_*WOUND MANAGEMENT.

by *hassanuh*
How do we manage wounds and what is the science behind the dressing why would you
use 3 gauzes and not one?
Rationale!!?
An acronym TIME spread across also called TIME principle management of wounds.
T-Tissue
I-Inflamation/Infection
M- Moisture.
E- Edge of the wound.
1. Tissue-: When you are dressing the wound, the colour of the wound will depict,
negative or positive progress. We have a score for this. Its called RYB score of
the tissue. R- for RED, Y- YELLOW and B for BLACK.
A red wound is a healthy wound, a yellow wound ranging yellow to green indicates a
dirty wound or sign of poor progress. A black wound means a necrotic wound i.e
needs debridement.
How you ensure the wound remains clean always ensure you consider factors necessary
for wound healing. A lot gauze use for a wound is left for either a bleeding wound
or an oozing wound. Clean wounds should be dressed with a light dressing to allow
air circulation hence facilitate quicker healing. Wounds wich are packed with alot
of dressing often lack oxygenation hence start necrotizing calling for further
implementation. Wounds that are red will require just saline swabs dressing. Yellow
wounds will require proper cleaning and toileting. Black wounds will require
debridement to remove the necrotic tissue. Ever wondered why the gauze is porous
and not like the strapping with no pores? Well now you know dont cover the
strapping all over the wound as it befits its intended air circulation purpose!
Types of debridement include: Surgical sharp, autolytic debridement and Debridement
by use of larvae ( sterile maggots)i.e magots are good for the wound as in they
feed on the dead tissue!
2.Inflamation/Infection. Inflamation may mean a normal healing process for the
wound healing. But also may signify poor progress. Infection may be underlying as a
result of invasion by microbes. For infection always ensure good antibiotic cover.
With reduction in ifectiom and good progress inflammation should subside. And thus
calls for sterility Maintenance.
3. Mosture content: For awound to heal properly you require a balance in moisture
between the ineternal and external environment. An excessively wet wound will
slough off hence deepening or widening and a dry wound will crack. So to ensure
your wound is healing properly and maintain moisture content balance its simple :
"when the wound is wet dry it and when its dry wet it!". Time to think when to use
dry dressing wnd a wet dressing!.
4. Edge of the wound: Always ensure the magins of the wound do not appear necrotic
by removing them to encourage closing in of your wound. When the edges of the wound
necrose the wound grows outwards!.
Currently: Only saline dressing is encouraged, cytotoxic agents such as povidone
aka iodine or hydrogen peroxide is an outdated practice.
Its not also of any value crashing antibiotics and pouring on the wound because
some need to be activated before they can reach the efficasy so science proves it
wrong and non valuable.
I hope we learnt something*_ @ *hassanuh*