Introduction to Wound Care
Paul M. Graham, DO
Proper wound care is vital to the restoration of normal skin function and integrity. Without the adequate care, many open wounds have the potential to become infected. These infected wounds lower the bodies ability for appropriate wound repair. This could lead to the formation of a chronic wound that will become very difficult to heal without more invasive interventions.
1. Bleeding
- For many wounds, bleeding is a common occurrence. Bleeding is usually easy to stop by applying firm pressure on the wound with a piece of gauze, tissue, or bandage. Continue to hold pressure on the wound for 20 minutes without any interruption. If bleeding continues, reapply pressure and wrap the wound tightly with gauze. Make sure the dressing is loose enough to place a finger in between the dressing and the skin and contact your doctor for further instructions to stop the bleeding.
2. Wound Cleansing and Irrigation
- All wounds are considered contaminated until they are thoroughly cleaned. Wound irrigation is of utmost importance and cannot be overstressed. Copious amounts of sterile saline should be applied to the wound. DO NOT use iodine or hydrogen peroxide on the wound as these solutions cause cell death and further damage to the wound tissue.
3. Debridement
- Debridement is a procedure that is used to remove devitalized tissue and wound debris from the site of injury. This procedure is often used as a necessary tool to help stimulate the wound to reinitiate the stages of wound healing. In absence of necrotic and cellular debris, the wound environment is suitable for wound repair to take place.
4. Wound Dressings
- Dressings are very important for maintaining wound sterility and absorbing excess blood and serous drainage. Adequate wound moisture improves the rate of epithelization and cell migration, thus expediting the rate of wound closure. Assuring optimal hydration is key: not too wet and not too dry. There are many types of dressings available and your doctor will choose the right one for you. The dressing should be kept clean and dry while in place and changed every 1-2 days depending on the physician’s recommendation. Avoid bathing when lower extremity wounds are present. Colonic bacteria may colonize the wound and inhibit the healing process. (I will post a separate article on wound dressings)
5. Monitoring for infection
- It is not uncommon for a wound to become infected. The ability to recognize a potential infection is very important. The signs and symptoms associated with infection include redness or streaking of the surrounding wound, the presence of heat, the discharge of pus, the presence of swelling, and the sensation of pain. Seek medical attention if any of these signs or symptoms develop as you may need to be placed on an antibiotic regimen.
6. Follow-up
- The importance of follow-up appointments can not be stressed enough. Follow-up appointments are intended to reassess and evaluate the existing wound in the case that minor changes may need to be added to the initial treatment plan. Small changes are usually implemented if the wound is not progressing appropriately through the stages of wound healing. As a general rule, always schedule and attend your follow-up appointments ranging from 2-4 weeks apart, unless told otherwise by your doctor.
This is part 1 of a 5 part series on wound care and repair. Stay tuned to the blog for more articles in the coming weeks. Thank you for your continued support. Please feel free to make any article recommendations or request.
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Dr PMG's Blog 
Great information!
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