Wound Management Essay Discussion Paper
Moist Wound Healing
To complete this assessment you must answer the following questions supported with research evidence using relevant resources including textbooks and reputable internet sources. You must document your research findings using the template provided below and provide a list of sources you have used to base your findings on. The word length required for each answer varies and is indicated with each topic.
As there are many different causes of wounds, there is no “one size fits all” approach to the assessment, treatment and management of wounds.
Each wound must be assessed for its individual characteristics to determine the best course of treatment and management strategy in order to facilitate optimal wound healing. You will need to conduct research to answer the questions in this assessment for each of the following topics associated with wound management:
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- Moist wound healing
- Holistic assessment
- Individualised plan of care
- Problem solving frameworks
- Risk and skin assessments
- Pressure injury support, management and prevention
- Visceral wound management
- History of contemporary wound management strategies
- Community resourcing
- Wound types and a nursing care technique for management of that wound.
- Wound care products
- Drainage tubes
- Causes of infection
- Reference list
You will need to ensure that your findings are supported by evidence-based research and you cite your references using the APA referencing style and that your response is consistent with the identified word counts below.
- What is moist wound healing and what nursing interventions should be applied to implement this wound management strategy?
- What are the benefits and limitations of moist wound healing? Wound Management Essay Discussion Paper
| Moist wound healing refers to the practice of keeping a wound moist which leads to rapid and relatively faster healing than in the normal environment. It is proven by many studies that moist wound healing heals the injury or wound around 5-6 times faster than usual dry environment.
The nursing intervention which is implemented in moist wound healing strategy is · Debride the tissue and cleansing of the wound in order to removing the debris. · Providing moist environment by using proper dressing and covering the wound with wet cloth or moist bandaids. · Protecting wound from coming in contact with infectious elements and further injury as well. · Providing proper nutrition to the healing process so that the wound gets healed faster. Benefits of moist wound healing The major benefits of moist wound healing is that : · Wounds get improved faster and take less time to heal. · Kerantinocyte cells a major component of the epidermis functions more easily. · Autolytic debridement is facilitated · Reduce the risk of infection occurs in the wound · Preserving the growth factor present in the wound fluid · Stimulates the collagen synthesis · Reduces pain and scarring around the wound Limitation of moist wound healing Some of the limitations of wound healing is that too much moisture is not good for the wound as excessive moisture because the fluid comes out of wound is very rich in melting the protein and removing the wound bed from the skin but excessive fluid can also melt out the normal skin bed and tissues Wound Management Essay Discussion Paper. |
- What does holistic wound assessment involve and how does it contribute to the management of wounds? In your answer you will need to identify what factors are included in a holistic assessment.
| The holistic wound assessment involves the patient medical history such as past and existing medical conditions. The history involves the factors such as psychological, social and spiritual history. It also involves their wound care environment and specialised health services. The holistic wound assessment approach contributes in wound management by helping in considering all the factors that are involved and affects the healing of the wound and provides the framework or a baseline to tracking and monitoring the process of healing of the wound. It provides the setting and adjusting the goals related to the management of the wound. The factor included in holistic assessment are self assessment of the patient, medical and wound history of the patient, ability of the patient to communicate, patient’s choice and preference related to the care they want to receive, cultural and religious beliefs of the patient, and the language and need for an interpreter. |
- What is your understanding of what constitutes an “individualised wound management plan of care”?
- What information needs to be considered and included in such a plan? Wound Management Essay Discussion Paper
| Individualised wound management refers to the reflective of ongoing assessments. It is used in the optimal management in order to enhance the effectiveness of the wound treatment. It includes maintaining communication with the patient related to the healing results of the wound. The important factors of individualised wound management plan of care are
Social – Social factors that affect patients care and treatment are ethnicity and cultural beliefs. Psychological – the psychological factors that are considered are health conditions such as diabetes, cardiovascular diseases, peripheral vascular which can also lead to depression. Physical – It is important to consider the physical condition as the condition such as obesity, cardiovascular disease and others can impact our healing in wounds. Nutritional – The healthy and nutritious diet affect the process of healing such as protein, carbohydrates, minerals, vitamins etc. lifestyle factors – Smoking and alcohol consumption are two factors that adversely affect the healing of wound (Woundsource, 2022)Wound Management Essay Discussion Paper. The information needs to be considered in individualised management plan of care starts from obtaining a through health history of the patient, the current list of medication which is taken by the patient. The information related to the diet combination including protein, carbohydrates, minerals, vitamins is important as it is essential for healing. |
Conduct research to identify and summarise and explain the following problem-solving frameworks used in nursing care:
- HEIDIE
- TIME
| The HEIDI problem solving framework is a structured approach which treat the person to its entirety and consider wound a larger approach rather than considering who the individual is. In HEIDI problem solving frame work stands for history, examination, investigation, diagnosis, and implementation.
