primary wound healing

Wound Assessment: The First Step to a Proper Treatment Plan

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Over 6.5 million Americans suffer from chronic wounds each year and the cost for treating them amounts to more than $25 billion. Today, these numbers are continuously increasing due to an ageing population and a huge rise in cases of obesity and diabetes not only in America but also across the world.

 

 

This is why proper wound assessment has never been more important. With wound care being an expensive area of treatment, it’s crucial for caregivers to know how to assess wounds properly because it is the first step to developing an effective treatment plan that promotes primary wound healing and excellent prognosis for patients.

 

 

 

Types of Wounds

 

Wounds typically fall into two categories—acute and chronic—and identifying what type of wound the patient should be the first thing that a caregiver should do:

 

  • An acute wound is assessed by its damage to soft tissues and bony structures, and the method by which the patient incurred the injury. Acute wounds usually don’t present their entirety until after a few days or weeks from the time of injury, which is why it’s important to ask this information when doing the assessment.

 

A caregiver should also take note of the presence of contaminants in the wound so antibiotic can be given to the patient before infection gets worse. Any underlying tissue damage should be repaired and the wound irrigated to get rid of bacteria and contaminants.

 

  • A wound is classified as chronic if it remains open and complete wound healing is not achieved within 12 weeks. The main goal of assessing a chronic wound is to determine the factors that affect primary wound healing and address them right away to prevent the problem from getting worse.

 

 

Elements of Proper Wound Assessment

 

Every caregiver should remember the most important steps in assessing a wound including:

 

 

  • Site: Determining a wound’s location is crucial to creating the right treatment plan, especially if you’re dealing with ulcers. The site of a foot ulcer, for instance, is important in finding the right pair of shoes for the patient to wear.

 

  • Measurement: A wound is typically measured using the clock method where width should be arm to arm and length is head to toe. It should also be measured using centimeters and its surface area calculated by multiplying the length by the width.

 

  • Skin Integrity: The presence of maceration should be noted during wound assessment because it is an indication that the dressing is not absorbing exudation properly and measures should be done to avoid infection.

 

  • Wound Bed: It’s very important to take a close look at the wound bed to assess if the wound is progressing in healing or not. Healthy granulation tissue has a light pink color while unhealthy tissue is usually dark red.

 

 

Proper wound assessment makes the foundation of an efficient and cost-effective treatment plan for any type of wound. This is why it should only be performed by professionals who know the principles of assessing wounds. This will help a patient’s healthcare team take the necessary steps to primary wound healing.

 

 

 

We specialize in diagnosis and treatment for any and all wound care issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.

Wound Healing

The Glossary of Essential Wound Care Terms and Definitions

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If you need wound care, it’s essential you know what treatment options are available. But in order to communicate clearly with your provider and wound care team about what potential procedures might be optimal, it’s helpful to know the most common terms used in the field of wound care.

To make it simple for you, our experts from the San Diego Wound Care Center have compiled this glossary of wound care terms and definitions, to give you everything you need to know before you begin treatment.

Acute wounds

An acute wound is a wound that heals in less than 12 weeks and doesn’t require any medical intervention.

Autologous skin graft

Chronic wounds are often closed through the use of skin grafts. An autologous skin graft is a skin graft that was taken from healthy tissue from another part of the patient’s body.

Biofilm

A biofilm is a film made up of a community of microorganisms stuck together in an extracellular matrix.

Chronic wound

A chronic wound is a wound that is not healing properly. Chronic wounds are often caused by complications such as infection, pressure, diabetes, poor circulation, or immune deficiencies.

Collagen

Collagen is a type of protein that is part of the skin’s connective tissue. It gives structure and elasticity to our skin.

Colonization

Bacteria colonize when they start to aggregate and form in the bed of the wound.

Dead space

A dead space is the gap in a wound that hasn’t properly closed.

Debridement

Debridement is the removal of damaged tissue or foreign objects from a wound.

Dehiscence

A dehiscence is a surgical complication that involves a wound rupturing along a surgical incision. This can be caused by trauma, poor stitching, obesity, diabetes, collagen disorders, and more.

Dermis

The dermis is the layer of skin between the epidermis, the outermost layer of skin, and the subcutaneous tissue, the innermost layer.

Epidermis

The outermost layer of the skin.

Exudate

Exudate is the fluid that seeps out of a wound. Exudate is typically made up of serum, fibrin, and white blood cells, and is usually excreted due to inflammation.

Full thickness

Deep tissue damage that spans the epidermis, the dermis, and the subcutaneous tissue. Full thickness damage may include the fat, muscles, and even bones.

Growth factors

Growth factors are the protein responsible for cellular growth, proliferation, healing, and cellular differentiation.

Maceration

When the wound is exposed to moisture for too long, the softened skin wrinkles and breaks down. Skin maceration often occurs from water and sweat exposure from a bandage.

Periwound

The perimeter of tissue surrounding a wound.

