Wound Care: Dos and Don’ts

When you have a wound, it is vital that you administer the proper care to ensure the wound site heals effectively through the body’s natural healing mechanisms. Wounds including cuts, burns, abrasions and surgical incisions must be cared for to prevent the risk of infection and long-term damage to the wound site. There are many ways that you can optimise the healing process through simple wound care practices.

What is Wound Care?

Wound care refers to the treatment and management of skin wounds. Wounds are damage or breaks in the surface of the skin and can range from minor cuts to serious lacerations.

Types of Wounds

There are two major types of wounds – acute wounds and chronic wounds. Acute wounds can be minor or serious wounds that progress through normal phases of healing, either with or without treatment. Chronic wounds are wounds that do not heal, heal very slowly, or that recur often. Chronic wounds typically require special care.

Most people will suffer from an acute wound at some stage; children often experience slight cuts and abrasions that require only basic first aid. However, chronic wounds are more often suffered by older people or people living with medical conditions. Chronic wounds can be caused by:

• Diabetes
• Vascular disease
• Infections, such as Bairnsdale or Buruli ulcers
• Trophic ulcers
• Surgical incisions
• Significant injuries
• Deep burns
• Being immobile with restricted blood flow (causing pressure injuries or bed sores).

Wound Care in Australia

Wound care is an important part of medical treatment in Australia. 50 per cent of community nursing is wound care, with chronic wounds affecting 270,000 Australians. More than 25 per cent of residents in Aged Care facilities have a wound. Older people take longer to recover from wounds, so it is crucial that they and their carers have a strong understanding of good wound care to prevent further problems.

Why is Wound Care Important?

Wound care is vitally important to facilitate positive health outcomes for people who suffer from acute or chronic wounds. When you suffer from a wound, your first priority should be getting the appropriate care so that you can return to normal life as quickly as possible.

The Healing Process

Wound care is intended to support and expedite the natural healing process of the body. When a wound occurs, healing normally progresses along three stages.

Firstly, the site of the wound will be inflamed as blood vessels constrict to prevent blood loss and then expand to increase blood flow. Platelets, or special clotting cells, gather at the site to build a clot. White blood cells also increase in the area to prevent infection. The wound will feel warm and look red and swollen.

Following this, the wound enters a fibroblastic stage of healing. Collagen grows within the wound to allow the skin to close over. Small blood vessels (capillaries) form to provide blood to the new skin. 

Over time, the wound will continue to heal as the body produces more collagen. Any scarring will fade and may completely disappear.

The entire healing process can take months or even years, but the first two stages of healing typically occur in days to weeks. However, if these stages are interrupted or a problem occurs, the wound may fail to heal.

Barriers to Healing

Some factors will slow down the healing process, resulting in wounds that are more difficult to manage.

• Infection: Foreign bodies can enter the body via a skin wound and cause multiple problems. When this happens, the body focuses on fighting the infection rather than healing the wound.
• Haemorrhage: If the clotting process fails, bleeding from the wound will continue. This prevents the next stage (the wound closing over) from occurring.
• Varicose veins: This can result in restricted blood flow, which interrupts the healing process.
• Dryness: Skin cells and immune cells require a moist environment. Dryness around the wound site can slow down the healing process.
• Poor immune system: A weakened immune system – caused by a medical condition, poor diet and lifestyle, or other factors – will slow the wound healing process.

20 Dos and Don’ts of Wound Care

10 Dos

Looking to expedite your wound healing and prevent scarring or lasting damage? These tips will assist the natural healing process and ensure you prevent infection.

1) Keep the Area Clean

Infection poses the greatest risk to your body healing itself. Always ensure your wound is kept clean by removing dirt and debris. You can clean your wound gently using a soft cloth. If you are concerned that there is some dirt or other foreign bodies in your wound that you cannot remove yourself, you should seek medical attention immediately. Any debris left in a wound site can result in infection.

2) Avoid Dryness

Many assume that exposing a wound to the air is the best way to encourage healing. However, moisture is required for new skin cells to form, closing up the cut or laceration. Check your skin for dryness regularly and use moist dressings. Speak with your doctor if you need advice on preparing these.

3) Keep the Wound Dressed

Wounds should be kept warm to assist in healing. A proper medical dressing will prevent your wound site temperature from dropping and will also ensure your wound is kept moist, clean and free of outside contaminants. If you need assistance in dressing wounds, an experienced nurse can tend to your dressings for you.

4) Be Gentle

Always be careful when handling the wound site. Treat the skin gently without stretching, tugging or pulling on it unnecessarily. Never pick at scabs or try to remove skin from the wound site yourself. If you are concerned about dead skin around a wound, talk to your doctor.

5) Use Warm Water and Mild Products

When washing your wound site, always use water that is warm to the touch and not too hot. You can check the temperature of the water against your elbow or inner wrist. It can be ideal to rinse wounds under running tap water rather than soak in a bath. Cleanse the skin with a mild, pH-balanced product, such as saline solution.

