Wound Management

Wound Management
In this essay, I am going to discuss traditional and contemporary wound dressings and management
techniques. I will be comparing the traditional dressings with today's current modern dressing.
When choosing a dressing many circumstances have to be accessed as what type of wound is it?
This makes it a lot harder on which dressing should be used as there are so many different types
available today. Many that are used in the veterinary practice are in fact used by humans.
When a wound is healing it is important to know the stages of healing so you can achieve the best
possible outcome. Wound healing is the physiological process of restoring the continuity of tissues
following injury. The two main processes are regeneration and repair. ... Show more content on
Helpwriting.net ...
Activon Tube: pure Activon medical grade Manuka honey. It can be directly applied to skin or put
onto gauze. Useful to maximise volume of honey placed on wound and for application into
abscesses or cavity wounds.
Activon Tulle: triple layer gauze dressing impregnated with Activon Medical Grade Manuka Honey.
Can be used on superficial wounds or dryer wounds and can be unwrapped to put around a limb.
Algivon: Calcium alginate dressing impregnated with Activon Medical Grade Manuka Honey.
Useful for wounds that are producing higher levels of exudate as the calcium alguinate fibres will
absorb exudate.
Polyurethane foam dressings
Highly absorbent and act by drawing excess exudate away from wound. Maintain some moisture
through humidity to keep wound moist. They are commonly applied on top of other products – e.g.
Hydrogels or honey. The dressing has a semi–permeable membrane backing allowing oxygen
exchange and controlled evaporation, resulting in a moist healing environment. Foam dressings with
anti–microbial properties are now available. The antimicrobial agent is called Polyhexamethylene
biguanide (PHMB). The Polyhexamethylene biguanide attacks the bacteria in wound exudate as it is
absorbed. The dressing itself helps to maintain a moist environment and also preventing pathogenic
organisms from growing within
... Get more on HelpWriting.net ...

AAnalysis On Wound Management
Wound management is one of the cornerstones for nursing care however, effective wound care
extends far beyond the application of the wound itself. Nurses may be required to assess, plan,
implement, and evaluate wound care; therefore, order to fill these roles it's critical to have an
understanding of the several different areas of wound care such as, integumentary system,
classification of wounds, wound procedures, and documentation. Knowledge in each of these areas
will allow nurses to make well informed decisions about wound care, and as a result play an active
part in wound healing.
Integumentary System
The integumentary system or skin is our body's largest organ, which weighs 20 pounds or more,
accounting for about 16% of total body weight (Thibodeau, 2014, p.93). According to Thibodeau
(2014 p. 145) the: number of structures fitting into 1 square inch of skin: 500 sweat glands; more
than 1000 nerve endings; yards of tiny blood vessels; nearly 100 sebaceous glands; 150 sensors for
pressure, 75 for hot, 10 for cold; and millions of cells.
The integumentary system can be broken down into three main categories the Epidermis, Dermis,
and Subcutaneous layer each of which contain certain specialized skin derivatives including hair,
nails, and several kinds of glands.
The outer most layer of the skin or Epidermis contains stratified squamous, keratinized, epithelial
tissue; which lacks blood vessels, and the cells are packed closely together (Sloane, 1994, p.85)
The

Surgical Wound Infection Essay
According to Walker and Avant (1995), concept analysis allows nursing to examine the attributes or
characteristics of the concept.
* Concept Analysis of the Surgical Wound Infection ?
I will like to identify patients conditions and other factors contribute to the development of
Surgical Wound infections.
* Determine the aims or purposes of analysis
The purpose is to understand the effect of environment in surgical wound infections.
Prevention of infection requires the application of the principles of microbiology and accept
practice.
Measure of this concept is based on the stages of wound healing and the Centers of Disease Control
and Prevention guidelines defining surgical site infection as occurring 30 days ... Show more content
on Helpwriting.net ...
Koch (Professor of Hygiene and Microbiology, Berlin, 1843–1910) first recognized the cause of
infective foci as secondary to microbial growth in his 19th century postulates. Semmelweis
(Austrian obstetrician,
1818–1865) demonstrated a 5–fold reduction in puerperal sepsis by hand washing between
performing postmortem examinations and entering the delivery room. Joseph Lister (Professor of
Surgery, London,
1827–1912) and Louis Pasteur (French bacteriologist, 1822–1895) revolutionized the entire concept
of wound infection. Lister recognized that antisepsis could prevent infection.[1] In 1867, Lister
placed carbolic acid into open fractures to sterilize the wound and to prevent sepsis and hence the
need for amputation. In 1871, Lister began to use carbolic spray in the operating room to reduce
contamination.
However, the concept of wound suppuration persevered even among eminent surgeons, such as John
Hunter, 1728–1793.[2]
As late as the 19th century, aseptic surgery was not routine practice. Sterilization of instruments
began in the 1880s as did the wearing of gowns, masks, and gloves. Halsted (Professor of Surgery,
Johns
Hopkins University, United States, 1852–1922) introduced rubber gloves to his scrub nurse (and
future wife) because she was developing skin irritation from the chemicals used to disinfect
instruments. The routine use of

Essay On Surgical Site Wound Closure
A critical literature review exploring the effectiveness of using skin staples as opposed to sutures or
skin adhesive as closing materials after orthopaedic surgery.
Aim: This paper considers the effectiveness of different methods of closure materials after surgery
looking primarily at complications such as infection rates and dehiscence of wounds. Secondary
outcomes measured include cosmetic scar evaluation, patient satisfaction, and cost, ease of use and
speed of application.
Background. Surgical site wound closure can play a key part in the recovery of patients post–
operatively. The use of closure material is usually according to the preference of the surgeon and is a
frequently debated issue.
Method. A review of English language literature ... Show more content on Helpwriting.net ...
Similarly in the study by Gupta et al (2015), a higher incidence of wound infections were found
when using staples compared to patients receiving a nylon suture. The nylon suture is different from
the vicryl suture and as a non absorbable material and have different properties to that of the vicryl
suture. This however was a much bigger sample size of 513 patients, randomised into two groups,
262 patients receiving a nylon suture and 241 patient's staples as closure material for their wounds
after orthopaedic surgery. It was concluded that as many as 36 patients in the staple group contracted
infections compared to the 14 patients in the nylon suture group. Also recorded in this study was the
incidence of wound dehiscence and a higher number were found in the patients that received staples
at 29 patients compared to 25 in the nylon suture category. Murphy et al (2004) mentions that
removing the nylon sutures were more painful to patients and took longer than having skin staples
removed. Nylon sutures are non–braided and have a reduced risk of infection as it lacks the grooves
and rough surface for pathogens to attach

Wound Healing Essay
Introduction
Wound healing is the final process in inflammation at which the architecture and the function of the
tissues were repaired after an injury.[1] Basically, before wound healing takes place, inflammation
occurs at which it helps to eliminate the injurious agents and if elimination is not possible,
inflammation helps limiting the effects caused by the injurious agents. Finally, it prepares the site of
injury for healing process.[2] Picture taken from:
http://www.pilonidal.org/aftercare/wound_healing_indepth.php
Inflammation
Inflammation is a very important process where it can dilute, destroy and even neutralize the
injurious agents that causes the wound.[1] Without inflammation, the wound would never heal as
infections at the ... Show more content on Helpwriting.net ...
The vasodilation caused by inflammatory response slows down the blood flow and the large
leukocytes, which move slower than the small size red cells were pushed out from the axial flow,
resulting in the increased leukocytes concentration adjacent to the endothelial cell lining.[1] The
process of accumulation of leukocytes at the peripheral of vessels is known as margination.[1]
 Adhesion
The adhesion of leukocytes to the endothelial surface is mediated by integrins which appears on the
surface of leukocytes, interacting with their subsequent ligands on the endothelial cells.[1] The
integrins are usually of low affinity and do not adhere to their ligands unless the leukocytes have
been activated by chemokines.[1] Once leukocytes are activated by chemokines, their integrins
undergo conformational change and convert themselves into high affinity form.[1] On the other
hand, cytokines such as tumor necrosis factor–α (TNF–α) and interleukin–1 (IL–1) will activate the
endothelial cells, increasing their ligands' expression for integrins.[1]
Some examples of ligands are intercellular adhesion molecule 1 (ICAM–1), which binds to LFA–1
integrins and vascular cell adhesion molecule 1 (VCAM–1), which binds to VLA–4 integrins.[1]
Once the leukocytes with specific ligands recognize its integrins, it will bind to it and this binding
process is known as adhesion.
 Emigration
After the leukocytes adhere to the

