Guidelines to aid healing of acute wounds by decreasing impediments of healing (original) (raw)
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Essential Concepts of Wound Management
2010
The practice of wound care has greatly improved and evolved over the years. Wound care techniques have been documented since 1500 BC in ancient Egypt and Greece where lint was used as a fibrous base, animal grease as a protective barrier, and honey as a topical antibiotic. 1 In 150 AD, the Greek surgeon, Galen of Pergamum, while working with a Roman gladiator's cuts, first addressed the fact that the wound should be kept moist to ensure adequate healing. Honey has been used as both a topical ointment and as an antibacterial for infected wounds. 2 Today the emergency provider (EP) can choose from a wide variety of sutures, adhesives, strips, and surgical staples, and uses proven wound closure techniques to address this common Emergency Department (ED) patient complaint. It has been reported that lacerations in the United States accounted for approximately 12% of all ED visits in 2005 (115.3 million visits), and almost 40% were related to blunt trauma. 3 The most common anatomic areas for lacerations in decreasing order of frequency are the scalp, face and neck, fingers and toes, lower and upper extremities, and trunk/back. Many factors contribute to the healing of lacerations. Factors that cannot be controlled by the EP are genetics, shape, and anatomic area. However, bleeding control, inspection, exploration, cleansing, debridement, closure technique, closure materials, dressings, infection control, anesthesia and analgesia, and wound after care can be affected by the EP's actions. The EP must have a good understanding of all these factors to assure that the wounds heal well with a minimum number of complications. Although patients presenting to the ED with wounds requiring treatment are generally assigned a low acuity level, and often do not have life-threatening injuries, these cases
Definitions and guidelines for assessment of wounds and evaluation of healing
Archives of Dermatology, 1994
Chronic wounds represent a worldwide problem. For laboratory and clinical research to adequately address this problem, a common language needs to exist. This language should include a system of wound classification, a lexicon of wound descriptors, and a description of the processes that are likely to affect wound healing and would healing end points. The report that follows defines wound, acute wound, chronic wound, healing and forms of healing, wound assessment, wound extent, woundburden, and wound severity. The utility of these definitions is demonstrated as they relate to the healing of a skin wound, but these definitions are broadly applicable to all wounds. (WOUND REP REG 4994 ;2 :965-70
Wounds : a compendium of clinical research and practice, 2017
Normal wound healing is accomplished through a series of well-coordinated, progressive events with overlapping phases. Chronic wounds are described as not progressing to healing or not being responsive to management in a timely manner. A consensus panel of multidisciplinary wound care professionals was assembled to (1) educate wound care practitioners by identifying key principles of the basic science of chronic wound pathophysiology, highlighting the impact of metalloproteinases and biofilms, as well as the role of the extracellular matrix; and (2) equip practitioners with a systematic strategy for the prevention and healing of acute injuries and chronic wounds based upon scientific evidence and the panel members' expertise. An algorithm is presented that represents a shift in strategy to proactive and early aggressive wound management. With proactive management, adjunct therapies are applied preemptively to acute injuries to reduce wound duration and risk of chronicity. For ex...
Beyond wet-to-dry: a rational approach to treating chronic wounds
Eplasty, 2009
This article reviews the current recommendations for the classification and treatment of chronic wounds. With a rational approach and a thorough understanding of available treatment options, plastic surgeons can provide better-quality and more cost-effective wound care. The authors reviewed the literature on the history of wound care and on recent advancements in wound care and also summarized the current clinical practices of the Johns Hopkins Wound Center. n/a. Optimized wound dressings decrease pain, diminish morbidity, and improve healing times.
Evidence-Based Care of Acute Wounds: A Perspective
Advances in Wound Care, 2014
Large variation and many controversies exist regarding the treatment of, and care for, acute wounds, especially regarding wound cleansing, pain relief, dressing choice, patient instructions, and organizational aspects. Recent Advances: A multidisciplinary team developed evidence-based guidelines for the Netherlands using the AGREE-II and GRADE instruments. A working group, consisting of 17 representatives from all professional societies involved in wound care, tackled five controversial issues in acute-wound care, as provided by any caregiver throughout the whole chain of care. Critical Issues: The guidelines contain 38 recommendations, based on best available evidence, additional expert considerations, and patient experiences. In summary, primarily closed wounds need no cleansing; acute open wounds are best cleansed with lukewarm (drinkable) water; apply the WHO pain ladder to choose analgesics against continuous wound pain; use lidocaine or prilocaine infiltration anesthesia for wound manipulations or closure; primarily closed wounds may not require coverage with a dressing; use simple dressings for open wounds; and give your patient clear instructions about how to handle the wound. Future Directions: These evidence-based guidelines on acute wound care may help achieve a more uniform policy to treat acute wounds in all settings and an improved effectiveness and quality of wound care. CLINICAL RELEVANCE Current clinical guidelines on acute wound care comprise the CDC
Wounds research for patient benefit: a 5-year programme of research
Programme Grants for Applied Research, 2016
BackgroundComplex wounds are those that heal by secondary intention and include lower-limb ulcers, pressure ulcers and some surgical wounds. The care of people with complex wounds is costly, with care mainly being delivered by community nurses. There is a lack of current, high-quality data regarding the numbers and types of people affected, care received and outcomes achieved.ObjectivesTo (1) assess how high-quality data about complex wounds can be captured effectively for use in both service planning and research while ensuring integration with current clinical data collection systems and minimal impact on staff time; (2) investigate whether or not a clinical register of people with complex wounds could give valid estimates of treatment effects, thus reducing dependence on large-scale randomised controlled trials (RCTs); (3) identify the most important research questions and outcomes for people with complex wounds from the perspectives of patients, carers and health-care profession...
Deutsches Ärzteblatt international, 2013
A chronic wound is defined as an area where the skin is not intact that fails to heal within eight weeks. Such wounds usually develop on the lower limbs as a complication of diabetes, venous insufficiency, or inadequate arterial perfusion. Most of the roughly 45,000 limb amputations performed in Germany each year are necessitated by non-healing chronic wounds. In the development of this S3 guideline, a systematic search was performed that yielded 4998 references including 38 randomized, controlled trials and 26 systematic reviews, which were used as the basis for the recommendations and statements made in the guideline. Twelve member societies of the umbrella Association of Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF), as well as the German Association of Nursing Science (Deutsche Gesellschaft für Pflegewissenschaft, and patient representatives participated in the consensus rounds in which the guideline&#...
Bioscience Journal, 2019
construct and validate an instrument for evaluation and evolution of chronic wounds. The content and apparent validities were appreciated by experts, the reliability by the analysis of concordance between evaluators using the interclass correlation coefficient and to verify the construct validity was used the instrument Pressure Ulcer Scale for Healing. the analysis of the scores of the instrument by the ICC showed an excellent and significant correlation (K = 0.914) and to verify the construct validity of the instrument, the Pearson correlation coefficient, whose result was 0.573, showed a statistically significant and strong correlation between the scores instrument and the Pressure Ulcer Scale for Healing. Most of the concordances of the items were classified as moderate or substantial. The instrument is valid and reliable. It is suggest longitudinal studies in larger populations, semantic validation in a sample of nurses, and an illustrative guide to standardize concepts in ord...