What Is Wound Care Treatment?
Wound care treatment involves the management and ongoing care for helping wounds heal. This is especially necessary with chronic non-healing wounds, which are wounds that have not completely healed in six weeks. The treatment of a wound will vary depending on the type of wound and its severity, however there are common elements of treatments that most wounds have in common.
All wounds should be regularly cleaned. This can be done with sterile water and saline solution to help clear the wound area of harmful bacteria or debris which may inhibit the healing process. In some cases, a wound may need to be flushed with medical syringes. For more significant wounds, dead tissue or foreign materials may need to be removed with the use of surgical debridement. After cleaning, wounds should receive recommended treatments such as topical antibiotic ointment as needed. This will help wounds heal well with a reduced risk of infection. In more serious cases, wounds may need to be drained to clear any lingering pus.
Most wounds should receive a dressing of clean adhesive bandages or gauze to protect the wound, keep it dry, and promote healing. The Centers for Disease Control and Prevention recommend replacing bandages and assessing the wound for signs of infection every 24 hours.
While not applicable for all patients, those who are experiencing higher levels of pain because of their wound may need to take medication during the healing process. This may include over-the-counter or prescribed pain medications to help alleviate discomfort and reduce inflammation. However, aspirin should typically be avoided as it can inhibit the healing process by delaying skin repair on and around the wound and cause additional bleeding.
What Are the Types of Wound Care?
Given the wide variety of wounds, severities, and stages, there is an abundance of types of wound care treatments that can be deployed to manage and heal non-healing wounds. While this is not a comprehensive list, it demonstrates the breadth of potential treatments that can be deployed to promote wound healing in most situations.
- Advanced Wound Dressings: While adhesive bandages and gauze are the standard for wound dressings, there are advanced options that can be leveraged to treat more significant wound issues. This is largely dependent on the wound conditions, characteristics and diagnoses. Among the advanced wound dressing options are:
- Hydrocolloid - A wafer type of dressing that provides a moist healing environment, autolytic debridement and insulation. It is best used with drier wounds with minimal discharge, including non-infected wounds, burns, pressure ulcers, venous ulcers, and necrotic wounds.
- Hydrogel - A primarily water-based dressing that provides a soothing comfort and ample hydration for a wound. These are best used for very dry or necrotic wounds, lesions, minor burns, and wounds that create depressions in the skin.
- Alginate - A natural wound dressing that is produced from the calcium and sodium salts of alginic acid. Ideal for wounds with higher discharge, as the alginate dressing forms a gel when in contact with exudates and makes use of its highly absorbent properties.
- Collagen - A protein-based dressing that comes in the form of pastes, gels, powders, or freeze-dried sheets that can be applied to the wound site. Collagen dressings decrease the risk of infection, and are commonly used with bed sores, minor burns, foot ulcers, chronic wounds, and large open cuts.
- Topical Dressings: This can include a number of applications for the wound, including creams, oils, sprays, or emulsions. Generally, topical dressings will help wounds retain moisture and lessen present odors.
- Negative Pressure Wound Therapy: A vacuum is utilized around the wound site to increase blood flow, draw out excess fluid, and promote healing.
- Compression Therapy: By using special pressure-exerting stockings, compression therapy encourages better blood flow to help promote healing of ulcers and other non-healing wounds.
- Debridement: To help a wound heal more efficiently, dead (necrotic) or infected tissue may need to be removed. Debridement can also be utilized to remove any foreign material from the wound. There are several different debridement methods to fit the needs of specific wound types.
- Skin Grafts: With skin-grafting surgery, wounds are covered with skin taken from a donor site (either from the patient themselves, another person, or an animal) to repair wounds and stimulate healing.
- Graft Alternatives: Products such as the XWRAP® Amniotic Membrane-Derived Allograft provide an effective, natural alternative to animal-derived or cadaveric products. Acting as a natural scaffold for cellular migration, attachment, and proliferation, the XWRAP® helps protect tendons and nerves at the surgical site.
