Integumentary system: Wounds

A wound is an injury to the skin and its underlying tissue. An intentional wound is made by a healthcare professional for therapeutic purposes and interventions, like surgery.

An unintentional wound is a result of an accidental injury like skin tears and trauma from a car crash or a fall. It is possible to prevent unintentional wounds in healthcare settings by using proper techniques to reposition and transfer clients.

If there is a break in the skin, the wound is open. If the skin is intact, the wound is closed.

A bruise is a good example of a closed wound. Immediately after an injury, blood vessels constrict and blood clots are formed to stop the bleeding.

Once the bleeding is stopped, the first stage of wound healing called the inflammatory stage begins. In this stage, the body is starting to heal itself and clear out any microbes that may have entered the wound.

The blood flow increases, and there are signs of inflammation, like redness, warmth, swelling, and pain. The second stage is called the proliferative stage.

In this stage, cells divide to increase their numbers and repair the damage. A structural protein called collagen is laid to make the tissue stronger.

The last stage is called the maturation stage. This is when the collagen becomes more organized and stronger, the wound matures, and the scar is formed.

There are a few factors that contribute to wound healing. First, there must be a good blood flow to the area to supply the cells in the area with oxygen and nutrients.

Next, there’s proper hydration and nutrition. Protein is essential for building collagen, so adequate protein intake is required for wounds to heal properly.

Lastly, protection from infection is needed because infected wounds take longer to heal. Some other factors can prolong wound healing, like advanced age, low blood flow, diabetes, and malnourishment.

Sometimes, there can be some complications during wound healing. A wound can be contaminated with microbes, which is called an infection.

Signs of infection include redness, warmth, swelling, and foul odor. Dehiscence is when a closed wound opens up again.

Evisceration is when abdominal organs protrude through an open wound. Hemorrhage is excessive bleeding, and if too much blood is lost, then the organs are not getting enough oxygen.

This causes another wound healing complication called shock.There are three ways a wound can heal. First intention healing happens when a wound is closed with sutures or staples.

Because the edges of the wound are close to each other, the wound can heal faster, and scarring is minimal. Second intention healing happens in infected and contaminated wounds, large wounds, and ulcers.

In these cases, the wound remains open, healing takes longer, and the scarring is larger and deeper. Third intention healing is a combination of the first two.

At first, the wound is cleaned and left open to reduce infection. Once the infection is under control, the wound is closed to speed up the healing.

Some wounds might produce a lot of fluid. This can happen as a result of an infection, bleeding, or the healing process itself.

If fluid collects in the wound, it can prolong the healing process or promote infection. Drains can be used to evacuate the fluid.

Some wounds can be covered in dressings. Wound dressings are used to protect the wound from infection, keep it dry, or absorb the drainage.

As a nursing assistant, your role will be to assist the nurse in wound care. If facility policy permits and it is within your authorized duties you might be instructed to perform interventions, like applying or changing wound dressings or bandages.

You should also observe the wound for any signs of infection or poor healing. Lastly, promote good nutrition and hydration and protect the client from infection to support the healing process.When caring for clients with wounds, there are a few things you should report to the nurse right away: broken sutures or staples, increased pain, fever, any complications of wound healing, and any changes in the area surrounding the wound.

If the wound has dressings, report if the dressings become wet or soiled. For wounds with drains, report if you notice any changes in the drainage appearance, odor, and quantity.

Document the date, time, and any observations you made regarding the client’s wounds.All right, as a quick recap… A wound is an injury to the skin and its underlying tissue.

Wounds can be intentional, like in medical and surgical procedures, and unintentional, like in trauma. Three stages of wound healing are inflammation, proliferation, and maturation.

Some factors contribute to wound healing, like good blood flow, proper hydration and nutrition, and protection from infection.

Others prolong healing, like advanced age, low blood flow, diabetes, and malnourishment. Complications of wound healing include hemorrhage, shock, dehiscence, evisceration, and infection.

A wound can heal in three ways: first intention healing, when edges are held together by stitches; second intention healing, when the wound is open; and third intention healing, when the wound is first open to clear the infection and later closed to speed up the healing.As a nursing assistant, your role will be to assist the nurse in wound care and observe for any changes that might indicate a problem with healing.

If you notice increased pain, fever, any complications of wound healing, changes in the area surrounding the wound, wet or soiled dressings, and changes in drainage, inform the nurse right away.

Document the date, time, and any observations you made regarding