Staging

Staging is the method of measuring and categorizing a pressure wound. Some wounds may become unstageable.

Surgical debridement

Surgical debridement is a treatment for chronic wounds. With surgical debridement, a scalpel or surgical instrument is used to clean up dead tissue, foreign debris, and residual material from dressings.

Subcutaneous tissue

Also known as the hypodermis, the subcutaneous tissue is the innermost layer of skin.

Ulcer

An ulcer is a chronic open lesion or sore.

Venous ulcer

A venous skin ulcer is caused by weak blood circulation. Specifically, the ulcer forms when the blood backs up or pools around the veins.

Possessing a basic understanding of the descriptive terms for wound care is a good start—but there’s so much more to learn about this complex field. That’s why the professionals at the San Diego Wound Care Center promote the education of their patients. Wound care is a partnership, and patients should be knowledgeable of how a potential procedure might affect them. If you’d like to know more about what wound care treatment options may be right for you, contact us for a consultation. At the San Diego Wound Care Center, we’re ready to answer any inquiries you may have, to get you the care you need.

 

We specialize in diagnosis and treatment for any and all wound care issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.

Wound care at home

8 Ways to Practice Proper Wound Care at Home

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Knowing how to practice proper wound care at home is an essential skill. There are a few ways to classify a wound: An abrasion is a scrape; a puncture is when a pointed, sharp object breaks the skin; an avulsion is when the skin is torn severely enough to expose tissue; a laceration is another term for a cut in the skin. But regardless of the type of wound, they’re all susceptible to infection. As a result, there are a few basic steps that everyone should learn for wound treatment at home. Because ultimately, wound healing is a process. Even if you’re suffering from a minor injury or a wound that doesn’t necessitate medical care, a life-threatening infection is still possible.

1. Wash Your Hands

The most basic principle behind practicing wound treatment at home? Keeping your hands clean. You can prevent infection by washing your hands regularly—especially before you take care of the wound.

2. Clean with Mild Solutions

After you’ve stopped the bleeding, it’s crucial that you clean the wound by washing away debris and bacteria. But avoid powerful disinfectants like hydrogen peroxide, iodine, or rubbing alcohol. Not only do these substances feel uncomfortable on an open wound, they could actually damage the tissue and destroy the healing factors your body naturally produces.

Instead, opt for saline solution, soap that’s been diluted with lots of water, or purified water.

3. Remove Debris

Gently remove any dirt or debris you find in the wound with disinfected tweezers.

4. Keep Your Wound (Mostly) Dry

Your wound’s skin will be tender—and if it gets too wet, it could break apart. That’s why it’s essential to avoid baths or soaking your wounds for the first 48 hours of the healing process. Water in the dirt could also seep into the wound, so it’s crucial that you keep the wound nice and dry.

Still, while conventional wisdom around wound care in the home setting would say that “airing out” a wound is good, it’s actually been proven that a slightly moist environment is optimal for a healing wound.  Wounds exposed to the air are more likely to form a crust, which prevents the growth of new, healthy tissue.

To keep the wound slightly moist, apply an antibacterial ointment under your dressings at least once a day.

5. Keep Your Wound Covered

Once the wound has been cleaned and dried, wrap it with a sterile dressing. Avoid touching the inside of the dressing, and for extra safety, wear sterile gloves. Then use tape or rolled gauze to secure the dressing.

6. Don’t Take Aspirin

Yes, wounds can hurt, but it’s important that you avoid aspirin during the healing process. Aspirin has been found to delay skin repair and increase bleeding. Instead, opt for other pain relievers like Ibuprofen.

7. Change Your Dressings

Remember to change your dressings at least twice a day.

8. Know When to Act

It takes weeks for serious wounds to heal. However, if you think your wound has become infected, you have to act fast. Here are a few indications that your wound may be infected:

  • An increase in fluids
  • An increase in pain or swelling
  • The presence of pus
  • A bad odor
  • A fever

Practicing these incredibly simple steps for wound care at homecan prevent the occurrence of a nasty infection and help speed up the healing process. But, in the event that a complication is preventing your wound from healing correctly, there are physicians and surgeons with the training and expertise to help you recover. If you think you may have a wound that won’t heal, don’t wait—contact the qualified professionals at the San Diego Wound Care Center. A friendly staff will be waiting to answer any questions you may have, and set you on the way to a better, faster healing process.

 

We specialize in diagnosis and treatment for any and all wound care issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.

diabetic sores

Why Diabetes Slows Down the Healing Process

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More than 100 million people in the United States live with pre-diabetes or diabetes, and the numbers are increasing rapidly each year. The bad news is, diabetes doesn’t stop within the disease. It also comes with a long list of complications that don’t only add burden to the affected individual but also affect their quality of life, one of which is delayed wound healing.

 

 

The Normal Wound Healing Process

 

Every wound goes through four stages of healing. The first stage is called hemostasis where the wound is closed by clotting. Inflammation follows right after where localized swelling is experienced in the affected site. This is the body’s natural response to a wound to control bleeding and prevent infection.

