Wound healing

definition, classification of wound wound healing process, factor affecting and complication

1. Mr. Mahesh Chand Nursing Tutor WOUNDS

2. A wound is a break in the integrity of the skin or tissues often which may be associated with disruption of the structure and function. (SRB’s 4 th Ed.) A cut or break in the continuity of any tissue, caused by injury or operation . ( Bailey 23 rd Ed.) DEFINITION

3. According to status of skin integrity A ccording to cause of the wound According to severity of injury According to cleanliness According to descriptive quality Classification of Wound

4. Classification Closed wounds Is one in which there is no break in the continuity of skin or mucus membrane. E.g. hematoma , fracture of femur Open wounds Is one in which there is destruction of skin or mucus membrane, thus exposing underlying tissues to the open air. E.g. incision, vein puncture , bites . According to status of skin integrity

5. According to Cause of wound Intentional or surgical wound: Is one which is produced for a specific purpose, usually under aseptic precautions. e.g. surgical incision. Traumatic or Accidental wound: Is one which occurs by accident. E.g. knife wound, burn

6. According to Severity of injury Superficial wound: Is one in which only the epidermis layer of skin is involved. E.g. abrasion, first degree burn. Penetrating wound: Is one in which there is break in the epidermal layers of the skin, dermis and deeper tissues or organs. E.g. bullet which enters the chest and lodges in the lungs

7. Perforating wound: Is one in which a foreign objects or instruments cuts open the whole thickness of a wall of a cavity or organ. The object enters and exits an internal organ e.g. Gunshot wound. Puncture wound: Is one in which there is an injury to the deep tissues, but there is only a very small opening on the surface E.g. sharp pointed instrument injury

8. According to Cleanliness Clean wounds: Is one which does not contain pathogenic organisms. Examples Thyroidectomy Mastectomy Lipoma excision

9. Clean-contaminated Wound: No inflammation/Infection present Minor break in sterile technique Examples Simple appendectomy Prostatectomy Cholecystectomy

10. Contaminated Wound: Traumatic wounds Acute inflammation present Major break in sterile technique Gross c ontamination from respiratory, gastrointestinal or genitourinary tracts Example Traumatic wounds Cholecystectomy with bile leak

11. Infected wound: Organisms present at surgical site prior to procedure/Existing infection Perforation ( Gastrointestinal , respiratory , genitourinary tract) Example Appendiceal abcess Peritoniti s Colonized wound: Is a wound that contains multiple microorganisms. E.g. Pressure sore

12. According to Descriptive Quality Lacerate wound: Is the wound in which tissues has irregular edges. E.g Cut by a glass. Abraded wound: Is a superficial wound involving scrapping or rubbing of skin surface by friction. E.g. fall on floor. Contused or closed wound: In this there is no break in the skin. Externally wound is characterized by swelling, discoloration and pain. E.g. Blunt trauma. Incised wound: A wound is a clean cut and has smooth regular edges that can be approximated. E.g. wound made during surgery.

13. STAGES OF WOUND HEALING Stage of inflammation. Stage of granulation tissue formation and organisation. Stage of epithelialisation. Stage of scar formation and resorption. Stage of maturation.

14. PHASES OF WOUND HEALING Inflammatory phase Destructive Phase Proliferative phase Maturation phase

15. FACTORS AFFECTING WOUND HEALING Nutrition Age Blood supply Hormones Drugs Extent of the injury Infection Chronic diseases Smoking Obesity Radiation Wound stress

16. COMPLIC A TI O N Hemorrhage Wound infection Abscess formation Cellulitis Necrosis or gangrene Keloids Fluid collection Delayed wound closure

17. Thank you