WOUND MANAGEMENT

1. Chronic Wound

 

A chronic wound is a wound that does not heal in an orderly set of stages and in a predictable amount of time the way most wounds do. Providing proper care and the use of antibiotic and antibacterial are one of the many ways to treat this wound. Proper management is our main priority in helping to prevent the wound from getting much worse.

 

Signs and Symptoms of Chronic Wounds

 

Infectious wounds: These typically have a bad odor, pus drainage, debris (yellowish to greenish) or dead tissue, and ongoing symptoms of inflammation (fever, pain, redness, hotness and swelling).

Ischemic wounds: Usually the wound area will be pale and cold. There might also be a decrease in the hair growth and a weak pulse sensation in the area.

 

Radiation poisoning wounds: These can present with redness, blistering, itching, inflammation and other unspecified symptoms that include nausea, vomiting, abdominal pain and fever.

 

Surgical wounds: Typically occur at the site of a surgical incision, but instead of a clean appearance, the tissue around the incision appears red, hot, and swollen, which can be infected or inflamed.

 

Ulcers:

  • Arterial ulcers: Usually involve the full thickness of skin, having a punched out appearance with smooth edges and occasionally pain that subsides when the legs are lowered below the heart level. In some cases, ischemia is present (poor circulation to area).

  • Venous ulcers: The skin is usually shiny and smooth with minimal to no hair. These ulcers are superficial, shallow, and irregularly shaped with pain and edema. These can sometimes be associated with infection or inflammation.

  • Diabetic ulcers: These can be either of neuropathic (secondary to nerve damage) origin, where the lack of sweat makes the skin dry and easy to crack and scale, forming callus (accumulation of dead skin layers). The callused area, mostly occurring on the foot, can eventually break down and form an ulcer. Diabetic ulcers can also occur from neuropathy with ischemic origin; where the ulcer area is cool with no pulse, in addition to the other signs of ischemia described above.

  • Pressure Ulcers: These present with redness that doesn’t go away when pressed upon, and includes itching, blistering, hotness, swelling and discoloration of the area.

 

Treatment and Prevention of Chronic Wounds

 

The best treatment is to prevent the wound from progressing to chronic state by avoiding all the risk factors. Preventative measures include maintaining proper hygiene and wound care as instructed by the doctors, while complying with the prescribed medications. Regular inspection of wounds to track healing progress is also a primary part of the treatment plan.

2. Post-Operation Wound

 

A surgical wound is a cut or incision in the skin that is usually made by a scalpel during surgery. A surgical wound can also be the result of a drain placed during surgery. Surgical wounds vary greatly in size. They are usually closed with sutures, but are sometimes left open to heal. It is essential for patient after an operation to take care of their wounds. Home care for a surgical wound may involve some of the same procedures, including frequent dressing changes and cleaning. Over-the-counter pain medication can also reduce discomfort. Often, patients are discharged from the hospital before a surgical wound has completely healed. It is essential that patients follow all at-home care instructions. Following directions properly will promote healing and decrease chances of an infection.

 

Managing Post Operation wounds

-Maintain cleanliness

-Wash the wound site

-Change the dressing

-Watch for sings of infection

3. Diabetic Wound

 

Diabetic wounds are very hard to heal and often take weeks to heal. Attentive cares towards those kinds of wounds are essential to not let it become more infected. The main concern with diabetic wounds is poor or delayed healing.

 

For a diabetic patient, every wound is a health concern and requires immediate attention. The most common two types are wounds of external origin and wounds of internal origin. Due to peripheral neuropathy, wounds of external origin, such as skin cuts, burns, bumps and bruises, may often go unnoticed by the diabetic patient. If external wounds go unnoticed for some time, delayed treatment can put the patient at risk for further complications. Wounds of internal origin, such as skin ulcers, ingrown toenails or calluses, can lead to the breakdown of skin and surrounding tissue, increasing the risk of bacterial infections.

 

Treatment of Diabetic Wounds

The best treatment is prevention, since medical treatment for diabetic wounds provides limited help. If a wound occurs, treatment can include:

  • Keeping all wounds clean and properly dressed

  • Antibiotics (for infected wounds or as a preventive measure for wounds at risk of getting infected)

  • Surgical debridement (the dead or infected tissue is removed to allow the healthy tissue to heal and regenerate)

  • Referral to a podiatrist or a wound care center (for patients with calluses, corns, hammertoes, bunions, toenail problems or chronic non-healing ulcers)

  • Limb amputation (to save as much of a limb as possible when there is a serious infection)

4. Bed Sore Management

 

Bedsores, also called pressure ulcers and decubitus ulcers are injuries to skin and underlying tissue resulting from prolonged pressure on the skin. Bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone. People most at risk of bedsores are those with a medical condition that limits their ability to change positions or those who spend most of their time in a bed or chair. Bedsores can develop quickly. Most sores heal with treatment, but some never heal completely.

 

Warning signs of pressure ulcers are:

  • Unusual changes in skin color or texture

  • Swelling

  • Pus-like draining

  • An area of skin that feels cooler or warmer to the touch than other areas

  • Tender areas

 

Bedsores fall into one of several stages based on their depth, severity and other characteristics. The degree of skin and tissue damage ranges from red, unbroken skin to a deep injury involving muscle and bone.
 

Prevention

You can help prevent bedsores by frequently repositioning yourself to avoid stress on the skin. Other strategies include taking good care of your skin, maintaining good nutrition and fluid intake, quitting smoking, managing stress, and exercising daily.

Contact

Location

Cheras & KL South

10, Desa Permai 1, Desa Permai,

43000 Kajang.

Kepong & KL North

19, Jalan Desa 2/8 Desa Aman Puri, Kepong, 52100 Kuala Lumpur, Selangor

Cheras & KL South

Kepong & KL North

Service Area

Bandar Damai Perdana

Balakong

Serdang

Bandar Tun Hussein Onn

Seri Kembangan

Kajang

Cheras Perdana

Mahkota Cheras

Sungai Long

Alam Damai

Semenyih

Sri Raya

KL

Selangor

Malaysia

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