Wound Management Essay

1411 words - 6 pages

Wound Staging and Wound Management.
Taking care of an aging friend or an ill relative in a hospital or nursing home can sometimes be difficult and exasperating even for the most educated individual. Discovering a bedsore or pressure wound on a person’s skin can cause even a medical professional to scratch his or her head as to the cause and most appropriate treatment of the wound. A decubitus ulcer also called a pressure ulcer is a medical term used to describe an area of the skin with tissue damage caused by unrelieved pressure to the skin due to decreased mobility or illness (Bluestein & Javaheri, p.22). Pressure wounds are described in stages. Stage ...view middle of the document...

Stage two pressure wounds are described as shallow open wounds with a red-pink wound bed or an intact, ruptured serum filled blister or an abrasion and the wound may have little to no drainage (Ignatavicius & Workman, 2013).Treatment for stage two wounds requires a conservative approach with continuous monitoring and proper care. Types of wound care include the use of water-based gels or transparent dressings. At this stage a wound usually heals within several weeks (Mayo Staff, 2011). Interventions are same as stage one with the additional use of a pressure relieving mattress or mattress overlay to increase pressure relief (Bluestein & Javaheri, 2008).
The next stage of skin destruction is called stage three. Pressure wounds at this stage are described by (Bluestein and Javaheri, 2008) as a "full-thickness tissue loss with visible subcutaneous fat." In this stage no bone, muscle, or tendon is exposed and dead tissue may be noted within the wound bed but will not hide the depth of tissue loss (Bluestein&Javaheri,2008). Appropriate treatment to these types of wounds may include debridement of the wound surgically, mechanically, autolytically or chemically to remove the dead tissue to allow the healing to begin (Bluestein &Javaheri, 2008). Surgical debridement is the removal of dead tissue by using a scalpel and cutting the dead tissue away from the wound bed. Mechanical debridement is the removal of dead tissue by use of whirlpool or special dressings (Mayo Staff, 2011). In addition, another type of debridement is called autolytic. In autolytic debridement, the wound bed is kept moist using special dressings to allow the body to naturally remove the dead tissue (Bluestein & Javaheri, 2008). The last type of debridement is called enzymatic. In enzymatic debridement the use of chemical enzymes are used with special dressings to breakdown the dead tissue (Mayo Staff, 2011). The depth of these wound may vary with the location of the wound on the body and the amount of fat in that area. Areas such as the shell of the ear and the shoulder blade have very little to no fat layer (Ignatavicius & Workman, 2013). These areas of the body may show a small open wound but the damage wound bed greater. At this stage the pressure wound may or may not exhibit tunneling or undermining (Ignatavicius & Workman, 2013). Drainage from these types of wounds may be heavy to light. Interventions for stage three wounds includes the same interventions for stage one and two wound including increase monitoring for infection and possible treatment with topical or oral antibiotic therapy(Mayo Staff,2011). Prevention of this wound includes proper positioning in bed with a turning schedule of every two hours, and to minimize shearing of the wound the bed should not be elevated greater than thirty degrees.(Ignatavicius & Workman,2013). Subcutaneous fat plays a major role in prevention and classification of the pressure wounds. Thicker layer of fat between the bones and the...

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