- Hyperbaric Oxygen Therapy (HBOT): HBOT supplies patients with pure oxygen in a pressurized room or tube to promote healing and restore normal cellular function in non-healing wounds. Tissue and cellular function typically respond positively to hyperbaric oxygen treatments, which also helps fight infections if present.
- Electrical Stimulation: Utilizing high-voltage pulsed current simulators, electrical stimulation can promote wound healing in various ulcers and wounds by promoting cell and tissue growth.
What Are the Six Primary Types of Wounds?
An abrasion is an open wound caused by friction against a rough surface. This could be as minor as a common scrape or as significant as road rash. Bleeding is minor, but the wound should be cleaned and treated to avoid infection.
Avulsions are serious wounds where there is a partial or complete tearing of skin from the tissue beneath. This typically occurs during an accident or other injury. Avulsions are usually bigger wounds that have a high potential for infection if not treated properly.
Also known as a surgical wound, an incision is a smooth cut made cleanly into the skin, causing an open wound. Incisions are usually longer than they are deep. Incisions are rarely non-healing wounds, and are often treated with stitches when occurring as part of a surgical procedure.
Although similar to an incision, a laceration is an irregular cut or tear that is typically made accidentally or forcibly. Accidents with knives, machinery, or other sharp items are common culprits for lacerations.
A skin ulcer is an open wound that commonly develops as a result of injury, poor circulation or pressure. There are three main types of chronic wounds that are classified as ulcers. Venous ulcers typically occur in the legs and mostly affect the elderly. Diabetic ulcers often often occur in relation to the reduced perception of pain in extremities because of nerve damage, allowing small wounds to increase in severity over time. Pressure ulcers usually occur in those whose mobility is significantly limited such as those who are bedridden, and are caused by a loss of blood circulation.
Caused by a pointy object such as a nail or a needle, a puncture wound results in a hole being formed in the skin and underlying tissue. Even with small puncture wounds, precautions should be taken to prevent infection.
What Can I Expect at a Wound Care Center?
When attending a wound care center you can expect to receive a full examination of your wound from a wound care specialist. This initial exam will include measurements of the wound and a review of circulation efficiency. Your personal and family medical history will be reviewed to help provide context to the current wound issue if there is any reasonable correlation. The physician must determine the cause of the wound and what the necessary steps will be to treat it. This examination process may involve other diagnostic tests to gather more information, such as blood tests, wound cultures to determine if viruses or bacteria are present, or an MRI or X-ray if the severity of the wound is not fully known.
Once your wound has been examined, treatments will be considered and recommended. Depending on the facility and the nature of your wound, you may receive treatment at the wound care center immediately to start the healing process. This may include the removal of dead tissue around the wound, hyperbaric oxygen therapy, negative pressure therapy, compression stockings, or simply a cleaning of the wound and a new dressing.
The physician will then provide you with a custom treatment plan for your wound, including future therapies and follow-up visits. They should also equip you with the knowledge and resources needed to manage your wound at home. Your treatment plan may include a variety of directions, such as guidance on nutrition and fluid intake, prescribed medications, and lifestyle modifications to promote healing. Information regarding your visit to the wound care center will also be relayed to your primary care physician to keep your health records up to date.
Regardless of the type of wound, all wounds should receive adequate treatment and be given the attention they need to heal. In the instances of chronic wounds, advanced efforts and professional help may be necessary for the wound healing to get on track. Luckily, there are many treatment options available for the majority of patients to get the wound care they need.
At Keystone Health, we are committed to providing our patients with customized treatment plans with a commitment to providing the best wound care possible. Our wound care specialist team is highly trained and here to deliver the necessary treatment to get our patients healing and healthy to improve their quality of life. If you need (non-emergency) wound care or have a wound that is not healing at an acceptable rate, please reach out to Keystone Health to set up an appointment. We look forward to building a treatment plan for you to get you on the road to recovery.