History – The patient history provides several items and information related to the past medical and wound. Examination – This step is related to examining the patient in order to identifying the symptoms which are required to manage in order to heal the wound. Investigation – Investigation of other related issues in the body, reviewing other symptoms in order to encourage the fast healing (Thewoundguy., 2018). Diagnosis – Diagnosis is related to following the results carried out after the investigation and examination of the body. Intervention – intervention refers to the plan of care in order to heal the wound or the injury soon and treating the other related symptoms and issues in the body. The TIME problem solving framework is structured for the healing of the wound it is consisted of four important factors that are tissue debridement, infection, inflammation, moisture balance and edge effect (Woundsource, 2016)Wound Management Essay Discussion Paper. |
- What is the purpose of conducting a skin and risk assessment to manage pressure injuries? In your response, include an example of a risk assessment tool and how it is used to provide wound care management.
| Skin and risk assessment is done in order to predict the pressure points for their injuries or the risk of pressure ulcer. Risk and skin assessment is considered to be a very important and useful preventive tool in order to prevent the skin pressure ulcers or take necessary interventions for healing and treating the wounds and pressure ulcers and other pressure points. Some of the common risk assessment tools are risk matrix, decision tree, failure modes, and effects analyses (effectivehealthcare, 2012)Wound Management Essay Discussion Paper. |
- Outline and discuss five different strategies which can be implemented to prevent the incidence of pressure injuries
- Outline and discuss how pressure relieving devices and supports are used to assist with the management of pressure injuries. Provide at least two examples in your response.
| Five different strategies to prevent the incidence of pressure injuries are
· Get seniors moving – keeping the circulation better and keeping the seniors and pressure area moving and changing time to time · Checking the area of skin in order to identify the sign of developing pressure sores. In case there is any development of sores early intervention and preventive measures can be taken. · Keeping the skin dry and clean – it is essential to keeping the area of pressure ulcers clean and dry and preventing open and moisture environment away · Encouraging the patient to maintain healthy and nutritious diet – it is important o instruct the patient to maintain health and nutritious diet which help in healing and prevention to the development of the sores. · Managing other chronic health conditions carefully – it is also important to managing other chronic diseases in order to prevent ulcers that are diabetes, blood pressure. Pressure reliving and redistributing devices help are widely accepted methods of trying to prevent the development of pressure ulcers for people considered as being at risk some of the pressure reliving devices are mattresses and heel troughs, and splints (Medlineplus, 2022)Wound Management Essay Discussion Paper. |
- Discuss what a “visceral wound” is (including blunt abdominal injury and surgical dehiscence)
- Outline the nursing care considerations for these wounds, including strategies for assessment and treatment, and any health professionals who may be involved in the management of these wounds.
| · Visceral injuries are the wounds in the internal organs, it is happened due to the blunt trauma in the leads to the solid organ rupture and visceral damage, and it causes haemorrhage, contamination with the visceral contents. Blunt abdominal injuries refers to the in children in the absence of the history of significant trauma are rare. The abdominal injury is the major cause of morbidity and mortality in the abused children (The Royal children’s hospital Melbourne, 2022).
· The nursing care considerations included in this including the assessment and treatment are initial management, history taking, current health status and lifestyle and social circumstances, wound status and wound assessment. |
- Research and discuss the following two examples of contemporary wound management strategies and how they have developed over time:
- Antibiotics
- Moist wound healing
| Antibiotics are the medicines that are used to fight and prevent the bacterial infection in humans and animals; they help in killing the bacteria and preventing it from growing and multiplying. In 1928 after the discovery of penicillin by sir Alexander Fleming antibiotics help in transforming the modern medicine and saving the several lives since then. Antibiotics helped in treating the serious infections in the 1940s (Medlineplus, 2015).
Moist wound healing is the practice of keeping the wound moist in order to speeding up the healing of the wound. In 1962, the idea of moist wound healing is discovered by George D. Winter after discovering the epithelisation which is the process of wound closure which is proceed twice which twice as faster in the moist environment that under the scam in the dry environment (Woundsource, 2016)Wound Management Essay Discussion Paper. |
a) community resources associated with wound management
b) educational resources associated with wound management
c) professional organisations associated with wound management
| Resource | Examples |
| Community resources | The Australian wound management association is the multidisciplinary non profit association committed to treating and improving the wound management
The world council of Enterostomal therapists |
| Educational resources | The two examples of educational resources are
Closer to zero online education – it is an online education podcasts and webinars in advanced wound management. Education and evidence – it provides the educational information about the therapeutic areas of wound assessment and management. |
| Professional organisations | The two major examples of wound management is professional organizations are
Australian wound management association South Australian society of vascular nursing |
| Wound type | Description | Nursing care technique |
| a) Surgical incisions | The surgical incision is the cut made through the skin and soft tissue during the operation or surgery to facilitate the operation. | Using of aseptic, which is a non touch dressing and changing?