Honey Uses on Wound
[pic]
[pic][pic]
Training Correspondence Course
[pic]
CONTENTS
1. The company and the brand 2. The Medihoney™ products 3. How to use Medihoney™ wound
products 4. Potential side effects 5. General questions 6. Medihoney™ products for use on unbroken
skin 7. References 8. Product range 8.1 Medihoney™ Antibacterial Medical Honey™ 8.2
Medihoney™ Antibacterial Wound Gel™ 8.3 Medihoney™ Derma Cream 8.4 Medihoney™ Barrier
Cream
[pic]
Comvita NZ Limited
Wilson Road South
Private Bag 1
Te Puke 3153
0800 504 959
This document, or part of, may not be reproduced or transmitted in any form without the ... Show
more content on Helpwriting.net ...
Recently advanced biomedical research has identified specific plants that produce honey with
exceptional antibacterial properties i.e. Leptospermum sp., of which Manuka is the best recognised.
This property is extremely stable and can be referred to as 'non–peroxide activity'. The specific
honey 'blend' used in the Medihoney™ antibacterial honey has been developed to maximize honey's
potential to heal. 4) There are more published research articles on the Medihoney™ products than
any other honey brand, giving end–users confidence in the products. Medihoney™ dressings are
currently used by hospitals worldwide and an ongoing research programme is in place.
2.0 The Medihoney™ Products

What are the Medihoney™ products?
Currently the Medihoney™ range includes an Antibacterial Medical HoneyTM and an Antibacterial
Wound Gel™, which both come in a tube. Either of these is appropriate for application to an open
wound.
The range also includes a Derma Cream and a Barrier Cream, which both contain a range of natural
ingredients including Medihoney™ antibacterial honey. The Derma Cream is appropriate for dry
skin conditions, while the Barrier cream will protect skin in 'wet' areas, such as under nappies.
Medihoney™ wound products
Tell me more about each of these wound products?
Medihoney™ Antibacterial Wound Gel™ contains 80% Medihoney™ antibacterial honey combined
with 20% waxes. The waxes change the viscosity of the honey to provide

Wound
Wound V.A.C. – KCI Protocol Emergency General Surgery Service Vanderbilt University Medical
Center 10 / 2004
Contributors: Sarah Debelak, APRN–BC Amanda Estapa, APRN–BC Ashlee Piercey, APRN–BC
Dr. Jose Diaz, Jr., M.D. STATEMENT OF PURPOSE: POLICY: Define process for implementation,
application, and management of negative pressure therapy
The Wound V.A.C. will be provided to patients based on physician order
PROCEDURES: I. Indications for V.A.C. Therapy A. For patients who would benefit from sub
atmospheric (negative) pressure therapy for promotion of wound healing B. For patients who would
benefit from drainage and removal of infectious material or other fluids from wounds under the
influence of continuous and/or intermittent sub ... Show more content on Helpwriting.net ...
unit settings per the Recommended Guidelines for Treating Wound Types Press THERAPY
ON/OFF button to activate the negative pressure therapy Observe wound site for collapse and seal
of the dressing 1. If collapse and seal are not apparent, assess dressing for leak which may create a
whistling sound 2. Often leaks are fixed by gently pressing around the drape around the and/or
edges of the foam to better seal the drape 3. Can also use excess drape to patch over leaks
VI.
Dressing Removal A. Raise the tubing connectors above the level of the therapy unit B. Tighten
clamps on the dressing tubing and canister tubing and disconnect C. Press THERAPY ON/OFF to
deactivate the pump D. Gently remove drape from the skin E Gently remove foam from wound 1. If
foam dressing adheres to wound base, introduce 10–30 ml of normal saline into foam, let stand, and
then remove 2. If foam dressing adheres to wound base, may consider applying a single layer of
non–adherent, porous material such as Adaptic, Xeroform, or Mepitel to serve as a barrier between
the wound base and the foam dressing F. Discard disposables in accordance with regulations
Maintaining the V.A.C. Device A. The V.A.C. canister should be changed when full (unit will alarm)
or weekly B. Patient may be disconnected from unit for specific activities, but no more than 2 hours
per 24 hour period C. To disconnect from the unit: 1. Close clamps on the tubing 2. Turn the unit
OFF 3. Disconnect the dressing tubing from canister

Wound Assessment Essays
Introduction The process of wound assessment requires accurate and appropriate interventions while
dealing with the patients. There are some major components which the operator must consider to
effectively access an infection, and they require a range of skills and knowledge. These factors are
the knowledge of relevant anatomy and physiology, the understanding of the various factors that
accelerate wound growth, and the ability to listen and understand the patient's needs. In wound
accessing, the doctor should have an idea concerning the number and location of wounds, the
required treatments depending on the type of infection, the type of wound in accordance to various
grading given, and the procedures to follow to achieve the treatment ... Show more content on
Helpwriting.net ...
Question 1: Importance of having information concerning the postoperative assessment during
nursing admission The assessment of the patient's care needs is based on the type of infection. As
such, nurses have the responsibility of providing a high quality health care to the patients. The
postoperative assessment involves assessing the patient's perceptions related to behavior and
physiologic responses. It also involves the monitoring of the pain from the patient during the
treatment period based on the operations performed. In postoperative assessment, the patient's
wound is monitored in relation to the healing frequency, pain felt, and the availability of some
foreign substances like the body discharges. Obtaining the information relating to post operative
assessment ensures that the patient is well taken care of by the nurse after operations, and avoids
incidences of other circumstances that might hinder quick healing (Grocott, 2007). Once the patient
gathers the information concerning the postoperative assessment, then a decision is made whether to
seek medication from the same hospital or look for other alternatives. In the case of Sophie, it was
clear that the nurses were not keen in following the postoperative assessment, therefore, causing the
wound to obtain infections.
Question 2: Role of nurses in consent procedures involving anesthesia Nurses are responsible for
preparing their patients undergoing the surgery

Wound Healing Case Study
Wound healing is an intricate process, whereas the skin may heal itself after an injury. At the time of
injury, the inflammatory phase begins and is noted as a significant time, because this process
prepares the wound environment for recovery. Since Mr. Jones laceration is five days old, suturing
the laceration may not be appropriate. The wound was not stitched and allowed to heal by primary
intention (first intention), because scarring is minimized during this process and no tissue loss is
noted. Mr. Jones wound will have to heal by primary intention. Cleaning the laceration daily and
applying a clean dressing will invoke healing. Since Mr. Jones will be a risk for infection, the
continuation of antibiotics will be beneficial. Mr. Jones ... Show more content on Helpwriting.net ...
Since AIDS (acquired immune deficiency syndrome) is a disease of the immune system caused by
HIV, which is a retrovirus that causes acute immunosuppression. HIV can produce an increase in
fatal diseases which includes wasting syndromes and central nervous system disintegration. People
with acquired immune deficiency syndrome (AIDS) develop opportunistic infections once the
immune system becomes severely compromised. A patient's CD4 T–cell is directly related to the
risk of developing an opportunistic infection. Additionally, HIV most frequently infects CD4 cells.
The CD4 cell count is a key gauge of the health of the immune system. CD4 levels lower than 200
will be at risk for an opportunistic infection. .Patients with AIDS routinely receives a test called the
CD4 test. This blood test is taken to count several types of cells. Moreover, this test do not count
CD4 cells, it is a calculation based on total white blood cells and the proportion of cells that are
CD4. The blood sample is tested to count several types of cells. Interpretation of this test does not
count the CD4 cells directly. Instead, the laboratory makes an estimate based on total white blood
cells and the percentage of cells that are CD4. Therefore, the CD4 count is not exact. When the CD4
cells has gone down, it is indicative of a weakened immune system. The lower the CD4 cells, the
more probable the patient will become sick. A patient loses the ability to fight infection when the
CD4 cells have gone down. Once the patient has lost the ability to fight off germs, an opportunistic
infection such as pneumonia, skin infections, oral disorders, diarrhea, AIDS related dementia,
Kaposi sarcoma, and CNS disorders may occur. Routinely patients are advised to check CD4 cells
every three to six months when initiating antiretroviral treatment and once levels has increased, test
every six to twelve

