Chronic Wound Care

WHAT YOU SHOULD KNOW:

• A wound is an injury that causes a break in the skin. A chronic wound is a wound that has not healed completely in 4 to 6 weeks. Normally, wound healing involves a complete and efficient process of tissue repair. A chronic wound occurs when this process is disturbed and healing becomes a problem. The wound may be a deep ulcer (open sore), a large burn, or an infected wound. Muscles, blood vessels, bones, and other body parts may be affected. Sometimes, tissue loss may be seen.
  
  
• Wound care is a procedure to clean the wound, prevent or stop infection, and help promote healing. Depending on the severity, location, and presence of other conditions, caregivers will choose the best treatment for your chronic wound. Wound care includes wound cleansing, debridement, and bandaging. Additional treatments, such as hyperbaric oxygen, negative pressure therapy, and medicines applied to the skin, may also be given. Treatments for your wound may change depending on how it is responding and how your health condition is doing. Your wound may be treated in the hospital, another care setting, or at home.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Having your wound treated may be very painful and put you at risk of bleeding. You may have problems with blood supply to the area that may lead to tissue death. A scar may form on your skin as it heals. If left untreated, the wound may get worse and may get infected. An infection may spread to other parts or organs of the body. This may lead to loss of a body part, function, and may even be life-threatening. Talk with your caregiver if you are worried or have questions about your wound, procedure, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Medicines: Your caregiver may give you the following kinds of medicines:

• Anesthesia: Anesthesia is medicine to make you comfortable during a procedure. Caregivers will work with you to decide which anesthesia is best for you.
  
  
• Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
  
  
• Medicines for pain, swelling, or fever: You may be given medicines to treat pain, swelling, or fever while you are in the hospital. These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease, a history of bleeding in your stomach, or any other medical problems. Also tell your caregiver about any allergies you have to medicines. Tell your caregiver about all other medicines, herbs, and supplements that you have taken lately.
  
  
• Others: Creams, ointments, or other solutions containing factors which help in wound healing may be applied directly to the wound.

Tests:

• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Wound culture: This is a test to grow and identify the germs that may be in your wound. This helps caregivers learn what kind of infection you have and what medicine is best to treat it. This test may be needed if your wound is infected or contaminated (dirty).
  
  
• X-ray: This is a picture of your bones and tissues in the wound area. You may need to have an x-ray, especially if the wound is near a joint or bone. Caregivers use the pictures to look for broken bones, injuries, or foreign objects such as glass or metal.

Chronic wound care treatments:

• Cleansing: This may be done by flushing the wound with sterile (clean) water. It may be done under high pressure, using a needle or catheter (tube) tip and large syringe. A solution that kills germs may also be used. If the wound is large and needs further cleaning, a whirlpool treatment or hydrotherapy may be done.
  
  
• Hyperbaric oxygen therapy: This is also called HBO. HBO is used to get more oxygen into your body. The oxygen is given under pressure to help it get into your tissues and blood. You may be put into a tube-like chamber called a hyperbaric or pressure chamber. You will be able to see your caregivers and talk with them through a speaker. You may need to have this therapy more than once.
  
  
• Negative pressure therapy: This is also called vacuum-assisted closure (VAC). A special foam dressing with an attached tube is placed inside the wound cavity and tightly covered. The tube is connected to a pump which will help suck out excess fluid and dirt from the wound. VAC may also help increase blood flow and decrease the number of bacteria in the wound.
  
  
• Surgery:
  
  
  • Debridement: Debridement is done to clean and remove objects, dirt, or dead skin and tissues from the wound area. Caregivers may cut out the unwanted areas in or around the wound. Caregivers may also drain the wound to clean out pus.
    
    
  • Skin substitute: Skin taken from another part of your body may be used to close a large wound. The skin may also be man-made, which contains special cells needed to repair damaged tissues.

Wound dressings: Dressings are used to protect the wound from further injury and infection. These may also help provide pressure to decrease swelling. Dressings may be in the form of bandages, films, or foams. They may contain certain substances that may help promote faster healing. Dressings, such as wet-to-dry dressing, may sometimes be used as additional means for debridement.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Link to Page

Print Page

Email Page