Wound care

Have you noticed a skin tear, cut, abrasion or operation wound that hasn’t healed within 4 weeks?

Are you confined to bed and noticing that red marks have begun to develop on your body from the pressure?

Have you got a nasty looking scab that hurts or smells bad?

Or perhaps you have lost sensation in your fingers and toes, you feel pins and needles or your fingers and toes have changed colour?

As we age, our skin changes and becomes more delicate, sensitive and inflexible. Sometimes even a slight knock can cause a tear that can be quite damaging to your health if it is not attended to properly. Wounds created by surgery and medical intervention also need to be managed much more carefully. Our nursing staff are trained to treat wounds and show you the best way to prevent infections and other complications.

What is a wound?

The skin is the largest organ of the body – accounting for 16% of your total body weight. It has several vital functions, including vitamin production, regulation of temperature, immune function, and of course sensation. Skin is a dynamic organ and is constantly changing – cells of the outer layers continuously shed and are replaced by inner cells moving up toward the surface.

However, as our population ages, chronic diseases (diabetes, vascular disease etc.) can compromise blood circulation and the skin’s integrity. Age and disease cause the skin to breakdown which makes healing a much longer and more tedious process. Unfortunately, the consequences of many of these diseases are ulcers and chronic wound development. This is extremely frustrating for both the patient and the family as it is difficult to know why a wound is not healing at the rate expected or anticipated.

The first step to managing the wound and promoting efficient healing is of course to identify what is going on, based on the signs and symptoms that are present. Some common causes can include:

  • Immobility (pressure injuries or bed sores)
  • Trauma injury to the skin
  • Surgery
  • Burns
  • Diabetes, ulcers, infections or some types of vascular disease 

Phases of wound healing and management

 3 phases
  • Phase 1 (0-3 Days) – In this phase, the body’s normal response to injury, there is increased blood flow associated with heat, redness, pain, swelling, oozing and loss of function.
  • Phase 2 (3-24 Days) – In this phase, the body makes new blood vessels, which cover the surface of the wound and help it to heal and become smaller.
  • Phase 3 (24+ Days) – In this phase, scar tissue is formed. However, the wound is still at risk and requires care.

Management

All wounds should be assessed regularly and the outcomes documented in a treatment chart. Our team of nurses can work with you to create and maintain a wound assessment and treatment chart to monitor and record the progress of your wound through the stages of healing.

Cleansing

The application of fluid to clean the wound and optimise the healing environment is one of the most common treatment options. The primary goal is to:

  • Remove debris and decaying tissue
  • Remove residue left behind by the dressing
  • Remove excessive fluid or crusting on the surface of the wound

Cleansing should ideally be done by a trained professional with prescribed solutions and tools. It is important not to disturb the normal healing tissue or traumatize the wound. Any disturbance to the tissue by the use of gauze swabs or cotton wool or by introducing of agents, soaps or cleansers that do not have the right pH balance, can cause more harm than good.

A wound will require different management and treatment at each stage of healing. No dressing is suitable for all wounds or stages, therefore it makes good sense to have a assessment by a trained professional and ongoing advice throughout treatment. Our team of nurses and personal carers can help you to:

  • Maintain a moist (but not wet) environment to promote healing
  • Control (remove) excess fluid and debris
  • Minimize trauma to the wound when cleaning
  • Protect the wound, keep it sterile and promote adhesion to the skin
  • Keep the wound close to normal body temperature
  • Maintain normal flexibility and body function
  • Save money and choose dressings which are non-flammable, non-toxic, and allow frequent inspection

Ongoing management

Inappropriate management of wounds can lead to delayed healing, deterioration and infection. Wounds should be carefully reassessed with each dressing change to ensure the most appropriate products are used. If you are unsure, please ask and we will provide you with suggestions and/or an assessment.

Factors delaying wound healing

A number of common, systemic factors can delay or impair wound healing. We can work with you to assess these potential factors and determine what can be done to safely accelerate the healing process:

  • Nutrition- protein, carbohydrates, fatty acids, and trace elements are essential for all phases of wound healing.
  • Restricted blood supply – diabetes, cardiovascular disease and patients who are bedridden
  • Certain drugs such as anti-inflammatory medications, corticosteroids etc deter healing
  • Chemotherapy – suppresses the immune system and the body’s response to healing and inflammation
  • Radiotherapy – increases production of free radicals which damage cells and prolong healing
  • Psychological stress and lack of sleep increase risk of infection and delay healing
  • Obesity – decreases tissue regeneration
  • Infection -prolongs the inflammatory phase
  • Reduced wound temperature delays healing
  • Inappropriate wound management in early phases
  • Inability to follow wound management plan due to lack of physical assistance by a carer
  • Unrelieved or prolonged pressure
  • Substance abuse including alcohol, cigarette and other drugs

For advice and professional assistance in managing your loved ones wounds at home, contact Sequel on 9499 1200. We would be happy to provide you with a free, no obligation checklist with some great self care suggestions and treatment options.

Michael's story

Michael is 68 years old and lives at home with his wife and disabled daughter. He has been in a wheelchair and oxygen dependent for two years now but only recently had his left leg amputated from the knee down due to a gangrenous wound.

Michael has had Type 2 diabetes for most of his adult life and his circulation has diminished considerably in the last 5 years. He now requires close supervision and support each day but his sister (who lives interstate) and his wife are unable to keep up and manage. His wife Emily also is the primary caregiver for their disabled child Julie, who also lives at home with them.

We’ve been providing care for Michael and his family for seven and half years. It started with us just going in four or five hours each week to give Emily some respite and also to help out with Julie’s transportation (to medical appointments) and personal care. When Michaels diabetes progressed and he became confined to a wheelchair, we were able to provide a nurse each day to help Emily clean and dress his wound, hoist him out of bed each day and into his chair and also ensure that he was taking the right medication at the right time.

With a little help from a personal care assistant and a nurse for two and a half to three hours in total each day, Michael and his family are able to get the medical attention and domestic support they need to keep their family together and ensure that both Michael and Julie are mobile and engaged. Emily still prides herself in being their primary caregiver of course, with a little help from Sequel to lighten the load and ensure the moments they spend together is quality time and not bogged down with logistics and domestics.