... with so many wound types, dressings and products, that when you are confronted with an actual
wound it can be hard to know where to start. However, there are some fundamental principles that
every clinician needs to know when assessing and managing wounds, and these can form the basis of
your decision-making. This article provides an overview of these key areas.
WOUNDS AT A GLANCE
›
Wound management can seem
complicated...
10
WOUND CARE TODAY
2014,Vol 1, No 1
Wound definitions
Wound types
Acute wounds
Acute wounds heal without
complications in an expected
timeframe, following the
normal wound healing process
of haemostasis, inflammation,
proliferation, and maturation. Such
wounds usually result from surgery
or trauma.
Surgical wounds
Surgical wounds are created by
incisions and excisions in a sterile
environment, so have minimal tissue
damage, are usually clean, and in
areas that avoid blood vessels
and nerves.
However, if the injury is caused
before the surgical procedure, i.e.
in a traffic accident or stabbing, the
risks of infection are higher.
Trauma wounds
Trauma wounds occur when an
object penetrates the skin. Their
seriousness will depend on the
extent of the force that caused
the injury, and so can range from
minor abrasions to serious, life-
threatening injuries, including
skin tears, grazes, lacterations and
penetration wounds.
Chronic wounds
Chronic wounds do not follow the
normal healing process but become
stuck in one of the stages, resulting
in delayed healing or a failure
to heal. A wound that has been
present for more than one month is
generally regarded as chronic. Such
wounds include diabetic foot ulcers,
pressure ulcers, leg ulcers, and
malignant wounds.
Diabetic foot wounds
Three factors are usually the cause
of diabetic foot wounds: peripheral
neuropathy, peripheral arterial
disease, and abnormalities of the
foot. Their management can be
challenging due to these inter-
related causes, and should involve
the multidisciplinary team. They are
a major cause of limb amputations.
Pressure ulcers
These are localised areas of damage
to the skin and underlying tissue
as a result of pressure, friction or
shear, or a combination of these
factors. They usually occur over bony
prominences, such as the sacrum,
heels and hips. The majority are
preventable, so risk assessment
is essential.
Leg ulcers
These usually occur as a result of an underlying disease process, such as
venous, arterial or a mixture of venous/arterial disease. Chronic oedema —
swelling greater than three months — can develop if leg ulcers of venous
origin are left untreated, along with other irreversible skin changes.