Honey As A Homeopathic Wound Care
Honey As A Homeopathic Wound Care
"If the bee disappeared off the face of the earth, man would only have four years left to
live" (Maeterlinck 317). When Maurice Maeterlinck wrote The Life of a Bee, he truly realized
the bee's importance to our environment, however did he recognize the importance of their
honey to medicine. Many people will argue that old–fashioned treatments are less effective than
modern medicines. While traditional medicines are simple and more easily applied, in most
cases, people will still be of the opinion that modern is better. A prime example of the
supremacy of traditional remedies is found within honey, which has been proven by numerous
studies to support bodily healing of all kinds more ... Show more content on Helpwriting.net ...
Pharmacies will always have a problem with the shelf life of general products,
specifically moist coverings for open wounds. Conversely, honey has many qualities that allow
it to have a near infinite shelf life permitting it to be stored for as long as necessary to be used
effectively (Geiling). This attribute of honey grants it an ease of access allowing it can be
transported from where it is collected to where it is needed. Honey can be found in bee farms
across the globe so there is nowhere that would be starved of this medical miracle worker. Bee
farms work through a series of manmade bee hives that will function as a normal bee hive would
by producing honey from nectar. Once they have produced enough honey, a beekeeper will
come and harvest some, but not all of the honey as to not hurt the population of bees in their

On the more tangible side of honey are its many positive physical properties responsible
for its extensive shelf life. Included in these properties is the fact that honey is a Hydroscopic
substance meaning that it contains very little water but has the capability to absorb copious
amounts of water if it comes in contact with the honey (Geiling). Most microscopic organisms
cannot survive in this type of

Surgical Wound Essay
Although pilonidal sinus cannot be considered a debilitating disease, patients are confronted with
discomfort and a lower degree of quality of life due to some complications like the formation of
abscess, sinus–related drainage, and pain12,13. The recurrence is often due to the omission of any
tract during the initial operation, infection of the wound, or abscess formation, that may lead to the
formation of the new sinus tract inside the cicatrizing surgical wound. Accumulation of debris or
dead tissue in the intergluteal cleft, sweating, friction or poor hygiene are the predisposing factors
for recurrence14. Also, placing the suture line on the midline with considerable tension on the line
and failure to lessen the depth of the natal cleft ... Show more content on Helpwriting.net ...
However, similar wound infection rates have been reported in adult and pediatric populations with
saline irrigation versus 1% povidone–iodine. A well–established disadvantage is its cytotoxicity to
healthy cells and granulating tissues. The solution dries and tends to discolor skin. It may also cause
local irritation to the peri–wound skin25. 73(36.5%) patients in the povidone iodine group reported
wound itching following dressing, which stopped within two weeks. Brownish discoloration of the
granulating tissues was reported by all patients in this group. There was no difference between the
Povidone iodine group and the other groups regarding cosmetic healing of the laid open wound. No
local or systemic adverse effects of Povidone iodine use or signs of toxicity were observed or
reported by any patient in our

Wound Care Education
Wound Care Education
Abstract
The purpose of this paper is to identify a patient health issue that would benefit from patient
education. During the clinical rotation at Jackson South the group identified a need in wound care
especially for patients with other underlying health issues such as diabetes. A large percentage of
patients had wounds that would require patients to properly care for them once discharged. The
group identified a lack of patient knowledge on how to care for these wounds and decided to
develop a patient education pamphlet to teach patients how to care for wounds while not in a
hospital setting. The group identified one particular patient that had insufficient knowledge in self–
care.
Wound Care
J.G. is a ... Show more content on Helpwriting.net ...
As well as explain to J.G. other health behaviors that will contribute to the healing process. It is
important for J.G. to have the proper nutrition because it will aid healing as well as managing his
blood sugar since he's diabetic. Since he is diabetic and is susceptible to loss of sensation and
circulation, it is important that he wears loose shoes and shoes that protect the toes from friction and
hitting objects. Mobility is also a significant factor (Heller, 2014). If J.G. cannot get out of bed and
walk a round, it is important for his daughter to turn him ever 2 hours to avoid pressure ulcers from
forming. J.G. has a history of wound infection. If there is any presence of pus or bleeding, excessive
pain, or odor, the wound may be infected. It is essential that J.G. and his daughter know what signs
may indicate infection and that they call their health care provider if infection is suspected. If
infection develops it can have a great impact on the wound healing process and can lead to
hospitalization (Grothie & Ousey, 2014). This can lead to chronic wounds. Chronic wounds are
slow to heal and take over 6 weeks. Chronic wounds might need a referral to a wound clinic. A
wound clinic will help the patient develop a healing plan and monitor the size and progress of the
wound. In part of patient education it is important to refer to additional resources outside of the
hospital setting (Heller, 2014). The ultimate goal for J.G. and his daughter is

Wound Bed Essay
THE ROLE OF DEBRIDEMENT IN WOUND HEALING OF PATIENTS WITH DIABETES
FOOT ULCERS (REFLECTIVE ANALYSIS)
INCIDENT
As a registered nurse with over 10 years of clinical practice experience in various field of nursing
including caring for patients with diabetic foot ulcers (DFUs), I was concerned with rise in the
numbers of DFUs cases resulting into higher rates of amputation, disabilities and mortality . DFU
are caused by a combination of peripheral neuropathy and vascular diseases resulting from diabetes
mellitus (Army and Tanja, 2012). Statistics provided indicate that a limb is lost to improper
management of DFUs every 30 seconds somewhere in the world (International Diabetes Federation,
2005). In addition, over 85% of lower ... Show more content on Helpwriting.net ...
ANALYSIS – ROLE OF DEBRIDEMENT IN WOUND HEALING OF PATIENTS WITH
DIABETIC FOOT ULCERS (LITERATURE REVIEW)
Since the concept of wound bed preparation arose (Schultz et al, 2003), striving to achieve a wound
environment that is conducive to healing has become increasingly important (Dowsett, 2002).
Debridement plays a crucial role in this concept. Eliminating non viable tissue from wound bed
which acts as a significant barrier to wound repair if not removed (Dowsett and Claxton, 2006). The
presence of necrotic tissue in wound has known deleterious effects including sepsis and delayed
healing. Debridement is therefore an essential adjuct in treatment of non healing ulcer (Anu, Emane
and Morris, 2001). Debridement is the removal of devitalized or contaminated tissue within or
adjacent to wound until surrounding tissue is exposed (Smith, 2002).According to International
Diabetic Federation (2004), removal of dead or devitalized tissue is paramount for effective wound
care of DFUs. Frykberg et al, (2006) advocate regular debridement to remove necrotic tissue and
reduce burden in order to expedite wound healing. Although it is widely accepted that debridement
may be necessary for optimal wound healing for DFUs, evidence from randomized trials relating to
the effectiveness of its different method is lacking and method of measuring its effectiveness are
poorly developed (Haycock and Chadwick, 2012). Debridement has always been

Wound Cleaning Research Paper
When the majority of the wound is not covered by necrotic tissue (at least 75%) our treatment
should be focused on selective debridement. With this type of removal we will only be working with
the necrotic tissue. Depending on the physicians order we may use this in our treatment. Another
important aspect is wound cleansing. Every time the dressing is changed they should clean the
wound. We should avoid using hydrogen peroxide, soap, povidone iodine because they could
damage the healing process. The recommended solutions are water (drinkable tap or sterile) and
normal saline. We should also consider using syringe irrigation to apply the solution. Finally, wound
moisture is another important aspect we would need to take into consideration.