 

The proliferative phase begins when new tissue is rebuilt. In healthy wound healing, this granulation tissue is usually pink or red and doesn’t bleed easily. Dark granulation tissue, on the other hand, can be a sign of infection or ischemia. The wound healing process ends with the maturation phase where the wound fully closes and collagen is remodeled. This usually occurs 21 days after the injury.

 

 

Wound Healing in Diabetic Patients

 

Unfortunately, wound healing is a lot slower for diabetic patients and it can cause pain, discomfort and a lot of frustration. Diabetic sores, for instance, can appear on the lower extremities and can measure up to six inches. They are itchy, painful and without proper management, can take a while to heal. But how exactly does diabetes slow down wound healing?

 

 

Elevated Glucose Levels

 

Blood sugar plays a huge factor in wound healing and when it’s above normal levels, it can prevent nutrients and oxygen from energizing your cells, increase inflammation in your body and affect your immune system.

 

 

Impaired Blood Circulation

 

Wounds heal faster when there is proper circulation in the affected area because blood is needed for skin repair. Unfortunately, poor blood circulation is a common complication of diabetes due to its effect on the nerves. This is why conditions such as diabetic sores and other wounds on the lower extremities heal slowly and can even lead to fungal infections and gangrene.

 

Peripheral neuropathy caused by elevated sugar levels can also cause diminished sensation in the nerve and vessels, which is why a lot of diabetic patients don’t notice wounds in their extremities immediately. If left untreated by professionals, these wounds can be a cause for amputation, which is one of the worst things that any diabetic patient can go through.

 

 

Infection

 

Diabetes causes the immune system to function poorly, which could easily make a patient susceptible to infections. This is why proper care is needed for wounds like diabetic sores and glucose levels must be controlled to avoid infections that could cause sepsis or gangrene.

 

 

 

For individuals who are not diagnosed with diabetes but have wounds that heal slowly, this could be a symptom of the disease. Therefore, it’s best to see a doctor right away so necessary laboratory tests to confirm diabetes can be performed and a proper wound care and management plan can be implemented.

 

 

 

We specialize in diagnosis and treatment for any and all wound care issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.

chronic wound care and management

Chronic Wound Management: Learning the Basics

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A chronic wound can cause a great deal of pain, discomfort and even debilitation for a patient. Whether it’s a venous stasis ulcer, a bed sore or a non-closing surgical incision, chronic wound care and management is essential to promote faster healing and help the patient get back to their quality of life.

 

To understand chronic wound care management, it’s important to learn the basics first:

 

 

What Is the Pathophysiology of Chronic Wounds?

 

Any type of wound will undergo the four phases of the healing process: hemostasis, inflammation, proliferation and remodeling. This usually happens within a specific time period depending on the severity of the wound and the overall health condition of the patient. A wound can be classified as chronic when it fails to heal within that reasonable time period, which is usually three months.

 

 

Several factors affect the chronicity of a wound including increased bacterial load, pressure or trauma, degraded growth factors and cell surface structures and of course, inappropriate treatment. The first step to proper chronic wound care is to do a full assessment of the patient and identify the causes of the wound’s chronicity.

 

 

 

What Are some Things to Check During Chronic Wound Assessment?

 

Wound assessment begins with locating the anatomic location of the wound since it’s important in creating a proper wound care plan. The wound should be measured for circumference and depth and classified as partial-thickness or a full-thickness wound. Other things to assess include its surrounding skin and tissue, the appearance of the wound-bed tissues, its exudate, edges and undermining and tracts. It’s also very important to take note of the patient’s pain level and discomfort so proper pain management can be included in the plan.

 

 

 

What are Some of the Steps to Chronic Wound Care?

 

 

Preparing the Wound

 

Wound preparation is critical for removing the hindrances to healing. Controlling bio-burden or the microbes that contribute to poor healing starts with cleaning the wound using a non-cytotoxic agent. Debridement follows to remove necrotic tissue and slough within the wound bed. To maintain moisture balance within the wound, proper dressing must be applied. This keeps the wound bed moist and exudates are managed to avoid the growth of microbes.

 

 

Choosing a Dressing

 

Factors such as appearance, exudate and pain need to be considered when choosing the right dressing for a chronic wound. Hydrogel dressing is applied for wounds that need extra moisture, a non-adherent dressing is ideal to avoid painful tearing and alginate dressing is used primarily for deep wounds.

 

 

 

To ensure good healing, it’s very important to re-assess the patient’s wound on a weekly basis to see if the chronic wound care plan worked. If there isn’t any progress, adjustments can be made quickly to ease the burden of the patient.

 

 

 

At the end of the day, proper chronic wound care and management is a collaborative effort between the health care provider and the patient. So, make sure that you work together in coming up with strategies that will help you achieve the common goal of full wound healing.

 

 

 

We specialize in diagnosis and treatment for any and all wound care issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.