6) Check Your Medication

As part of the healing process, a wound site will become red and inflamed. Although this swelling can be uncomfortable, it is an important part of healing. Do not take medication, such as anti-inflammatory drugs, to suppress this inflammation. This will hamper your immune system cells and slow down the healing process. If you usually take medication, ask your doctor if your prescription needs to change in the short term while your wound is healing. Remember that some over-the-counter pain killers, such as aspirin, contain anti-inflammatory properties and should be avoided.

7) Eat a Balanced Diet

A healthy diet encompassing all major food groups is a good choice regardless of whether you have a wound. However, it is especially important when your immune system is working hard that it is supported by good food choices, including lots of citrus fruits, green vegetables, oily fish, ginger, blueberries, and probiotic foods such as yogurt.

8) Increase Blood Flow

When you have a wound, you may be tempted to spend most of your time resting and stationery. However, blood flow is required for faster wound healing. Gentle exercise can encourage blood flow to the wound site. Speak with your doctor about appropriate exercises for you.

9) Boost Your Immune System

Your immune system is an important part of the healing process. When you have a wound, you are also at greater risk of bacterial infection and it is important that your body is able to fight off any foreign invaders. You can improve your immune system by eating foods rich in vitamin C, such as fresh fruit and vegetables. You can also take an over-the-counter supplement.

10) Use Support Aids

Special medical aids, such as support stockings, can assist in managing chronic wounds. Speak with your doctor about whether these may be useful and use them as instructed.

10 Don’ts

There are a few things that you should avoid when taking care of a wound. Incorrect care can further damage the wound site and slow the healing process.

1) Compress or Elevate the Site

Inflammation and increased blood flow are a normal and necessary part of wound healing. Compression methods or elevating the affected area to prevent swelling will disrupt this natural process and slow down the healing of the wound. Unless excessive blood loss is a concern, there is no need to compress a wound site.

2) Apply Ice or Cold Packs

Wounds require heat to heal. Avoid cooling your affected area by using ice packs or similar methods. The wound site will become hot and inflamed during the first stage of healing, but this is normal and not cause for concern.

3) Bathe in Hot Water

It is preferred that people with wounds use warm water rather than hot water when bathing and cleaning the area. Very hot water can irritate the wound site.

4) Use High Pressure Water

A high-pressure shower or similar can damage the skin of the wound and slow the healing process. Use slower moving tap water or fill a bucket and gently pour water over the affected area instead.

5) Use Alcohol Wipes

Skincare products that contain alcohol can be abrasive and damaging to sensitive, healing skin. Avoid alcohol wipes and similar products and choose gentle alternatives instead.

6) Use Antiseptic Creams and Sprays

There are many products that are marketed as being appropriate for wound care. However, many antiseptic creams, washes or sprays can actually have a negative effect on the skin cells and immune cells involved in wound repair. Check with your doctor before applying any over-the-counter products.

7) Apply Tape or Sticky Bandages

Bandages and tape with a sticky adhesive can be difficult to remove and may result in further damage to the wound site. Use a soft, non-sticky bandage instead. If you need to, you can secure the outside with tape that does not come into contact with the skin.

8) Scratch the Skin

Healing wounds can be itchy and unpleasant, but it is important to resist the temptation to scratch! Scratching can reopen a wound and slow down the healing process. Additionally, our fingernails can trap bacteria that enter the wound site when you scratch the skin.

9) Stretch the Area

Although some gentle physical exercise is recommended to assist in wound care, any movement that causes the skin of the wound site to stretch or move a lot can cause the wound to reopen. This will significantly slow down healing and could even result in infection and further problems. Talk to your doctor about how you can exercise while keeping the wound site safe.

10) Ignore Changes to the Site

If you notice that the wound is not improving or seems to be getting worse, contact your healthcare provider without delay. A wound that recommences bleeding or reopens after closing over may indicate additional problems that could require treatment. Always monitor your wound closely; it may be helpful to take photos of the site so that you can check for changes and show photos to your doctor if needed.

How Homage Can Help

 If you have a wound that requires medical or nursing care, the team at Homage can assist you in ensuring your wound is well looked after and heals as quickly as possible. Our wound care service includes cleaning and dressing your wound and monitoring it for signs of infection.

Become a Wound Care Nurse

If you are a qualified nurse looking for a flexible schedule, competitive rates, and a rewarding career, becoming a nurse with Homage could be the perfect fit for you. We match dedicated workers with clients who suit your strengths and interests. Being a wound care nurse with Homage means you can enjoy a better work-life balance, with the freedom to choose your own hours and the peace of mind that you are covered by our professional indemnity insurance. Find out more about working with Homage.

If you have suffered a wound, it is important to know the best way to treat and manage the wound site for optimal healing. Avoid anything that can interrupt or slow the body’s natural healing process, and always seek the assistance of a wound care nurse and other healthcare providers when needed.