Wound Assessment
Wound characteristics Location of the wound A wound assessment was performed on perineal area
of the patient. It was considered as a chronic wound due to delayed in the healing. Level of Exudate
An extensive amount of seropurulent discharge was present when a dressing was removed. Peri–
wound skin The skin around the wound was slightly moist. A slight maceration on the edge of the
wound was also noted with a lightly sloping border. Erythema was also present around the wound.
According to Carville (2012, p 31) 'erythema occurs with vasolidation of capillaries in the skin as a
result of blushing, temperature changes, thermal injury, an inflammatory response to healing or the
presence of infection'. Depth/Wound measurements The wound was measured, where the length was
approximately 8 cm with a width that varies from proximal to distal, 0.5 cm and 0.45 cm,
respectively. Moreover, a depth of the incision was between 4 and 5 cm from the time it was
measured without undermining. Wound odour Skin was not well approximated and there was a
presence ... Show more content on Helpwriting.net ...
The wound was initially cleansed with water or normal saline. The principle of aseptic technique
was applied. The soaked gauges was used to clean the surrounding skin. Moreover, when cleaning
the depth of the wound, a circular motion was observed, to allow the removal of suspected biofilms.
According to Carville (2012, p 78), 'a gentle cleansing technique is used to remove excessive
exudates, whilst a more vigorous approach may be required to remove foreign bodies or suspected
biofilms which retard healing'. The wound was lightly dressed with large combines and secure with
Transpore. Due to an identified Staphylococcus infection, intravenous antibiotics were commenced;
and at times, the dressing was changed to mesorb, a super absorbent non–adherent dry dressing used
to allow absorption and to contain large amount of

Abdominal Wounds Research Paper
Chest and abdominal wounds were nearly always fatal. Treatment of abdominal wounds often
involved pushing in protruding organs and suturing the wound. Food was withheld because fecal
material leaking from the intestines caused contamination. Opium was often administered to halt the
action of the digestive system. Chest wounds were cleaned and the wound was sutured. Abdominal
wounds were fatal in almost 90 percent of the cases reported by Union surgeons.
An example of this is the case of Henry A. Barnum. Major General Henry A. Barnum was injured at
Malvern Hill, Virginia on July 1st, 1862, by a musket ball that passed through his left lower
abdomen. The ball penetrated his intestines and hip bone. The wound was determined to be fatal and
he was left in a field hospital. A few days later, he was captured by the enemy and taken 18 miles to
Libby Prison. Fifteen ... Show more content on Helpwriting.net ...
The grisly wounds caused by bullets and shrapnel were often contaminated by clothing and other
debris. Cleaning such a wound was time–consuming and often ineffective. However, amputation
made a complex wound simple ("To Bind Up the Nation's Wounds"). Amputation performed within
24 to 48 hours after injury was considered a "primary amputation." A "secondary amputation" was
one performed more than three days after injury. Surgical manuals taught that an amputation should
be performed within the first two days following injury. Confederate General Thomas J. "Stonewall"
Jackson, who had his left arm amputated, was said to have stated that the sound of the saw on the
bone was the sweetest music he had ever heard. He also described chloroform as "an infinite
blessing" (Wheat, T. A.). Of the approximately 30,000 amputations performed in the Civil War there
was a 26.3–percent mortality rate. In the 1870 Franco–Prussian War, despite the lessons learned in
the Civil War, the mortality rate for amputations was 76 percent (Burns, Stanley

Quick Wound Assessment
Within the authors current practice setting, patients are mobile and walk into the clinic for a quick
wound assessment. On occasion, patients are wheelchair bound due to various health reasons and
need to be assessed for sacral pressure injuries. Other common pressure injuries include heel ulcers
from nursing home bed ridden patients, and diabetic foot ulcers related to pressure injuries from
improper footwear. At the initial visit, the patients health history, current medical status, mobility,
and ulcer condition are assessed to establish baseline information. From this data, the doctor,
patient, and family can create a care plan with focus on areas in need of improvement.
The RPNAO guideline places emphasize on health history and medical status within
recommendation 1.1 and 1.7. (1) Through the health and psychosocial history, the clinician can
understand what conditions may affect wound healing, lead to further stress on the patient, or place
the patient at risk for infections. Within this category, the history of ulcer development is discussed
along with current or past treatment plans. (1) The authors experience has shown a thorough and
focused interview can take 5–10 minutes and establishes both the patient and family members'
knowledge, expectations, values, and ... Show more content on Helpwriting.net ...
Each assessment uses numerous aspects of the guideline to guarantee appropriate and complete
assessments are performed and appropriate recommendations are made for the patients to take
home. Entrusting the complete circle of care to assist the patient in daily needs, focuses on healing
through the psychosocial and inter–professional care. Education for patients, family, and other
health professionals is performed at each visit and can also aid in evaluating the patients and
family's understanding of the healing process thereby directing the learning information and

Phases of Wound Healing
(A)Wound healing is a biological process occurring in the human body. In this lecture we had
discussed about both acute and chronic wounds. An acute wound is an injury to the skin that occurs
suddenly rather than over time. It heals at a predictable and expected rate according to the normal
wound healing process. The chronic wounds do not heal in an orderly set of stages and in a
predictable amount of time the way most wounds do.
The normal wound healing process mainly consists of four main stages being haemostasis,
inflammation, proliferation or new tissue formation, and tissue remodeling or resolution. For a
wound to heal well the above mentioned stages should occur in a sequential and orderly manner.
Disturbances, abnormalities ... Show more content on Helpwriting.net ...
The main function of neutrophils is to clear the wound region from being exposed to
microorganisms and remove the debris near the wound area, although they end up producing some
proteases and reactive oxygen species which causes some minor damages. Monocytes appear in the
wound after this and differentiate into macrophages. These macrophages produce cytokines which
recruit and activate specific leukocytes that promote inflammatory response. Macrophages along
with neutrophils help in removing the apoptotic cells. During this process the macrophages undergo
phenotypic transition to stimulate keratinocytes, fibroblasts, and angiogenesis to promote tissue
regeneration, thereby promoting the transition from inflammation to proliferative phase of healing.
The next event in inflammation is T–lymphocytes migrating to the wound site. Although their role is
not yet clearly understood, studies using mice models have revealed that delayed T–lymphocyte
infiltration and decrease in concentration of these cells may lead to impaired wound healing.
Specifically the dendritic epidermal–cells (DETC), due to their unique dendritic morphology,
transform keratinocytes and produce fibroblast growth factor 7 (FGF–7), keratinocytes growth
factors, and insulin–like growth factor–1, to support keratinocyte proliferation and cell survival.
The third phase is proliferation or new tissue

Wound Healing: A Case Study
The Role of Nutrition involving Wound Healing
While reading chapter one of the book "Nutrition Essentials for Nursing Practice" (2014), I
developed interest on the physical symptoms suggestive of malnutrition. According to Susan G.
Dudek a nursing diagnosis has to be based on a patient first nutritional assessment (p.9–11). Dudek
stated in her book the four steps of a nutritional care process in which assessment is the primary
stage of this concept. However, since the word assessment incorporates the patients physical
findings, poor or delayed wound sores can be determine by the inadequate malnutrition of a human
being (2014).
According to Brown & Phillips (2010) several biological process in the skin require nutrients for
proliferation. The

Description Of ' Nutri  ' On ' And ' Chronic Wounds '
Arcle Title: Nutrion and Chronic Wounds
Molnar, J.A., Underdown M.J., Clark, W.A. (2014). Nutrion and Chronic Wounds. Advances in
Wound
Care, 3(11), 663–68
Wound
Care, 3(11), 663–68
Wound
Care, 3(11), 663–68
Wound
Care, 3(11), 663–68
Wound
Care, 3(11), 663–68
Wound
Care, 3(11), 663–68
Article Title: Nutrition Strategies for Wound Healing
Posthauer, Mary Ellen, RD, LD, CD. (2012) Journal of Legal Nurse Consulting, Volume 23,
Number 1.
Maintenance of sufficient nutrition is an essential part of the treatment process for any patient
admitted to the hospital. Early identification of patients who have a decreased nutrition status or
have nutritional deficits helps to increase healing and overall improves the quality of life for a
patient. Nutrition is more than just general food; it includes the overall amounts of

