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Wounds and treatment
Factors that contribute to wound healing
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1. Introduction 1.1. Background Wound occurs when the integrity of any tissue is compromised (e.g. skin breaks, muscle tears, burns, or bonefracturs). A wound may be caused by an act, such as a gunshot, fall, or surgical procedure; by an infectious disease; orby an underlying condition (1). The wound-healing process consists of four highly integrated and overlapping phases: hemostasis, inflammation, proliferation, and tissue remodeling or maturation (2). These phases and their biophysiological functions must occur in the proper order, at a specific time, and continue for a specific duration at an optimal intensity. There are many factors that can affect wound healing which interfere with one or more phases in this process, thus causing improper or impaired tissue repair (3). Surgical incision leads sterile tissues to come into contact with the septic environment and causes contamination. Wound healing is delayed when …show more content…
SSI continues to remain a major problem in hospitals, contributing significantly to increased rate of morbidity, mortality and cost of care (18). In developing countries like Ethiopia postoperative wound healing still remains a problem to surgical patients and a challenge to clinicians despite that much effort on wound care management has been provided. Ethiopia still suffers from a lack of qualified health workers. Increased burden of diseases affects the quality and supply of effective health services, which has seen postoperative patients get inadequate wound treatment and wound (dressing) care management in surgical wards, resulting to wound healing delay and complications
Carlton suffered an acute tissue injury on his foot after stepping on a sharp edge shell, which disrupted the layers of the skin. Immediately after an injury occurs, an inflammatory response begins, which serves to control and eliminate altered tissue/cells, microorganism, and antigens. This takes place in two phases. 1) The vascular phase, in which small vessels(arterioles, venules) at the site of injury undergo changes. Beginning, with
There are many outpatient surgical procedures and one of them is an incision and drainage
The challenges that all acute care hospitals and facilities faces are the demand for highly specialized services has increased. The US population is constantly aging and the elderly tend to need more acute care services. Because many people lack health insurance, they tend to use emergency rooms in the hospitals as their source of care. The increase demand in acute care prompted hospitals to expand their facility
In 1865 before an operation, he cleansed a leg wound first with carbolic acid, and performed the surgery with sterilized (by heat) instruments. The wound healed, and the patient survived. Prior to surgery, the patient would need an amputation. However, by incorporating these antiseptic procedures in all of his surgeries, he decreased postoperative deaths. The use of antiseptics eventually helped reduce bacterial infection not only in surgery but also in childbirth and in the treatment of battle wounds.
Melling, C. A., Baqar, A., Eileen, M. S., & David, J. L. (2001, September 15). Effects of preoperative warming on the incidence of wound infection after clean surgery; a randomised control trial. The Lancet, 358, 876-880.
It regulates the ratio between epithelial cells and collagen fibers as well as changes in their morphology. The imbalance of collagen metabolism and its arrangement is attributed to many factors which result in increased synthesis of collagen by fibroblasts and myofibroblasts, which in turn inhibit the activity of collagenase, leading to extensive scar hyperplasia. Matrix changes, mainly changes in fibronectin and mucopolysaccharides, result in scar stiffness. MEBO Scar Ointment can accelerate the re-arrangement of twisted collagen andreduce proliferation of fibroblasts, thus restricting scar hyperplasia. [11,13,14,15 ,21] The accumulation and synthesis of mucopolysaccharide can also be reduced once local tissues are compressed, thus reducing generation of collagen and the corresponding scar tissue. [11] Moreover, massaging the MEBO Scar ointment onto old scars can potentially reduce blood supply within scars, decrease synthesis of collagenous fiber, and,reduce α2-M (alpha 2-macroglobulin) globulin of collagenase in serum which facilitates collagenase activity and speeds up disintegration of collagen in old scars,this facility by applying MEBO scar ointment .
Inflammation: the response to injured tissue that stops bleeding and causes swelling and warmth as the tissue prepares to repair itself
CLABSIs are not confined to one unit of nursing care and there are many precipitating factors that may contribute to the development of a CLABSI. Often times these lines are placed in emergent situations in the emergency department (ED) and there may be a break in sterile technique. However a study conducted by Smith, Egger, Franklin, Harbrecht, and Richardson (2011) found a higher incidence of CLABSIs among intensive care unit (ICU) patients compared to those patients whose CLs were placed either in the ED or operating room (OR). This indicates further education for ICU s...
A pressure ulcer is an area of skin with unrelieved pressure resulting in ischemia, cell death, and necrotic tissue. The constant external pressure or rubbing that exceeds the arterial capillary pressure (32mmHg) and impairs local normal blood flow to tissue for an extended period of time, results in pressure ulcer (Smeltzer et. Al., 2013). According to National Pressure Ulcer Advisory Panel, 2014, pressure ulcers are a major burden to the society, as it approaches $11billion annually, with a cost range from $500 to $70,000 per individual pressure ulcer. It is a significant healthcare problem despite considerable investment in education, training, and prevention equipment. This paper includes two different studies to link cause-effect
Maintenance of an appropriate healing environment is also essential throughout the management of diabetic foot ulcers. The choice of dressing is dependent on many factors including presence of infection, amount of exudate and the required frequency of wound bed inspection.
Electrical stimulation (ES) therapy involves the transfer of electrical current across wound tissue through the two electrodes and uses three types of currents: AC, DC and Pulse DC. According to various studies, electrical stimulation therapy has shown to reduce inflammation, edema, improve wound appearance, cause a faster reduction in wound size by helping to kick start the wound healing process and is cost effective for many patients. It has generated a positive impact on patient’s comfort and convenience. Electrical stimulation therapy has provided numerous beneficial effects in wound healing demonstrated by various studies, however; further research trials are needed in order to prove the effectiveness and benefits of electrical stimulation therapy as it relates to wound healing (Cutting, 2006).
Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). ( book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa.(secondary) Urinary tract infections occur when one or more of microorganisms enter the urinary system and affect the bladder and/or the kidneys. These infections are often associated improper catheterization technique. Surgical site infections occur after surgery in the part of the body where the surgery took place. These infections may involve the top of the skin, the tissue under the skin, organs, or blood vessels. Surgical site infections sometimes take days or months after surgery to develop. The infections can be cause by improper hand washing, dressing change technique, or improper surgery procedure. Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung in...
Although the importance of aseptic technique has been continually reiterated, I have realised its substantial role in the perioperative environment. Aseptic technique refers to the practice of creating and maintaining a sterile environment used for sterile procedures (Laws, 2010a). This is incredibly important as repetitive minor breaches of the sterile environment is one of the major factors increasing the risk of surgical site infection (Harrop et al., 2012).
Our approach in managing wounds was far from being optimal in our own setting. After having read the article of Sibbald et al (1) and assisting to presentations during the first residential week-end, our approach at St. Mary 's Hospital Center 's Family Medicine Clinic must change. We were not classifying wounds as healable, maintenance or non-healable. We were always considering the wounds in our practice as healable despite considering the system 's restraints or the patients ' preferences. In the following lines, I will define and summarize the methods one should use in order to initial management of wounds and how to integrate it better to our site. The first goal we need to set is to determine its ability to heal. In order to ascertain if a wound is healable, maintenance or a non-healable wound.
The white blood cells destroy any unfamiliar pathogens in the bloodstream and can cause inflammation. Therefore, the inflammation causes a surplus of white blood cells to clot the wound for healing.