Ask the treatment expert ... about wound healing principles
Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC
I am a registered nurse and very interested in wound care. I understand that there are some general “wound healing principles.” Can you explain?
There are “Wound Healing Principles” covered by three major categories:
1. Origin of the wound
In caring for a wound, factors that produced the wound should be addressed, reduced or eliminated. These may include external pressure, friction and/or shear, which can be addressed through proper turning and repositioning, along with the addition of an appropriate support surface for the bed and the chair.
2. Systemic factors
Providing an adequate systemic foundation is essential. This includes nutrition and hydration, blood flow to provide oxygen to the local area of the wound and infection control. Protein supplements, fluid replacement therapy and antibiotic therapy require a physician's order.
3. Topical treatment
Therapeutic treatment at the local tissue injury includes:
• Debridement of dead or necrotic tissue
• Elimination of infection
• Elimination of dead space
• Absorption of exudate
• Provision of a moist wound healing environment
• Protection from additional trauma and/or bacterial assault
• Ensuring thermal regulation
Care at the wound site includes cleansing, exudate management and dressing or device options. For example, if the wound is covered with necrotic tissue, this must be removed for optimal wound healing. Infection of the tissue also must be identified and treated. Removal of the necrotic tissue and adequate cleansing is crucial for wound healing to occur. And remember: Documentation of wound status is essential.