Wound Care

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.

I have significantly developed my skill in wound care assessment and dressing, in developing this skill I now recognize the importance of documenting each dressing. Morison (2001) supports this in saying that by detailing pressure ulcer assessment it provides a basis for deciding the effectiveness of the current treatment.

Deficiencies in a persons diet can impede progression through the normal stages of wound healing. Malnutrition has also been related to an increase in infection rates. Jean understood this and assured me she would take this in to account to enable the healing process. Jean went on to explain that the injury was caused when somebody ran into her leg with a supermarket trolley. She had initially applied a dry dressing but attended her GP’s when the wound became wet and painful.

An interdisciplinary team of professional staff is a necessity to overcome the issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse, nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of completing and documenting skin and risk assessments, monitor progress and/or changes in medical/skin conditions, report patient problems to the hospitalist, and work with the wound team

In this reflection I am going to discuss a procedure that I have carried out whilst I have been on placement and the importance of infection control using the Aspetic Non Touch Technique (ANTT). The procedure I am going to discuss is a dressing change to a leg ulcer which took place during a routine home visit with the community nurse. I am going to use Gibbs Model of Reflection (1988), to reflect on the experience and evaluate my thoughts and feelings of the procedure, and to outline what I have gained from the experience for my future practice.

• 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

I get to see various types of wound, from pressure ulcer of different stages, unbelievable edemas, arterial and venous ulcers, diabetic ulcers, and many other wounds of uncertain causes. I have never expected to see those kinds of wounds. I have seen different drainage amount, color, and odor, various shapes and location of the wounds, and amputated edematous legs. I have learned also the different types of dressings and antibacterial ointments used. I had given the chance to observe a client on their high-tech hyperbaric oxygen therapy which makes the wound healing even faster. The most important lesson I have learned from the team members was, “DO NOT GET

Even in the hospital setting while in Basildon Hospital Stroke Rehabilitation (Lister Ward) and in Mountnessing Court Billericay (The Mental Health Placement), I have found caring for patients with open wounds very interesting and diverse. Considering my interests in wound care, I slowly realised following this career path is what would suit me.

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

While shadowing Dr. Julia Shuleshko, I enjoyed witnessing the osteopathic philosophy in her practice, and how it led her to heal wounds better. She often described healing wounds as if it were a puzzle, and the best place to start was with any underlying health problems such as diabetes or circulation issues. I found it eye-opening that her default was to address the patient’s overall health as much as the wound itself. Her treatments utilized products to encourage tissue growth, but largely relied on the body’s ability to self-heal. She also implemented preventative strategies whenever possible—either through education or therapeutic methods. Her forward-thinking approach, grounded in osteopathy, was amazing, and inspired me to pursue a career

Instead of having an experimental component the article goes into depth about the different nutritional benefits patients should be getting. Because those in critical care are ill and in a compromised position, preventing pressure ulcers can be even more challenging. This article proposes however, that nutrition is essential in slowing down the formation of pressure ulcers and increasing the efficiency of wound healing. Though the article is not an experimental study it is reliable in the sense that all of the information is valid. The article defines important terms, talks about the specific nutritional benefits certain food groups contain and how this all relates to preventing and treating pressure ulcers. The research integrity of this article is strong because it is not based on biased opinions but rather it is based on factual information applicable to the critical care patients. I do find that because there isn’t any comparative study being done that the article has its limitations. It would be interesting to weigh the benefits of the nutritional component with the damaging effects of not doing anything at all. The key findings of this article include the importance of screening patients to find out their nutritional status as well as getting them in touch early with a registered dietitian. This will help to figure out the appropriate feedings the patients need to be administered including beneficial micronutrient and macronutrient supplementation. Both of these supplements promote the healing of wounds and are helpful when it comes to making improvements for the critical care patients and their nutritional status.

Harper, Young, and McNaught, (2014) explain the four distinct phases of wound healing that are identified as hemostasis, inflammation, proliferation and tissue remodeling. Hemostasis is the body’s response to prevent exsanguinations; thusly, the cascading response to injury causes constriction of blood vessels but if continued, leads to tissue hypoxia and acidosis. The next stage of healing is inflammation. This stage is a result of cells that inhibit and prevent infection and once the resulting threat of infection is gone, inflammation will subside. Prolonged inflammation can lead to chronic wound formation. The next stage of healing is proliferation which consists of angiogenesis, formation of granulation tissue, collagen deposition, epitheliazation and wound retraction. It is during this stage the extracellular matrix is laid down forming

Basically, the wound healing process depends on proteins and energy in the forms of carbohydrates and fats to promote collagen synthesis and the prevention of protein-energy malnutrition (Leaker, 2013). Foods like salmon, sweet potatoes, bananas, and butternut squash are considered high in protein, carbs, and the right kind of fats to provide the necessary energy for collagen synthesis in wound healing. “Protein-energy malnutrition occurs when there is inadequate uptake of protein and energy, causing the body to breakdown and use protein for energy” (Leaker, 2013, The Role of Nutrition in Preventing Pressure Ulcers, para 8). This is something I should be watching for in patients with poor nutrition from possible medication side effects, anorexic patients, even patients who partake in preoperative fasting, etc. Micronutrients like Vitamin A, Vitamin C, Vitamin K, Copper, Manganese, Zinc, and Iron have additive effects on wound healing as well from tissue regeneration to oxygen delivery of the