Contac Contact Wounds
A contact wound is one in which the muzzle of the weapon is held against the body at the time of
discharge. In contact wounds, gas, soot, and vaporized metal from the bullet and cartridge case,
primer residue, and powder particles are all driven into the wound track along with the bullet.
(DiMaio 1998)
In hard contact wounds, the muzzle of the weapon is held very tightly against the skin or clothing of
the victim, indenting it so that the skin/clothing covers the muzzle at the time of discharge,
essentially forming a seal. This seal prevents the escape of the gases due to combustion, forcing
them and other materials emerging from the muzzle into the wound, often leaving very little external
evidence. However, upon further inspection, you will note searing and soot (black powder) around
the immediate edge of the wound. (Crankshaft, n.d.) ... Show more content on Helpwriting.net ...
These types of wounds are most common in the head and are caused by the effects of the gas upon
discharge. When the gun is fired, the gases caused by the combustion of the propellant escape the
barrel in a highly compressed state and enter the skin into the subcutaneous tissue where the gases
expand. In a contact wound to the head, these gases will expand between the skin and outer layer of
the skull, lifting the skin up, much like an expanding balloon. If the skin is not elastic enough for the
expansion, it will tear, producing the "stellate" or cross–like appearance. Another type of wound to
the head may occur, other than a stellate or skin tear as the skin may balloon out against the gun
muzzle with sufficient force to imprint the muzzle onto the skin, sometimes in great detail. These
types of imprints can also occur in the chest and abdomen. (DiMaio

Wound Relationship Study
Addressing a chronic wound requires a myriad of individuals, each with their own unique
knowledge, and expertise, to contribute to complete wound healing. (1) This collaboration goes
against the discipline–based training instilled in schools and requires establishments to further
investigate the collaboration paradigm. (2) In order for interdisciplinary teams to work effectively,
elements such as trust, respect, adaptability, openness, and communication need to be effective. (1,3)
In the team–link study by Harris et al., a review of the current multidisciplinary teams in Australia's
divisional health care system were reviewed. Although general practitioners (GP) in each division of
practice had great support systems for each other, flaws were ... Show more content on
Helpwriting.net ...
Caregivers are trained to provide aseptic wound care, patients are closely monitored compared to
their own home setting, and physicians are always nearby to reassess wounds as needed. So where
do these infections come from? Literature reviews have opened the gateway to further questions and
investigations in order to answer this question. Comparing multiple studies listed in table 1, there
are still many unanswered questions as to where infections originate. Most studies are looking into
various prevention methods and the organisms present postoperatively, but do not address the
question of why these infections are occurring. Strengths and weaknesses in all studies show that
one needs to evaluate the studies carefully before consideration for implementation as

Wound Care
Wound care (Pressure Ulcer)
Descriptions
During community placement, my mentor and I visited M (patient), a 75years old lady, who was
presented with a Pressure Ulcer, on the heel of her right leg. On arrival, my mentor asked me to
manage M's wound. However, I have observed and participate in carrying out this skill (wound care)
with my mentor on several occasions. I explained the procedure to M and gained her consent to
carry out the procedure.
The preparation and application of aseptic technique was quite challenging in M's home, however I
washed my hands, worn apron and gloves, and adopt aseptic technique. When I remove the old
dressings and assessed the wound, I observed that M's wound was slightly exudates, odour, sloughs
and dry ... Show more content on Helpwriting.net ...
Barrett (2009) concurs that, the management of wound required dressing that can maintain a moist
environment, absorbs exudates as well as remain in situ over number of days.
As a novice practitioner, I found it quite challenging carrying out aseptic technique in M's home.
Hallett acknowledge this situation and state's that
"The nature of the home environment makes it difficult to maintain control over any procedure, but
particular problems arise when the procedure involves trying to prevent contamination" (Hallett
2000 cited in Unsworth 2011).
Another bad situation was when M asked me 'How is the wound?' I could not answer her and my
mentor had to rescue me. NMC (2004) warns that, Nurses are accountable for their actions in
practice and it's the nurse responsibility to explain treatments to the patients.
Analysis
On assessment, the wound was slightly exudates, odour, sloughs and dry skin patches on the
surroundings. Sprakes (2010) state that, holistic assessment of patient and the wound are essential in
order to facilitate the wound healing process. Ousey and McIntosh (2010) points out that, chronic
wounds are exacerbated by a sequence of misdiagnosis, neglect, incompetence or inappropriate
treatment strategies. I observed that, M's wound was with exudates and sloughs; this

Head Wounds
Perform First Aid for an Open Head Wound
Conditions: You see a casualty who has an open head wound. The casualty is breathing. You will
need the casualty's emergency bandage or field dressing and a canteen of water.
Standards: Apply a dressing to the wound following the correct sequence, without causing further
injury to the casualty. Properly position the casualty and secure the dressing without applying
unnecessary pressure.
Performance Steps
1. Check the casualty's level of consciousness.
a. Question the casualty.
(1) "What is your name?"
(2) "Where are you?"
(3) "What is today's date (day, month, and year)?"
STP 21–1–SMCT 18 June 2009 081–831–1033 3–69
Performance Steps
b. Report incorrect answers, inability to answer, ... Show more content on Helpwriting.net ...
(2) Wrap one tail down under the chin and bring it up in front of the ear over the dressing to a point
just above, and in front of, the opposite ear.
WARNING
Ensure the tails remain wide and close to the front of the chin to avoid choking the casualty.
(3) Wrap the other tail down under the chin in the opposite direction and up the side of the head to
meet the first tail.
(4) Cross the tails.
(5) Wrap one tail across the forehead above the eyebrows to a point just above and in front of the
opposite ear.
(6) Wrap the other tail above the ear, low over the back of the head, and above the opposite ear to
meet the other tail.
(7) Tie the tails using a nonslip knot.
c. Side of the head or cheek.
(1) Apply the dressing, white side down, directly over the wound with the tails extending up and
down.
(2) Wrap the top tail over the top of the head, down in front of the ear, under the chin, and up over
the dressing to a point just above the ear.
(3) Wrap the other tail in the opposite direction to meet the first tail.
STP 21–1–SMCT 18 June 2009 081–831–1033 3–71
Performance Steps

(4) Cross the tails and complete the procedure as follows:
(a) Wrap one tail across the forehead above the eyebrows to a point just above, and in front of, the
opposite ear.
(b) Wrap the other tail above the ear, low over the back of the head, and above the opposite ear to
meet the other tail.
(c) Tie the tails using a nonslip knot.
5.

Silver Impregnated Wounds
Silver impregnated dressings have been used extensively over the past few decades in the
management of chronic wounds and burns. Before the 1800s, Silver was used for the treatments of
ailments such as seizures, leg ulcers, skin infections, partial burns, surgical wounds, perinanal
abscesses, disinfection of fluid and sexually transmitted diseases. By mid 1900s, the use of Silver
started to expand and was used in different forms such as dressings, eye drops, powder and so on.
Silver nitrates were also used as antibiotics to prevent eye infections after deliveries, MRSA,
Staphylococcus aureus, B–hemolytic streptococci, Pseudomonas aeruginosa and Escherichia Coli
(Castellano et al, 2007, pp. 114–115). Nevertheless, adverse effects were not monitored. ... Show
more content on Helpwriting.net ...
Wounds have a major impact on an individual's quality of life due to many factors such as pain,
infection, increase drainage and foul odor. Factors such as diabetes, hypertension, coronary artery
disease, nutrition, peripheral vascular diseases, vitamin deficiency, smoking, infection, stress,
obesity, and medications can affect wound healing. The presence of those factors that can impede
wound healing makes it crucial for accurate assessment, early diagnoses and appropriate treatments.
Thus, choosing appropriate treatments in the management of chronic wounds is vital to wound
healing. Silver dressings have been shown to be very effective in the treatments of chronic wounds
and leg ulcers. Due to the advance in technology, the use of Silver has expanded. Nowadays, there
are many types of Silver impregnated dressings such as elemental silver, inorganic compound,
organic compound and silver nitrates. Choosing appropriate silver impregnated dressings is vital to
wound management and cost savings. The roles of the CWCN is to obtain a thorough history,
provide correct assessment and diagnoses, recommend appropriate treatments, educate staff and
patients on types of dressings, intended/ adverse effects, proper dressing changes, collaborate with
multidisciplinary teams such as dieticians for proper nutrition, physicians, surgery, vascular lab,
nurses and so on. In addition, the CWCN is responsible to develop regular in service on wound
assessment and new

