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Principles of Wound Healing and Treatment Options. By Jacquelyn M. Sullivan, MSN, GNP, RN. Principles of Wound Healing Inflammatory Stage. Characterized by redness, heat, pain and swelling Last approximately 4 to 5 days

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principles of wound healing and treatment options

Principles of Wound Healing and Treatment Options

By

Jacquelyn M. Sullivan, MSN, GNP, RN

principles of wound healing inflammatory stage
Principles of Wound HealingInflammatory Stage
  • Characterized by redness, heat, pain and swelling
  • Last approximately 4 to 5 days
  • Initiates the healing process by stabilizing the wound through platelet activity that stops bleeding & triggers the immune response
principles of wound healing inflammatory stage3
Principles of Wound HealingInflammatory Stage
  • Within 24 hours of the initial injury, neutrophils, monocytes and macrophages are on the scene to control bacterial growth and remove dead tissue
  • Characteristic red color and warmth is caused by the capillary blood system increasing circulation & laying foundation for epithelial growth
principles of wound healing proliferation stage
Principles of Wound HealingProliferation Stage
  • Begins within 24 hours of the initial injury and may continue for up to 21 days
  • It is characterized by three events:
    • Epithelialization
    • Granulation
    • Collagen synthesis
principles of wound healing granulation
Principles of Wound HealingGranulation
  • Formation of new capillaries that generate and feed new tissue
  • Granulation tissue is the beefy red tissue that bleeds easily
principles of wound healing epitheliazation
Principles of Wound HealingEpitheliazation
  • Formation of an epithelial layer that seals and protects the wound from bacteria and fluid loss
  • It is essential to have a moist environment to foster growth of this layer
  • It is a very fragile layer that can be easily destroyed with aggressive wound irrigation or cleansing of the involved area
principles of wound healing collagen synthesis
Principles of Wound HealingCollagen Synthesis
  • Creates a support matrix for the new tissue that provides it with its’ strength
  • Oxygen, iron, vitamin C, zinc, magnesium & protein are vital for collagen synthesis
  • This stage is the actual rebuilding and is influenced by the overall patient condition of the wound bed
principles of wound healing differentiation or maturation
Principles of Wound HealingDifferentiation or Maturation
  • Final stage of wound healing
  • Begins around day 21 and may continue for up to 2 years
  • Collagen synthesis continues with eventual closure of the wound and increase in tensile strength
  • Tensile strength reaches only about 80% of pre-injury strength
principles of wound healing normal age changes
Principles of Wound HealingNormal Age Changes
  • Decreased epidermal cell turnover
  • Increased capillary fragility and reduced vascularization
  • Reduced oxygen flow to the area
  • Altered nutrition and fluid intake
  • Impaired immune response
  • Reduced dermal and subcutaneous mass
pressure ulcer management
Pressure Ulcer Management
  • Eliminate or minimize intrinsic and extrinsic factors of pressure ulcer development
  • Provide nutritional support and monitor nutritional status
  • Create and maintain a clean, moist wound environment with adequate circulation and oxygenation
clean moist wound environment
Clean Moist Wound Environment
  • Soap and water
  • Removal of dead tissue and eschar on open wounds
    • Sharp debridement
    • Enzymatic debridement
    • Chemical debridement
    • Mechanical debridement
    • Hydrotherapy
    • Autolysis
clean moist wound environment12
Clean Moist Wound Environment
  • Too much moisture
    • Desitin/zinc oxide
    • Copolymer starch dressings
    • Alginates
    • Wound VAC therapy
clean moist wound environment13
Clean Moist Wound Environment
  • Too little moisture
    • Hydrogel dressing
    • Hydrocolloid dressing
    • Semi permeable dressing
evaluation of chronic wounds
Evaluation of Chronic Wounds
  • Nutrition
  • Treatment
    • If no results after two weeks, change treatment
  • Infection
    • All wounds are colonized with many bacteria after 24 hours
additional treatment options
Additional Treatment Options
  • Electrical stimulation
  • Whirlpool
  • Ultrasound
  • VAC wound therapy