Rosemarie Chung

B. Sc. Hons. Nursing Practice Development.

Wound Infection

Anatomy of the skin

1. Acute wounds Surgical woundPenetrating wound (e.g. knife or bullet wound)Avulsion Injury (e.g. finger tip amputation)Crushing or shearing InjuryBurn InjuryLacerationBite wound (e.g. Animal and human bites)

Types of Wounds

Types of Wound Injuries

2. Chronic wounds Arterial ulcer (Peripheral Vascular Disease)Venous Ulcer (Venous Insufficiency)LymphedemaPressure Ulcer (Decubitus Ulcer)Neuropathic ulcer (Diabetes Mellitus)

Types of Wounds

Process of Wound Healing

Primary intention healing The edges of the wound are closed (in apposition) and secured with sutures, clips or skin closure strips usually within 24 to 48 hours. Simultaneously in 8 to 10 days, healing takes place throughout the depth, and little new tissue is formed. For the first 2 days, there could be a little leakage of bloody exudate or of odour from the wound. A warning sign of a potential complication is beyond the normal signs that is a prime consideration in management of risks associated with the open phase of healing .

Modes of Healing

Secondary intention healing The wound has to be left open to allow

healing by contraction and replacement of missing tissue with granulation and epithelial tissue.  This is a common method of healing in surgical excisions or traumatic wounds with tissue loss.  However, the duration of healing depends on the amount of tissue that must be replaced which the resulting scar can be quite extensive.

Modes of Healing

Tertiary intention healing / delayed closure the wound

Such wound is kept open to allow for drainage of exudate, control of contamination or for further surgical procedures to be completed.  Usually within 7 days as bacterial contamination rises markedly from the 8th day onwards, the wound is surgically closed again.  Wound that has to be kept open for longer periods of time with significant bacterial contamination has to be reduced before surgically closed.

Modes of Healing

Normal Healing Process of Surgical Wound

RednessPainHeatSwelling of wound

and periwound area

Signs of Wound Infection

Wound Breakdown

Management of Wound Sepsis

http://www.youtube.com/watch?v=D6KtFyFTtgI

Method of wound swab for C+S

Maintain sterility during dressingUse sterile water only if the wound is infected

with MRSAEnsure proper taking of wound swab for c+sAlways practice 5 moment hand hygiene and

standard precaution. Refer to website Family Practice

notebook.com: Wound Dressing for different types of wounds

Observe and document characteristic of wound / progress of wound healing.

Wound Dressing Management

Wound. Available at: http://www.fpnotebook.com/Surgery/DER/Wnd.htm

Management of surgical wounds. Available at: http://docs.google.com/

Additional referencePreventions of hospital acquired infections.

Available at: http://apps.who.int/medicinedocs/documents/s16355e/s16355e.pdf

Wound Dressing. Available: http://www.fpnotebook.com/Surgery/Pharm/WndDrsng.htm

Reference