Difficult Wounds Research Paper
Wound treatment is challenging but crucial as soon as a wound or injury occurred or discovered.
Wounds or injury depending on the seriousness of the problem needs to be initially treated by the
athletic trainer and referred to a medical practitioner to initiate the correct treatment and prevent
short or long–term complications.
Treatment of difficult wounds needs a total history of the patient that includes an individualized
approach to successfully treat the type of injury the individual has.
https://emedicine.medscape.com/article/194018–treatment
Wound infection especially open wounds can become a serious problem especially for individuals
with compromised immune systems such as Diabetes Mellitus, people who do not seek medical
treatment ... Show more content on Helpwriting.net ...
NATA states that "woven and nonwoven gauze for clinically infected abrasions, avulsions, blisters,
incisions, lacerations, or punctures. Woven, nonwoven, and impregnated gauze for puncture wounds
that have cavities. Wound–closure strips with superficial, linear lacerations and postoperative
incisions under minimal static and dynamic tension. Woven gauze with superficial to full–thickness
abrasions, avulsions, blisters, incisions, and lacerations to achieve wet–to–moist debridement.
Woven and non–woven gauze, non–adherent pads, and adhesive strips or patches for superficial to
partial thickness abrasions, avulsions, and blisters and superficial–thickness incisions, lacerations,
and punctures as a temporary dressing and on irregular body surfaces." Once the dressing is
completed, it is important to observe the wound for any signs of infection such as fever, foul–
smelling wound drainage, swelling, redness, warmth and delayed wound healing. According to the
NATA's position statement, "the patient should be monitored for the development of adverse
reactions stemming from the use of some cleansing solutions, topical antimicrobial agents, and non–
occlusive and occlusive dressings. The individual must also be observed for rash, eczematous
reaction, vesicles, white discoloration, tenderness, nodularity, burning, pruritus, or systemic
reactions such as urticaria and anaphylaxis". To

Research on Wound Care
Wound Cleansing: Water or Normal Saline?
Ashtin Plummer
MidAmerican Nazarene University
Wound Cleansing: Water or Normal Saline? Wound cleansing has been discussed about for many
years, different solutions and techniques have been discussed to use, and it is an important part of
preventing infection. Wound cleansing is described as the use of fluids to remove debris and dead
tissue from the surface of the wound. The purpose of wound cleansing is to make the best possible
conditions at the wound site, for uncomplicated wound healing. The most commonly used solution
would be normal saline due to being an isotonic solution and it does not disrupt with normal healing
process of wounds (Ljubic, 2013). Normal saline has just been ... Show more content on
Helpwriting.net ...
Review of Literature
One of the articles that was reviewed to determine if tap water would be appropriate for wound
cleansing was a systematic review by Fernandez and Griffiths (2007). In this study, various
randomized and quasi–randomized controlled trials comparing the effects of water with other
solutions for wound cleansing were assessed. Of the nine trials used in this study, five trials were
identified that compared the rates of infection in wounds cleansed with water or normal saline
(Fernandez & Griffiths, 2007). These trials involved people of all ages, with a wound of any
etiology, in different settings including hospitals, communities, nursing homes, general practice, and
wound clinics. The trials also included an objective measure of wound infection, such as bacterial
counts, wound cultures, or wound biopsy (Fernandez & Griffiths, 2007). After data extraction
and analysis of the trials, the authors concluded that there was no statistical significance between
cleansing with tap water and normal saline (Fernandez & Griffiths, 2007). However, the
authors also acknowledged two major flaws in this review, including "the lack of consistency in the
criteria and validated tools of measurement used to assess wound infection, as well as insufficient
detail in reporting the method used for

Stab Wounds: A Case Study
Stab wound
Introduction:
Injuries produced by sharp force trauma produce a range of injuries, which include stab and incised
wounds. So, sharp force injuries differ from blunt force injuries as the latter produce by simple
impact, as well as the former inflict as a result of usage different weapons in a specific way which
will create wounds with variable natures.1
Universally, stab wounds are conceder as one of the most common means for homicide. The FBI
statistic in 2013 revealed that knives were commonly used as five time more than firearm in
homicide.2 Also, the usage of knives for murder are commonly occurred by male.3
History:
The deceased was a 21 year old Saudi male. On 14/3/1438 AH, according to his father report, the
deceased was ... Show more content on Helpwriting.net ...
An elliptical oblique wound at the lower right side of the back, had regular sharp well defined
margins and acute lower end and blunt upper end, extending deep to the muscle, measuring about 2
cm in length after approximation, and the upper end situated about 8 cm to the right of mid body
line, while the lower end situated about 10 cm to the right of mid body line (Fig.3).
The genitalia were those of a normal developed male with no obvious injury.
Upper and Lower Limbs:
The upper extremities showed the following recent injuries noticed:
1. An U–shaped abrasion, red in color, about 1 cm, located at the middle of the anterior aspect of the
right arm about 10 cm above the right elbow (Fig.4).
5. Three sharped edge wounds saw in the left hand, one of them located transversely at the palmer
aspect of the proximal phalanges of the index finger with medial extension about 3 cm long, while
the second was situated transversely at the palmer web between the thumb and index finger with
medial extension about 4 cm long, finally the third was situated obliquely at the palmer web
between the ring and little fingers with proximal extension about 2 cm long (Fig.5).
Lower extremities are symmetrical with no apparent injuries.
Upper and lower extremities:
The cuts wounds at the left hand were limited to the superficial layers of the

Wound Care
Case Study One
Identification of the Care that Mr Jones will require in relation to the safe management and
promotion of wound healing
This essay will focus on the holistic care of Mr Jones, with particular attention to the management of
his wound. The points that will be discussed and analysed are the role of the skin, wound
assessment, the nutritional status of Mr Jones and the problem of his obesity. Added to this, an
analytical discussion of the involvement of the multi–disciplinary team, the way that Mr Jones'
wound should be managed including the problem of infection and pain plus the suitable dressings,
which could be used. Lastly, health promotion for Mr Jones will be addressed.
It is important that the role and functions of ... Show more content on Helpwriting.net ...
(Pinchcofsky–Devin, 1994) Hoban (2005) supports the idea that nutrition can be overlooked
especially concerning surgical wounds.
The case study states that Mr Jones has spent the last six months on a diet that mostly consisted of
junk food. This is an indicator that Mr Jones could be malnourished. It is very likely that the junk
food he was consuming had low nutritional value yet high fat hence the 10 kilogram weight gain.
The nutritional status of Mr Jones is detrimental to the healing of his wound. Manley and Bellman
(2000) states "Tissue breakdown occurs when adverse factors such as malnutrition combine with the
predisposing condition. It is then that healing may be impaired". It can also be noted from the case
study that Mr Jones has a very poor appetite, added to this the fact that he has undergone major
surgery and may be having a high exudate loss from his wound indicates that he is at high risk of
poor nutrition anyway irrespective of the fact that he could have been malnourished prior to
admission (Gunnewicht and Dunford 2004).
In order for Mr Jones' wound to heal, his nutritional status would need to be improved as part of his
nursing care. An array of authors have noted that protein in particular is essential in wound healing.
Lewis and Harding (1993), state that protein is like a building block in the process of constructing
the wound bed. They also note that malnourishment of protein prolongs the inflammatory phase of
wound

