Wound careAcceleration of the wound healing process and improvement of the quality of life Chronic wounds represent particular challenges for the members of the medical staff who are in charge of the wound care (both physicians and nursing service specialists). Often they have also serious consequences for the concerned patient and impacts on his quality of life.
The appropriate approach to the causes combined with the use of the adequate wound cover is crucial as to the improvement of the patient’s quality of life.
Forms of chronic wounds
According to the cause, the following forms are distinguished: “ulcus cruris” (ulcer of the legs), diabetic gangrene, “decubitus” and ulcerous tumours. They may be due to cutaneous dysfunctions caused by of circulatory or metabolic disorders (“ulcus cruris”, diabetic foot syndrome), to permanently exercised pressure (“decubitus”) or to systemic diseases (ulcerous tumours). The normal wound healing is slowed down or is even totally inexistent. Therefore it is important to look at the patient in his entirety and to verify scrupulously the underlying causes and the specific needs of the patient before starting the examination of the wound. Wound healing phases
Wound healing progresses in three overlapping phases: the wound cleansing or exudation phase, the granulation or proliferation phase and the regeneration or epithelialization phase. Wound cleansing phase
It is necessary to remove avital and necrotic tissue as well as greasy films, so that the wound can heal. There are various conservative and surgical treatments for the debridement.
Granulation phase
The most important goal within the granulation phase is to protect the developing tissue from drying up by a permanent moisturization. For if the wound dries up the cells die. This can seriously delay the wound healing process.
Epithelialization phase
The last and crucial step in the wound healing process is the re-epithelialization. Similarly to a well formed granulation tissue, the growing epithelial tissue needs warm and humid conditions favouring the migration of the epithelial cells. However, the wound should be protected from exterior mechanic influences.
|
