Woundcare

 

It might be scraped shins or a puncture wound from walking barefoot, but with an active lifestyle it’s hard to avoid minor wounds for you and your children.  If it’s dirty, bleeding, or painful, it’s easy to nervously wonder just what you should do for your injury.

Types of wounds

 

Abrasions or Grazes

 

Children are extremely prone to abrasions, which you may know simply as “grazes.” You’ll see it on their elbows or knees after a fall on gravel, cement, or even on the forest floor. These grazes are superficial damage to the knee and look a lot like typical rug burn, but may gently bleed and sting, causing some discomfort. While a grazed knee or elbow is usually not severe in nature, it’s still uncomfortable for you or your loved ones. Generally, a scraped knee or grazed elbow will take a week or so to heal, maybe 2 to 3 weeks if it is more severe.¹

Treatment

 

To care for your abrasion or grazed knee:

Exudate and Pus

 

Exudate is produced as a natural part of the healing process. At one time, exudate was considered unhealthy or at the very least a nuisance. However, recent knowledge reveals that exudate is a helpful and nourishing part of wound healing. Healthy exudate is made from protein-rich fluid which leaks from the porous site of injury. Its purpose is to promote a healthy moist healing environment.[1] Exudate can be minor, moderate, or heavy and therefore different wound dressings will be necessary.

  • Assessing Your Wound’s Exudate

    If you’re not a medical professional, it can be difficult to tell whether a wound’s exudate is minor, moderate, or heavy. To keep an eye on your wound’s status, check on things like:

     

    • The rate of dressing changes. If you are changing a dressing infrequently, it’s likely that you have minor exudate. Normally, a dressing for a minor wound can be changed every eight hours depending on the dressing. A moderate and heavy amount of exudate will mean that your dressing will likely be changed much more often.
    • How well your dressing is keeping in place. A moderate to heavy amount of exudate will cause more leakage at the wound site. This fluid will cause the dressing to lose its ability to adhere to the site. A dressing to a wound with minor exudate should stay firmly in place.
    • Comfort of dressing removal. The more exudate that a wound produces, the easier it will be to remove the dressing.
    • Saturation of the dressing. How wet is the dressing when you change it every eight hours? Is it dry or moist? If dry, this is likely a minor amount of wound exudate. If it is wet or saturated it may be moderate. If the dressing is saturated or leaking from the dressing before eight hours, it’s likely a heavy amount of exudate.
When to See Your Health Care Professional

 

Visit your health care professional if your wound doesn’t seem to be healing correctly, if there is a lack of scab formation, no change in the wound’s size, or continued bleeding from the site. These may be signs of a more serious underlying issue that delays wound healing.

Redness

• Redness around the wound site, streaking red lines beneath the skin, a temperature above 37°C, swelling, and foul-smelling exudate or pus may all indicate wound infection and will need treatment from a medical professional.

Bleeding

• If the wound begins bleeding profusely or has high-pressured bleeding, it should be dealt with at an emergency care facility immediately. A doctor’s visit should be made if you are regularly bleeding through your bandage in less than eight hours. As with all of these signs and symptoms of improper wound healing, delayed treatment can be serious and can cause worsening systems, the need for emergency surgery, or worse. Don’t neglect your health care. If you’re unsure about your wound’s healing, its exudate or pus, seek medical treatment.

[1] Wound exudate and the role of dressings.
Wounds International. 2016. Available at: http://www.woundsinternational.com/media/issues/82/files/content_42.pdf. Accessed August 23, 2016.

Healing Stages of Minor Wounds

 

Assessing Your Wound’s Exudate

 

There are three stages in which normal wound healing occurs.

1

Inflammation

 

First, inflammation occurs as blood vessels constrict, making it difficult for fluid to return to the vascular system. Platelets do the tough work and create a chemical which builds clots and stop bleeding. Once bleeding has stopped, blood vessels are dilated again, allowing nutrients into the site of injury and old blood back into circulation to be processed.

2

Proliferation

 

During this phase, the wound begins to rebuild with what is known as “granulation tissue.” Wound care nurses and doctors look for this tissue as a sign of normal wound healing and assess its colouration.

3

Maturation

 

During the final stage of wound healing, the wound completely closes up. Although it may look as though the healing process is finished, it can take years for tissue under the skin to fully heal. The maturation process is in actuality, the longest phase of wound healing.

Wound Complications¹

 

When something doesn’t seem right with your wound, it can be frightening. You may wonder whether you need to see a doctor or if your injury is healing the way that it should. Here are some wound complications you might see with your injury. If you see these, please seek medical advice:

 

  • Delayed wound healing.
  • Infections: look for signs of infection such as redness and pain at the site, swelling, flu-like symptoms, or an elevated temperature.
  • Inadequate scar formation which could lead to dehiscence, a condition where the wound doesn’t completely close.
Slow Wound Healing

 

Most wounds heal on their own and won’t be an issue for healthy individuals. However, there are times when wound healing takes longer than expected or halts all together. This can cause many problems for the injured, including an increase in risk of infection, longer time spent in pain, and decreased mobility. Factors that delay wound healing include:

 

  • Smoking
  • Age
  • Alcohol use
  • Stress
  • Poor nutrition
  • Obesity
  • Some medications may slow the healing process.

Consult your doctor if you’re concerned that your medications are delaying healing.

 

¹ Guo SDiPietro L. Factors Affecting Wound Healing. Journal of Dental Research. 2010;89(3):219-229. doi:10.1177/0022034509359125

Wound Care Management

 

For minor injuries, wound care is simple.

Wound Severity

 

Although they may be acute in nature at first, most minor wounds heal on their own. However, certain illnesses and situations may cause wounds to heal slowly or become infected. If you think this might apply to your wound, it’s always best to seek medical attention.

  • Consult a healthcare professional when your wound

    • Won’t stop bleeding
    • Contains any foreign material
    • Is deep
    • Looks infected eg. red, swollen, pain at the site
    • Is caused by human/animal bite
    • Is caused by a metal object and when you have not had a tetanus shot
  • How to Prevent Wounds

    Prevention is the best medicine when it comes to wound care. You should prevent minor wounds by:

     

    • Staying away from dangerous areas.
    • Using a flashlight at night.
  • Wound Dressing Types for Minor Wounds

    Wound dressings are available at pharmacies and can be used to support the healing of your wound or to prevent worsening of an existing wound. Different dressings include¹:

     

    • Low-adherent dressings: low adherent dressings are designed to absorb small amounts of exudate from minor wounds.
    • Hydrocolloid: hydrocolloid dressings are generally used on minor burns, blisters and lacerations.
    • Adhesive Foam: foam dressings come in varying thickness for mild, moderate and high exudating wounds.
    • Adhesive bandage: adhesive bandage or plaster that is designed to be flexible and used on minor wounds.
    • Non-adhesive foam: non-adhesive dressings are designed to be extra gentle so they do not damage to healthy or newly formed skin when removed. They also come in varying thicknesses.

     

    ¹ Tissue A. What are the Different Types of Wound Care Dressings?. Advanced Tissue. 2013. Available at: http://www.advancedtissue.com/different-types-wound-care-dressings/. Accessed June 15, 2016.