Wound Product Selection Process
Infection control and wound product selection contribute to the wound healing environment.
It is the hypothesis of this report that infection control and wound product selection that is based on
best practice guidelines, will enhance wound healing in patients.
According to, International Best Practice Guidelines; Wounds International, 2013, 'With appropriate
and careful management it is possible to delay or avoid most serious complications'. When wound
care products are selected appropriately for the patients wound, and used as instructed, they are very
effective. Best practice wound care requires the nurse to be able to follow infection control
guidelines and choose the appropriate dressing to achieve optimal healing for patients. There are
many dressings to choose from, but failing to correctly assess a wound and chose the right dressing
will delay wound healing, potentially causing further distress to the patient and create further costs.
... Show more content on Helpwriting.net ...
'As a wound advances through the stages of healing so should the materials used, National institute
for health care excellence 2016' Advanced wound dressings such as hydrocolloids, hydrogels,
silicone dressings and foams are more expensive than traditional dressings. My plan is to make
advanced wound care products and dressings more easily assessable, through government funding
ensuring products are more affordable for patients.
Modern day dressings have advanced extensively throughout the past few years, providing nurses
with a wide range of dressings to choose from, all of which provide a different healing function.
This wide selection of wound care products can lead to confusion, resulting in the wrong dressing
selection and inappropriate usage of products. When choosing a wound dressing it will depend on
odour, pain, exudate and prevention or management of wound

Wound Healing
Review Questions
Write one–paragraph responses to 4 of the following 6 questions below. Each paragraph should be 5
to 10 sentences (or about 70 – 150 words), and written in your own words.
Session 2: Remember – choose 4 out of 6!
3. Explain the role of polymorphonuclear neutrophils (PMNs) in acute inflammation. How do they
emigrate to the site of injury or infection, and what do they do when they get there?
PMNs or neutrophils as they are more commonly known as are the first responders to the scene
when it comes to inflammation/infection since they are highly mobile and more common in the
blood stream which allows them to react quickly unlike other leukocytes. Their jobs are to search
and destroy any foreign material at the site. Through ... Show more content on Helpwriting.net ...
Collagen fibers play a big role in strengthening the scar by replacing immature to mature collagen
and to reorient it with surrounding tissue. Some times when the scar is not formed properly the
body; some additional assistance might be needed. A medical professional would apply force to the
scar in order to assist in reshaping it. Remodeling is an ongoing process, which can vary in times
within the first year to longer. But once the remodeling is completed, there are no more alterations
that can occur which can leave scars the inability to sweat or even feel sensation. It's important that
medical professional take in the consideration when dealing with wound closures to ensure proper
protection is used in order to avoid issues like

Wound Care: A Case Study
Wound care education for healthcare provider
A breakage in the normal arrangement of the cells with or without damage resulting in impairment
or functional loss is termed as wound. The nurses and physical therapists play a critical role in
wound care management and is effective as it helps in reducing the amputation rates and minimizes
the related complications and expenditure. Standardized protocols are needed to provide best
healthcare and practices (Health Service Executive, 2009). The potential of different solutions and
techniques in wound cleaning and preventing the spread of infection is still debated (Fernandez,
2007). Normal saline is mostly used for cleaning wounds, as it is isotonic in nature and does not
interfere in the healing ... Show more content on Helpwriting.net ...
This study will include several quasi– randomized and randomized studies. The studies that consists
random participants, large sample size and test measures that assesses the infection rates will be
shortlisted for this study to make it reliable. Trevillion (2008) in his study claimed that the varying
degrees of wound cases that came in the emergency department were cleaned better using tap water
than normal saline or other cleaning solutions. He concluded that tap water effectively reduces the
infection rates, is cheaper, and can be easily used by the patients to clean their wounds at home.
Moscati et al. (2007), in their study chose random population with wound in the emergency rooms
and divided the population in two groups of which few were subjected to cleansing by sterile saline
(200ml) with splash shield and the others by irrigating their wounds under normal tap water for 2
min. After 5– 14 days, they found a difference of 0.7% of infection rates in both groups, which was
not significant concluding that tap water and sterile saline were both safe for treating wound. Bee et
al. (2009) evaluated the effectiveness of the cleansing solutions by reviewing 7 out of 9 selected
articles including both randomized and quasi–randomized experimental studies based on their
reliability. They found no significant difference in the infection rates when used either of the
solutions (tap water vs. sterile saline) for treating wounds. However, after assessing 4 randomized
study, they concluded that saline enables effective wound healing while the tap water was effective
for irrigation and debridement if used appropriately. Salami et al (2006) conducted wound healing
experiments on rats with 2x2 cm full thickness wound on their dorso–ventral flanks, which were
treated with chlorhexidine, tap water or saline. They

Wound Healing Essay
The healing of wounds–particularly chronic wounds–is currently an important area of research. With
more than 6.5 million patients in the United States dealing with chronic wounds, and $25 billion
spent yearly on treatments (Sen et al, 2009), a better understanding of the wound healing process is
beneficial to a wide range of patients dealing with wounds related to accidents, burns, and disease
processes. It has been suggested that therapeutic strategies to promote wound healing might focus
on immune system modulation (Julier, 2017). The overall progression of a healing wound involves
multiple types of cells, cellular processes, and growth factors (Strbo, 2014). However, significant
contributions come from the response of the innate ... Show more content on Helpwriting.net ...
(Godwin & Rosenthal, 2014). Additionally, research has demonstrated that during wound healing,
changes occur in the thymus (the organ in which T–cell maturation occurs) revealing increases in
thymus size, changes in morphology, and proliferation of a variety of immune cells within the
medulla (Franchini & Bertolotti 2014).
Research Goals
We propose to study the relationship between the thymus, T–cells, and wound healing by
performing larval thymectomy to generate T–cell–deficient tadpoles and frogs. Alternatively, many
studies have demonstrated that mice missing the recombinase activating gene (RAG) are deficient in
functional B and T–lymphocytes (Thompson, 1992; Mombaerts et al, 1992; Belizário, 2009). Our
study can be accomplished by the use of RAG knockout frogs, which we hope to obtain. Regardless
of the method of obtaining T–cell–deficient tadpoles and frogs, wound healing will be evaluated by
a combination of molecular and histological techniques. Our goal is to better understand the role T–
lymphocytes have in wound healing.
Research Plan
Generating tadpoles and frogs without a thymus Microscope–guided electrocautery of the thymic
lobes will be performed on early–stage (Niewkoop Farber, NF, stages 42–48) tadpoles. The
procedure will consist of first anesthetizing the tadpole, then using sharpened tungsten wires
connected to an adapted power supply to pierce the thymic lobes and perform

Regenerative Wound Medicine
Regenerative medicine such as tissue replacement and wound healing has been used quite
extensively for skin treatments over the years. Understanding the pathology of skin injury will bring
effective treatments and wound healing outcomes. Several strategies like traditional skin grafts,
certain biomaterials, and stem cell therapies are vital for current tissue injuries and the future of
tissue regeneration.
Introduction and Pathology
The skin is said to be the largest organ in a human body. It is divided into 3 layers: epidermis (outer
layer or superficial layer of the skin), dermis (connective tissue, hair follicles, and sweat glands),
hypodermis (subcutaneous fat) (Chen, 2009). These layers act as a barrier by protecting the body
from environmental ... Show more content on Helpwriting.net ...
Stem cells are multipotent which give rise to multiple cell types and are known for their self–
renewing and tissue differentiation abilities. Research has shown SCs to have successful results in
the field of skin regeneration (Duscher, 2016). SCs of interest for wound healing include adult
mesenchymal stem cells (MSC's), embryonic stem cells (ESC's), and induced pluripotent stem cells
(IPSC's). MSCs are isolated mainly from the bone marrow and other tissues such as adipose and
nerve tissues and are administered locally as well as systemically with little to no immunoreactivity
(Tartarini, 2016). MSCs regenerative benefits in wound injury is not seen in its structural
capabilities rather it's seen in its escape of trophic mediators (Duscher, 2016). Bone marrow MSCs
injected in wound sites produce high amounts of collagen and growth factors leading to faster
healing, epithelialization, angiogenesis, and cellularity (Duscher, 2016). Studies also show that bone
marrow derived MSCs injected in injury sites had decreased wound size, increased vascularity and
dermal thickness (Duscher, 2016). Although MSCs for wound therapy has been proven effective and
well tolerated in patients, there still seems to be limitations such as invasiveness of their harvest,
cost of resources, and hazards that deal with growing cell cultures to attain healing

