wound types and healing consise and easy to learn

3. Wound is the breakdown in the protective
function of the skin ,loss of continuity of
epithelium ,with or without the loss of
underlying connective tissue following
injury to the skin or underlying tissue
organ caused by surgery, a blow ,a cut
,chemical ,heat or cold, friction, pressure,
or as a result of a disease

5. • WOUND ARE CLASSIFIED BASED ON
1. OPEN/CLOSED WOUND
2. CLEAN/UNCLEAN WOUND
3. SEVIERITY OF WOUND

6. OPEN WOUND
• WOUNDS THAT ARE EXPOSED BY UNDERLYING
TISSUE/ORGAN THAT ARE OPEN TO OUTSIDE ENVIRONMENT
I. INCISED WOUND
• AN incised wound is an injury caused by a weapon with
a sharp edge .example knife ,razor
• The edges of the wound are clean cut
• All the tissue are divided including blood vessel so they
bleed more

7. 2.AVULSION
• PARTIAL OR COMPLETE TEARING AWAY OF SKIN
AND TISSUE BENETH
• Occur during violent accidents, body crushing, and explosion or
deep break to the skin tearing it away from underlying tissue

8. • 3. LACERETED WOUND
• THESE are wounds in which the skin and underlying
tissue are torn as a result of application of blunt force,
• These wounds have irregular and torn edges and bleed
less.
• They are caused by industrial accidents ,falling over
houses, self and claws of some animals

9. • 4. CONTUSED WOUND
• It is an injury causing bleeding and tissue damage under
the skin usually without Breaking the skin .Falls ,blows
sustained during fight or for from falling objects.
• There is infiltration of blood into tissue following rupture
of vessels and hence it appears red

10. • 5.PUNCTURES WOUND
• An injury caused by a pointed object when it is driven in
through the skin.
• such wounds are caused by knife, dagger needle,
Spear, arrow scissors.
• they have small opening but are very deep vital organs
may be injured by them
• They are of two types
• Penetrating and perforating wound

11. • 6 .ABRASION
• An aberration is a superficial injury involving only the
outer layer of the skin.
• It is caused by friction OR pressure of rough objects .
• Bleeding occur slightly

12. CLOSED WOUND
• 1. BRUISE

13. • INTERNAL BLEEDING
• bleeding inside the body particularly
• In chest cavity, muscles that is caused by
major trauma

14. CLEAN AND UNCLEAN WOUND

15. SEVERITY OF WOUND

16. COMPLICATIONS OF WOUND
INFECTION
• INFECTION
• Pus
• Foul smell
• Fever
• Pain
• Swelling
• heat
INFLAMATION
• INFLAMATION
• Hot
• Red
• Painful
• Hard to move
SCARING
• SCARING
• Replacing
tissue with
fibrous scaring
tissue

18. PROCESS OF HEALING
• HEALING INVOLVES TWO PROCESS
• REPLACEMENT OF
LOST CELLS AND
TISSUE OF THE SAME
TYPE
REGENERATION
• LOST CELLS BEING
REPLACED BY
CONNECTIVE TISSUE
REPAIRING

19. REGENERATION
• proliferation of parenchymal cells that
usually result in complete Restoration of
the original

20. • THE ability of cell regeneration depends
on its cell type

21. • It is a healing outcome in which tissue do not return to
their normal architecture and function.
• repair result in scar formation.
• It is more Complex than regeneration.
• repairing occurs by primary secondary or tertiary
intensions

22. Primary,Secondary,Tertiary

23. Primary intention
• Primary healing takes place, when wound
margins are neatly approximated ,as in a
surgical incision or paper cut

24. INITIAL PHASE(inflammatory phase)
3-5 days
• The edges of incision are first aligned and sutures in
place
• Filling of blood from blood vessel and forming a matrix
for WBC, FIBRINE
CLOTS,ERYTHROCYTES,MACROPHAGES
• Clot formation by FIBRINOGENS to make a meshwork
for epithelial process
• WBC cause acute inflammatory reaction
• MACROPHAGES ingest and digest cell debris thereby
cleaning the wound

25. GRANULATION PHASE
5DAYS-4WEEKS
• Components of granular tissue-proliferating
fibroblast ,proliferating
angioblast,wbc,exudate,loose semifluid
ground
• Migration of fibroblast
• Secretion of collagens
• Abundance of capillary buds
• Wound fragile
• Angioblasts are
embryonic cells from
which the
endothelium of blood
vessels arises

26. Maturation phase
7days to several months
• REMODELING OF COLLAGEN
• STRENGTHING OF SCAR

27. SECONDARY INTENTION
• wounds that have occurred from trauma, ulcer and
infection ,have large amount of exudates and wide,
irregular wound margin with extensive tissue loss
• Wound cannot be brought together
• Debris must me cleaned away before healing
• Healing and granulation take place from the edge
inwards and from bottom of the wound upward until the
defect is filled. There is more granulation tissue and as a
result there are larger scars

28. TERTIARY INTENTION
(delayed primary intention)
• This happen when a primary wound that is is
contaminated /infected , is allowed to granulate and is
then sutured
• Tertiary intention may result in larger and deeper scar
than primary or secondary intention

29. – ADVANCING AGE
– ANEMIA
– CORTICOSTEROIDS
– DIABETES
– INADEQUATE BLOOD FLOW
– INFECTION
– MECHANICAL FRICTION ON WOUNDS
– NUTRITIONAL DEFICIENCY
Vit C,protein,zinc
– OBESITY
– POOR HEALTH CONDITION
– SMOKING

30. PRINCIPLES OF WOUND CARE
1. CLEAN
2. TREAT
3. PROTECT

31. FIRST AID FOR MINOR WOUNDS
• wash hands thoroughly in soap and warm water.
• avoid touching the wound with fingers.
• do not cough and sneezing over the wound .
• if the wound is dirty clean it by rinsing lightly under running Water .
• pad gently drive with sterile Scrub.
• cover the wound with an adhesive dressing household medicine
like Soframycin that can be used on minor wounds.
• apply cold compress around the world

32. PREVENTION OF WOUND INFECTION
• CAUSE-germ imbedded in knife,bullet,rust
• -germ implanted into original wound -
by droplet infection/careless aider
• DIAGONOSIS-obtaining swab culture for the presence of
MRSA/vancomycin resistant enterococcus
• MANAGEMENT
1. Tropical antimicrobial agents as primary treatment
2. hydrogen peroxide create an effervescence which push out
excess cell debris,pust and can be washed with normal
saline to remove any trapped oxygen
3. Proidone-iodide, acetic acid and sodium hypochlorite are
used only if the wound is contaminated/ infected.
4. SURGICAL MANAGEMENT-BYPASS SURGERY
5. Physiotherapy ,nutrition therapy,psychological therapy

33. Nursing assessment
• Assess and document characteristics of
wound and surrounding area in size, location,
depth, margin and wound base .
• record the consistency, color and odor of any
drainage and report if abnormal for the
situation.
• streptococcus and Pseudomonas are
common organisms that can cause pus
draining
• chronic wounds must be assessed for any
complications.

34. COMPLICATION OF WOUND HEALING
1. Keloid formation
2. Infection
3. Hemorrhage
4. Fistula formation
5. Excess granular tissue
6. Evisceration
7. Contraction
8. dehiscence

35. Nursing diagonosis
• Acute pain related to swelling secondary
to inflammatory response
• Risk of infection related to open wound
• Ineffective tissue perfusion related to
obstruction to blood flow due to swelling