATIVE PHASE-extends from
day 3 to about day 21 post injury.
collagen synthesis establishment of new
capillaries creation of granulation tissue
wound contraction epitheliazation.
3. REMODELLING OR MATURATION
PHASE
-final healing stage may continue for I year
or more.
Remodeling of scar tissue to provide wound
strength.