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How Doctors Apply Principles of Wound Management in the Clinical Environment

Principles of Wound Management
June 16, 2021
Author : Keith Morris

A visit to the emergency room is not what most people look forward to. However, emergencies do not give prior intimations. In case of sudden accidents, it is important to act quickly. The wounded person must be given immediate medical care and attention as per the set standards of first aid and wound management. It is important to note here that there are more than 100 categories and classifications of wounds as per modern medicine. It is important to recognize the principles of wound management so that a wound can be treated effectively and promptly. 

Before the diagnosis and prognosis, it is important to identify the type of wound and apply principles of wound management to ensure fast healing. When it comes to the wound the identification is considered even more important than the process of diagnosis itself. This is because the diagnosis and planning of the preliminary treatment rest on the wound identification. As discussed before, there are more than 100 categories of wounds both topical and internal, and thus medical professionals and paramedical personnel must be familiarized with how to apply Principles of Wound Management in the Clinical Environment. 

Difference Between a Wound and Laceration

A laceration: A simple and rudimentary concept in medicine, laceration refers to the separation, fragmentation or deterioration of the natural skin due to a sudden injury. This could include a cut, crush injury, or a deeper displacement. However, if one were to define laceration in strictly medical terms, laceration is a cut arising out of an injury that looks like a normal skin wound. It is not an abrasion because the skin on top is not missing. Typically, a cut is a wound caused by a sharp object such as a shard, shrapnel or glass. In medical terms, lacerations are a direct outcome of the trauma caused to the skin by contact with a sharp object with force.The difference between a wound and a laceration is rather minute. It may take a medical professional to completely understand the minute differentiation between a wound and a laceration.

wound management

There is a simple list of some of the most rudimentary principles for the management of a wound or laceration. These principles remain common and uniform for all types of wounds. However, the exact wound treatment is decided by the medical practitioner after a thorough physical examination of the wound. It is also equally important to be mindful of one’s safety while treating a wound.

Hemostasis

Hemostasis is the first aspect of wound management. It is defined as the natural process that occurs within the tissues of the skin to stop the bleeding. It is usually very spontaneous. 

Cleaning the Wound

Whereas most people tend to think of wound cleaning as something they can pass at if the wound or laceration is severe, it is important to understand that wound cleaning is the basic step in reducing the infection and promoting healing. There are some things that one is required to take care of while cleaning up a wound. Here are the important steps in wound care:

  • It is important to start by disinfecting the wound properly by cleaning up the damaged, dead or severed skin around the site of the wound. For this purpose, an antiseptic solution or saline water can be used. The purpose of cleaning the wound is:
  • In case of sharp object-induced cuts, glass cuts or abrasions, it is important to remove any damaging substances from the skin so that the wound is not worsened.
  • It is also important to clear the site of the wound of any blood deposits, dirt or any other debris so that the medical staff or the doctor can carry out an objective examination of the prevailing wound.
  • Avoid using alcohol or detergents on the wound: one must remember to use an alcohol-free antiseptic solution or a saline water solution while cleaning a wound. Alcohol-based cleaning solutions can irritate and even slow down the healing process.

It is also an important part of the cleaning process to decontaminate the wound. One can start by manually removing any foreign particles present on the surface of the skin. Where there are any broken or severed skin tissues or devitalized skin, it is important to remove it from the surface of the skin by debriding the skin where possible. 

The next step is to irrigate the skin thoroughly with a saline water solution. If you are not able to spot any prominent contamination on the skin, irrigation through low pressure is sufficient. Irrigation can typically be defined as the process of applying the normal saline solution from a sterile container into the crevice of the wound. This must be done with all due care and caution. If there is no obvious contamination present, low-pressure irrigation is sufficient* (pouring normal saline from a sterile container carefully into the wound)

Antibiotics can also be administered in case of high-risk wounds or where clear signs of infection can be seen. Here it is important to follow antibiotic prescription guidelines.

Cleaning the wound is extremely important in case of heavily soiled wounds as they could turn potentially infectious. It is also an important part of cleaning venomous bites as well as fractures. This is done to remove any foreign parts or contaminants from the site of the wound so that a process of pragmatic diagnosis can follow

Analgesia

The administration of Analgesia allows for easier and more effective closure of the wound. The most common method of administering analgesia is through Infiltration with a local anesthetic. A regular systemic analgesic like paracetamol can be used as an adjunct.

types of wounds

Skin Closure

Skin closure is the next principle in wound management. It is another step towards the recovery of the skin to gain normalcy. Regardless of how well a wound has been cleaned or sterilized, the damaged part of the body cannot be used till the wound heals completely. For that purpose, the following may be used:

  • Skin adhesive strips or steri- strips. They can be extremely useful where there is no possibility or risk of infection. Steri strips have a strong adhesive effect and they can close wounds or lacerations easily within minimal time.
  • Tissue adhesive glue or Indermis is also a widely-preferred solution which can be used for closing minor wounds and lacerations. The use of tissue adhesive glue is among the most popular choices in wound management.
  • Sutures commonly known as stitches. They are typically used for any wound which is greater than 5cm in the length of the incision. Sutures are considered useful in the case of deep dermal wounds for cuts that are prone to tension caused due to constant flexing or wetness. 
  • Dermal staples can also be used for topical dermal wounds.

Conclusion; Why Applying Principles of Wound Management is Important

If the wound is dressed carefully and securely, it is likely to heal fast. In case of anon-infected wound or laceration, the first layer of the wound dressing can include the application of saline-soaked gauze. This step is then followed by an absorbent material to solve the problem of wound exposure. To secure the application tightly, a soft gauze tape is put in place to secure the dressing place. if the wounded person is not sure of his or her tetanus immunization status, it is also prudent to administer Tetanus prophylaxis in the required dosage.

After completing these steps, it is important to advise the patients on the required care and caution which they must exercise in caring for their wound. Any sutures or adhesive strips will most likely be removed within a week or two. With proper treatment and careful management, a wound can heal pretty quickly. However, it will be important toapply the Principles of Wound Management in the Clinical Environment. Students of medicine are provided with thorough training in wound management. They have to submit several assignments and papers on the topic before they can get a qualifying grade. 

The depth of the subject as well as the rigorous requirements of the curriculum can be overwhelming even for the best of the students. You can rely on our nursing assignment help and academic guidance on how to apply the principles of wound management:

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About the Author

Keith Morris

Keith Morris

Keith Morris is a certified nurse who retired as a registered nurse after participating in a WHO campaign in Geneva. He is dedicated to helping students score good grades in their nursing courses and are offered a chance to help the people and establish a better healthcare community across the globe. He works as a nurse at a local clinic with underprivileged children and provides assignment guidance to the students. Reflection writing, aged care, Gibbs reflective cycle, cardiac nursing, pathophysiology, etc. are a few to name from his area of dominance.

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