Wound care
The following is a guide to managing different types of wounds.
Surgical wounds
Wound edges should be kept together with wound closure strips. Serious wounds such as post-surgical wounds heal faster and with less scarring if the wound is kept moist. You should use special dressings to prevent these wounds from drying out and to absorb fluid (exudates) from weeping wounds.- Non-stick wound pad dressings absorb fluid but won’t stick to the wound.
- Film dressings are waterproof and bacteria-proof moist dressings that do not absorb exudates.
- Non-waterproof island dressings have a non-adherent wound pad, which absorbs wound exudates without sticking to the wound.
- Self-adhesive waterproof and bacteria-proof island dressings have a special transparent film that allows the wound to be monitored.
Punctures
For small wounds such as splinters, remove debris and clean the wound with weak salt solution (normal saline).- Cover minor wounds with dressing strips or non-stick dressings.
- Use wound pads or island dressings for more extensive wounds.
Household burns
Apply immediate first aid, that is, cool the burn with cold water, for at least 20 minutes. Remove all jewellery from the affected area.- Initially use hydrogels (such as Intrasite Gel, Solosite or Solugel). These are specialised water-based gels that provide moisture to the wound.
- Non-stick tulle gras dressings may also be used.
For more serious burns, always seek advice from your doctor. After referral to your doctor, the dressing may be changed to an island dressing (see above), a hydrocolloid wound dressing, or an alginate dressing.
- Hydrocolloid wound dressings protect the delicate tissue during healing. They are moderately absorbent, binding exudates and preventing skin maceration and breakdown.
- Alginate dressings are absorbent dressings that can help to prevent bleeding.
Skin tears
Keep the wound edges together with wound closure strips. Skin tears often occur in the fragile skin of the elderly. Salvage the skin flap if possible. Keep the flap moist and stop any bleeding by using an alginate dressing. Cover the skin tear with a moist healing wound dressing.Ulcers
You should make sure that chronic ulcers are correctly diagnosed by your doctor before commencing treatment. Dressings that keep the wound at body temperature are best for new skin growth.- Use a moderately absorbent dressing such as hydrocolloid dressings, which absorb exudates from the wound, while providing a moist healing environment.
What else can you do to assist the healing process?
You should watch the wound closely for signs of infection, such as redness spreading out from the wound, and clean the wound before applying a dressing. The solution of choice for cleaning most serious wounds is sterile normal saline (a weak salt solution).Incorrectly diluted antiseptics can damage the healing skin and delay healing. Antiseptics can also be absorbed directly into the body through deep or large open wounds, and may make the person feel unwell.
Topical antibiotics such as mupirocin (Bactroban) are not necessary where there is no sign of inflammation or infection. Overuse of these medicines can lead to bacterial resistance. You should also be careful if using an antiseptic cream. The cream may not kill all the bacteria, creating a good environment for resistant bacteria to grow, especially if the area is covered with a dressing.
Avoid putting irritating agents on the wound. Keep cleansing and dressings simple and do not pick the scabs off as the wound heals, as this can cause scarring. Crusty scabs should be moistened.
When should you seek medical advice?
You should seek medical advice if:- you have a wound that is chronic or recurring (such as leg ulcers, varicose ulcers or bleeding moles);
- there is copious bleeding;
- the wound is very extensive, very deep, or very dirty;
- foreign objects are deeply embedded in the wound or unable to be removed easily;
- the wound and surrounding area is very painful and warm;
- you have fever or flu-like symptoms;
- the wound contains pus; or
- you are not covered by a tetanus vaccination.
Last Reviewed: 12 July 2001
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