Chronic Wound Healing

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.

Outline and discuss a clinical audit that you have undertook into one aspect of care delivery and reflect upon the experience using Driscoll’s model of structured reflection. Word Count (2197)

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

Dale Gordon has been a patient in the ICU for 6 days after developing complications after open heart surgery. He is an 82-year-old African American who is disoriented to place and time. He lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him.

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

Stechmiller, J. K. (2010). Understanding the Role of Nutrition and Wound Healing. Nutrition in Clinical Practice, 25(1), 61-68. doi:10.1177/0884533609358997

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

Skin repair is an important physiological process which is essential for homeostasis, restoring barrier function and preventing infection (Martin, 2009; Boateng and Catanzano, 2015). Wound healing is defined as a complex, dynamic and the specific biological process associated with the phenomena of tissue regeneration and growth (Mazumder et al., 2016). Regeneration can be defined as a tissue that significantly damaged either completely or partially removed and tissue's original function and cell types must be functional and structurally restored (Mazumder et al., 2016). The process of healing comprises a cytokine, blood cells, extracellular matrix and growth factor (Joao De Masi et al., 2016). The growth factor is a protein that activates and

I can relate to one of the points in your discussion. I work in a small community hospital in the Wound Healing Clinic. We are an outpatient addition to the hospital. We have one nurse who has the primary responsibility of the acute admissions wound care. Last year we were bought by a large health systems. Recently, we were informed that we, the Wound Center, are held responsible if a patient has a hospital acquired pressure ulcer (HAPU). As part of this new directive we were also informed that prevalence rounds were to be done weekly. This is what you described your facility does once a month. These changes place responsibility for care which our staff does not even provide, moreover the changes were never discussed with our clinical coordinator.

In the UK, there are 200,000 patients, who have slow healing wounds, which costs National Health Services £2.3-£3.1 billions per year and it reduces patients’ quality of life and mobility (Posnett & Franks, 2008). In addition, patients may have sleeping difficulties due to painful wound (Posnett & Franks, 2008). Patients may become depressed, isolated and have impaired body image due pain and embarrassment of unpleasant wound odour (Santy, 2008).

Integra is a synthetic wound dressing frequently used to treat burn wounds (Figure 5). It is a bilayer composed of bovine tendon collagen glycosaminoglycan (chondroitin-6-sulphate) cross-linked to it, onto which a silicone (synthetic polysiloxane polymer) membrane is sealed to the upper surface to act as a protective temporary epidermis. The silicone layer is applied as a liquid monomer; curing occurs on the surface of the collagen at room temperature. It serves to control moisture loss from the wound. Water flux across this silicone membrane is the same as that across normal epidermis. The collagen-GAG matrix contains pores ranging from 70 to 200 µm that are invaded by host fibroblasts upon application to an excised wound bed. The pore size was carefully designed by adjusting the collagen-GAG mixture. In GAG-free collagen, the resulting structure was more closed than in collagen-GAG matrices. Smaller pores can delay, or even prevent, biointegration, whereas larger pores would provide an insufficient attachment area for invading host cells. Freeze-drying procedures followed by slow sublimation are used to control pore size too. The degradation rate of 30 days of the collagen-GAG sponge is controlled by glutaraldehyde-induced cross-links. The polypeptide collagen is used for its low levels of antigenicity (it has minimal rejection potential) and because it exerts a hemostatic effect on vascular wounds. Collagen is already found in skin. It is degraded by collagenase deposited

One of the best methods of reducing infection in patients with any type of wound is sterile technique with dressing change. Heavy colonization of infected sites is a risk factor for infections associated with any type of wound but mostly for wounds that penetrate deeper into the skin. Sterile site dressing is advocated to protect the open wound from contamination because it will come in to direct contact with the wound, and sterility is required in order to execute the application of the dressing successfully. The nursing process is an important principle to use when examining, treating, and maintaining any type of wound or applying wound

Similarly, in a literature report, bacterial cellulose-collagen hydrogels act as a barrier against microbes and provide moisture (Moraes et al., 2016). It was also found that NCs wound dressings could be easily removed from wounds without causing any disruption in the healing process. Similarly, bacterial cellulose-vaccarin membranes have also been reported to better retain the wound fluid beneficial for enhancing healing in rats (Qui et al., 2016).

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.

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