Leaving the wound untouched for up to 48 hours. |
| b) arterial ulcers | The arterial ulcers are the injuries caused by the poor circulation. | Improving circulation, conservatively debriding the wound and controlling the pain |
| c) Venous ulcers | These are the injuries occurs in leg due to issues in the blood flow in the leg veins | Healing the ulcer, improving the blood flow, leg elevation and healthy diet. |
| d) Mixed ulcers | it is the condition when the person might have venous disease and a significant level of arterial disease but still their arterial blood supply is not poor enough | Treating the venous disease and the arterial disease. |
| e) malignant wounds | Maligent wound are caused due to the loss in vascualarity leads to the death of tissues | Symptom management, treatment of the underlying tumour. |
| f) neuropathic ulceration wounds | It is the loss of protection sensation which results into the regular stress and development of injuries leads to painless ulcers in pressure points | Reducing pressure from the affected area, reliving the pressure points and improving the circulation. |
| g) infected wounds | It happened due to the infection of pathogenic organisms which invaded the tissue surroundings | cleansing and debriment of the wound, changing dressing |
| h) burns | Burns is the damage of tissue due to heat, sunburn or chemical or electric reaction | Assessing temperature of urine and in every 4 hours
Monitoring the white blood cells Protective isolation |
| i) fistulas and sinuses | Fistulas is the after result of injury or the surgery
Sinus is the small opening in the body |
Dressings that result into the granulation of the cavity and track. Skin protection, odour control, pain management and patient care |
| j) skin grafts | It is the patch of skin removed in the surgery from one area and attached to another one | Rest, dressing, cleansing of wound, dryness around the area, non touch dressing. |
| k) visceral wounds | These are the injuries in internal organs. | Cleaning wound and removing debris, proving healing by proper dressings. |
| l) discharging wounds | It is the dilation of the blood vessels during the early healing, it can be caused by presence of bacteria over wound | Protecting wound from bacterial exposure, cleansing of the wound and dressing |
| m) pressure injuries (ulcers) | It happens due to force on the surface of the skin | Washing the area, cleansing it, covering the sores with special dressings |
For the following wound care products, identify the key indications for use and one example (brand) of the product.
| Wound care product | Indication for use | Example |
| Semipermeable film | This is a transparent dressing used for the IV, donor incision and minor burns. | 3M and Tegaderm |
| Foam | It is use for the leg ulcers, surgical wounds and, skin grafts and burns | Medoine stock biatain, Mepilex and Medstock. |
| Wound cleansing solutions | It is used for removing the infection and contaminated bacteria and wound surface | Alpha Cleanse, Dakin’s and 3M. |
| Hydrocolloid
Sheets, paste and powder |
This is used majorly in third degree wounds and infected ulcers. | DuoDERM, RepliCare |
| Hydrogel | It is used for pressure ulcers, cavity wounds, leg ulcers and graft wounds | AMERIGEL, 3M AquaSite |
| Calcium alginate | It is used for the primarily dressing in the treatment, full thickness draining wound, IV pressure ulcers. | Aliginates, 3M and Tegagram |
| Gelling fibre (Hydrofibre is a trademark term) | Lower leg ulcers, thickness burns, traumatic wounds | 3M, Kerracel, AQUACEL |
| Hypertonic saline impregnated | It is used in providing absorbation, debriment and protection | 3M |
| Acrylic dressings | It is a transplant wound dressing fluid handling absorption capacity | 3M and Tegaderm |
| Odour absorbing | It is a dressing with activated charcoal used for absorbing the odour from the wound | CarboFLex and Medline |
| Silicon | It is used to improving the skin healing | Dayvital, fruitlam woman and Gluspan |
| Silver dressings | It is used in the primary and secondary dressing of minimal and acute and chronic wound | Algicell, silvasorb and Mepilex |
| Negative pressure therapy devices | It is indicated for acute and minimal wound for diabatic foot wound | 3M ActiV and Avelle |
A drainage tube acts to promote healing by providing an exit for blood, serum, and debris that may otherwise accumulate and result in abscess formation (Koutoukidis & Stainton, 2021, p. 1377)Wound Management Essay Discussion Paper. For each of the wound drains and drainage systems below, outline their characteristics and nursing consideration in relation to wound drain care.
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| Surgical drainage tube | Characteristics | Nursing considerations |
| The non-suction drainage tube (Penrose or Yates drain) | This tube is used to remove the pus, blood and other fluids from the wound | Cleansing the wound and disinfecting and changing the dressing. |
| The closed-wound drainage tube (Survac, Redivac, Provac, Exudrain) | The perforated tubing connected to the portable vacuum unit | Preserve the integrity of the surgical wound |
| Jackson-Pratt Wound drainage | It is the tube which prevents the fluid from getting collected to the site of the surgery. | Empty it, milking it, keep it secured, assess it regularly |
| Pigtail | It is a type of drainage help in letting the fluid getting out of the area near lungs and abdominal organs. | Flushing the drain and changing the dressing |
| Factor | Description and example |
| a) Bacterial infection | Bacterial infection occurs due to the entrance of the bacteria in the body which causes reaction to the body. Some of the bacterial infections are salmonella and tuberculosis |
| b) Common viral infection | Infection caused by the presence of the virus in the body which infect the body from inside. Some common viral infections are Ebola, HIV and COVID 19 Wound Management Essay Discussion Paper |
| c) Common fungal infection | Fungal diseases are occurred due to the presence of fungi in the body or environment. Some of the common fungal infections are ringworm and Jock itch. |
Wound Management Essay Discussion Paper