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Chronic Wound Care

WHAT YOU NEED TO KNOW:

A wound is an injury that causes a break in the skin. There may also be damage to nearby tissues. Chronic wounds are wounds that do not heal completely in 6 weeks. Examples of wounds that can become chronic are deep ulcers (open sores), large burns, and infected cuts.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

  • NSAIDs help decrease swelling, pain, and fever.
  • Acetaminophen decreases pain and fever.
  • Antibiotics may be given to prevent or treat an infection caused by bacteria.
  • Creams or ointments may be put on your wound to help it heal.

Tests:

  • Blood tests are done to see if you have an infection and to find its cause.
  • A wound culture is a test of fluid or tissue used to find the cause of your infection.
  • An x-ray is a picture of your bones and tissues in the wound area. You may need to have an x-ray if the wound is near a joint or bone. Caregivers look for broken bones, or foreign objects such as glass or metal.

Treatment:

  • Cleansing is done by flushing the wound with sterile water. Caregivers may use a large syringe with a needle or catheter (tube) tip. They may also use a liquid that kills germs.
  • Debridement is done to remove anything from the wound that can delay healing and lead to infection. This includes dead tissue, and objects such as small rocks and dirt. Your caregiver may cut out the damaged areas in or around the wound. He may also drain the wound to clean out pus. Moist bandages may be placed inside the wound, or bandages that contain enzymes may be used. Hydrotherapy (whirlpool treatment) uses water to clean wounds. It may be used to clean and debride burn wounds.
  • A skin substitute is skin taken from another part of your body to close a large wound. Caregivers may instead use artificial skin that contains cells needed to repair damaged tissues.
  • Wound dressings may be in the form of bandages, gauze, films, gels, or foams. They are used to help your wound heal, and to protect it from further injury and infection. They may contain substances that help you heal faster. Elastic bandages may be used to give light pressure that helps to decrease swelling in tissues around the wound area.
  • Negative pressure wound therapy (NPWT) may also be done. This therapy is also called wound vacuum, or wound vac therapy. A vacuum device uses suction to remove fluid and waste from your wound and pull the edges closer together. NPWT may also increase blood flow and new tissue growth in the wound.
  • Hyperbaric oxygen therapy (HBO) is used to get more oxygen into your body. The oxygen is given under pressure inside of a tube-like chamber called a hyperbaric or pressure chamber. You may need to have this therapy more than once.

RISKS:

  • Wound treatment may be painful. Decreased blood supply to the area can lead to tissue death. Muscles, blood vessels, and bones may be affected. A scar may form on your skin as the wound heals. The risk of infection may increase with hydrotherapy (whirlpool treatment) or negative pressure wound therapy (NPWT). The risk of serious bleeding from the wound increases with NPWT.
  • Without treatment, the wound may get larger or more painful, and it may get infected. Infection may spread to other parts of your body. Infection delays healing, and you may need surgery to treat it. Infection can damage a body part or function, and may even be life-threatening.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.

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