Wound Healing
Analysis: Psychological Stress and Wound Healing
**********FOCUS ON TRANSITIONS (FIX INTRO) Being especially stressed during exams/ at
work, and you cut your finger, you may notice that paper cut takes longer than usual to heal, or that
the pimple you popped seems to stay on your face for an eternity./ fin./ Wounds can be as simple as
a paper cut, or as extreme as the wound from a limb amputation. In both instances, fast healing is
promoted/wanted because the longer that a wound is open and exposed to air, the greater the risk of
infection and complications. This is why research into the factors that decrease healing time, or vice
versa is important. Psychological stress is a factor to which many people are exposed/subject to and
must deal ... Show more content on Helpwriting.net ...
Pressure wounds, caused by keeping weight on bony prominences for too long, are more likely to
develop eschar/ debride. In the stage of clot formation, which is the normal body's immediate
response to a tissue disruption/injury, involves a fibrin In both acute and long term care settings,
extended wound healing time keeps patients and take a toll on resources. Requires more care,
longer, more supplies. Especially, as mentioned above in burn units where the priority is expediting
the healing of tissue wounds is a priority. Resources cannot be used as they have to be sterile, so as
not to bring new bacteria into the wound bed. When the body is fighting off infection and trying to
heal a wound, it takes a lot of the person's resources that they can no longer allocate to fighting other
illnesses or recovering from or properly managing illnesses. A common example of this is seen in
individuals who have type II diabetes mellitus, as they tend to have significant wound healing
impairment because of poor circulation to extremities and the high blood sugar circulating which
tends to carry bacteria and postpone healing of the tissues

Wound Management Essays
Module Title Wound Management
Module code NURS09106
Banner No B00209786
Tutor Vicky Wilson
Assignment Assignment 2
Word Count 3222
Submission Date 3rd May 2011
Introduction.
The following assignment will take the form of a case study. The subject is a 79–year–old sikh
gentleman, who will be known as patient X. Patient X only speaks English as his second language.
Patient X has developed a wound on his right hip after being admitted a few days previously, after
suffering from a stroke. Patient X has a history of a mild stroke and has slow mobility and uses the
aid of a frame to mobilise. Patient X is obese, a heavy smoker and now ... Show more content on
Helpwriting.net ...
This increased evidence that smoking is associated with poor wound healing could be viewed as
bias though, as most of the studies have looked at surgical wounds and few have been concerning
chronic wounds (Sorenson, 2003). Nutrition– Mani (2003) claims that nutrition is a fundamental
role that must be adopted in the treatment and healing process of pressure ulcers. A balanced diet
with adequate nutrients should be key for all patients deemed to be at risk of pressure ulcers. Both
nutrition and hydration are the basic components in promoting wound healing and maintaining
normal tissue integrity. Patients at risk of pressure ulcers should be nutritionally assessed at regular
intervals (Shepard. 2003). This could have been adopted by the use of assessment tools such as, The
Nutritional Screening initiative. This tool includes nutritional screening at regular intervals and a
comprehensive assessment that includes nutritional assessment, functional assessment and
evaluation for depression. This comprehensive approach allows the nurse to quantify the nutritional
problems and initiate the appropriate resources that will meet with the individual needs (Bryant,
2000). Another optional tool is the Malnutrition Universal Screening Tool or MUST. This has been
designed by the Malnutrition Advisory Group (MAG) of the British

The Principles and Practice of Moist Wound Healingg
The Principles and Practice of Moist Wound Healing
Abstract
Caring for patients with wounds is commonly encountered in a nurse's career in most health care
settings, whether it is in neonatal, mental health, community, or aged care. In the past, wound
dressings were created to absorb all exudate, believing that dry wounds will reduce the risk of
infection. Within the last fifty years, the concept of moist wound therapy has become the most
effective approach to wound care. Before treating any wound, it is important to discover the
underlying cause and consider other possible factors that may impact on the healing process and
deliver a systematic and rational approach towards wound care assessment. Nurses must have a
basic understanding of ... Show more content on Helpwriting.net ...
Describing the overall appearance of the wound is necessary to classify it (Brown & Edwards,
200, p.223). Open wounds can be found in pressure ulcers that involve the skin separating apart,
whilst closed wounds the skin is held together mainly by sutures [FIGURE 1 page 3] (Dealey
& Cameron, 2008, p.68). Identifying the aetiology correctly also determine if the wound is
either acute or chronic and what depth of the tissue is affected (Brown & Edwards, 2008,
p.227).
Table 1
Basic Principles of Moist Wound Healing * Thorough assessment of the wound * Controlling
factors that may affect wound healing * Select appropriate moist wound dressing products *
Maintain and monitor wound progress
Source: (WUWHS, 2007).
Table 2
Common Causes of Wounds
Chronic Acute Ulcers Trauma * Pressure *Burns * Surgical *Crushing Injuries * Neoplastic
*Lacerations * Arterial *Gun shot * Venous * Neuropathic
Source: (Ireland, 2010).
Along with measuring the wound dimensions, a colour description of the wound bed [red, black,
yellow] along with the type and quality of exudate by

Wound Care Intervention Paper
Begin with a brief description of your project that includes your clinical question, your planned
intervention, the type of study you will conduct and how you plan to evaluate the outcomes.
Population–(P) Inpatients receiving wound care. Intervention– (I) Wound Care Education for Health
Care Provider. Comparison– (C) Usual care by a healthcare provider who has not participated in
wound care education. Outcomes– (O) Improving wound care skills among healthcare providers,
alleviation of pain resulting from improperly treated wounds, speedy healing of wounds. Time– (T)
6 months. The project will seek to establish the level which continued or frequent wound care
education for health care providers, especially the nurses would facilitate the ... Show more content
on Helpwriting.net ...
Adults beyond the age of 18 years will be considered eligible for the study and will be required to
sign a consent for once informed of the impending study, which will however not interfere with their
earlier developed care plans (LoBiondo–Wood & Haber, 2014). As a matter of precaution, all
patients with Type 2 diabetes and gout will be excluded as study participants (Corbett, 2012).
What is a reasonable timeline for your project?
The timeline for this project is around six months. The final goal is designing a new educational
training manual related to chronic wound management for nurses in the home health care agency.
What expenses should be considered? Include both obvious expenses, such as materials, as well as
those that are hidden, such as time, which equates to part of your salary.
The material used during this project was provided by the administrator of the home health care
agency, and her collaboration was essential in the development of the project. Also she donated
some material to elaborate the survey, brochures, the pre–test and

Essay On Wound Drainage
The orthopedic literature has a long history of investigating the use of postoperative wound drains
(Cobb, 1990). In total joint arthroplasty, wound drains were associated with increased rates of
transfusion (Hallstrom and Steele, 1992; Quinn et al., 2015) but not a decrease in the rate of wound
complications. A systematic review of the orthopedic literature comparing closed suction drainage
systems with no drainage system for all types of elective and emergency orthopedic surgery found
that there is insufficient evidence from randomized trials to support the routine use of wound drains
in orthopedic surgery (Parker et al., 2007). Similarly, a meta–analysis of randomized controlled
trials of wound drainage after hip fracture surgery ... Show more content on Helpwriting.net ...
They found that the group without drains developed epidural fluid collection by MRI detection at a
much higher rate of 89% compared to the drain group at 36% (Mirzai et al., 2006). Their data
suggested that drains could help clear excess fluid from the surgical site and adjacent spaces.
However, they did not observe a difference in clinical outcomes between groups. A meta–analysis of
seven studies of postoperative suction drain use after posterior spine surgery included 2,098 patients
and found that drains did not influence healing rates and or infection (Andrew Glennie et al., 2015).
The relationship between surgical drains and hematoma prevention could not be established.
Similarly, another recent meta–analysis failed to demonstrate an association between surgical site
drains and decreased odds of hematoma and infection (Waly et al., 2015). While the benefit of
surgical site drains in the lumbar spine remains to be demonstrated, the benefit of surgical site drains
in the cervical spine remains an unanswered question.
The study of surgical site drains in the posterior cervical spine is limited. Payhs et al. suggested
surgical site drains in the posterior cervical spine in combination with alcohol foam or vancomycin
powder are associated with reduced odds of surgical site infection among patients undergoing any
posterior cervical spine surgery (Pahys et al., 2013). Our data regarding

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