Wound(nursing foundation)(pathology)

wound , types of wound , management

1. Wound

2. I ntroduction- A wound is a type of injury which happen relatively quickly in which skin is torn, cut, or punctured or where blunt force trauma causes a contusion. In pathology, it specially refers to sharp injury which damages the epidermis of the skin.

3. Definition of wound- An injury to the body from violence, accident or surgery that typically involve laceration or breaking of membrane.

4. Types of wound- Open wound Close wound 1. Incision 1. contusion 2. Laceration 2. Hematoma 3. Abrasions 3. Sprain 4. Puncture wounds 5. Penetrating wounds 6. Avulsion wounds

5. Some types of open wound OPEN WOUND - (a):- Incision - Caused by a clean, sharp edges object such as knife, a razor or a glass sphinctor . (b):- Laceration - Rough, irregular wound caused by crushing or ripping forces. (c):- Abrasions - A superficial wound in which the topmost layer of the skin are scrapped off, often caused by a sliding fall on to a rough surface . (d):- Puncture wounds- Caused by an object puncturing the skin, such as mail or needle.. (e):- Penetration wounds - Caused by an object such as knife entering the body. (f):- Avulsion wounds - A wound that occurs due to the integrity of any tissue is compromised.

6. CLOSED WOUND- Closed wound have fewer categories, but are just as dangerous as open wounds. (a):- Contusions - Also known as bruise caused by blunt force trauma that damage tissue under the skin. (b):- Hematoma - Also called a blood tumor caused by damage to a blood vessel that in turn causes blood to collect under the skin. (c):- Sprain - Also known as a ligament torn, is the stretching or tearing of ligament within a joint.

7. Wound healing - Wound healing (tissue healing) refers to the body’s replacement of destroyed tissue by living tissue. OR Wound healing is the process by which the body is trying to achieve anatomical integrity of the injured part and restore full function..

8. Phases of wound healing Phase 1- Haemostosis phase - I n this phase, the body activate its emergency its repair system (clotting system) and forms a dam to block the drainage. During this phase, platelets come in to contact with collagen, resulting in activation and aggregation. An enzyme called thrombin is at the centre and it initiates the formation of a fibrin mesh, which strengthened the platelet clumps in to a stable clot.

9. Phase 2- Inflammatory phase defensive – During phase II, Neutrophils enter the wound to destroy bacteria and remove debris and the WBCs leave specialized cells called macrophages arrive to continue clearing debris these cells also secrete growth factors and protein that attract immune system cells to the wound to facilitate tissue repair. This phase often last four to six days and is often associated with edema, pain and heat, reddening of the skin .

10. Phase 3-proliferative phase- The proliferative phase features three distinct stages- filling the wound- contraction of wound margin- covering the wound. During first stage, shing , deep red granulation tissue fills, the wound bed with connective tissue and new blood vessels are formed During contraction the wound margins contract and pull towards the centre of the wound . In the 3 rd stage wound is covered C epithelium. The proliferative phase often lasts from 4 to 24 days.

11. Phase 4- Maturation phase – During the maturation phase, the new tissue slowly gains strength and flexibility collagen fibers re-organize. The tissue remodels and matures. The maturation phase varies greatly from wound to wound often lasting from 21 days to 2 years.