Wound Care 101: A Guide to Wound Care

Wounds are a normal part of life for almost everyone. Most people will experience at least one wound at some stage in their life. From scraping knees on the playground as children to diabetic wounds and ulcers in our older age, wounds can happen anywhere, anytime. Knowing how to identify and properly care for a wound is essential for effective recovery, so you can feel back to normal sooner. Read on to find out more about wound care, how to care for your wound at home, and when to seek professional medical support.

What is Wound Care?

Wounds are any breaks or damage that happen to the surface of your skin. There are many different types of wounds that require specific treatment. The right treatment pathway for a wound depends on its severity, location and how likely it is that the wound will heal well. 

The mechanisms in our body that promote wound healing can become less effective as we age. Chronic wounds and wound care are important issues for older Australians, including those residing in residential aged care. Wound care accounts for around 50% of the workload of community nursing professionals. Over 25% of older residents in Aged Care Facilities have one or more wounds requiring ongoing management and treatment. 

Every 15 minutes in Australia, people undergo amputations as a result of diabetic wounds that do not heal correctly. Early intervention and effective, holistic ongoing management are crucial for effective wound care and healing. 

Why is Wound Care Important?

Left untreated, even minor or shallow wounds can lead to secondary issues like infections, tissue damage and even the need for surgery or amputation. Wounds that become infected with dirt and manure, such as a puncture or animal bite, can lead to tetanus. Tetanus is a serious type of infection that can spread throughout the bloodstream via an open wound. Keeping up to date with your tetanus shots and getting a booster every few years is a great way to protect yourself from tetanus. 

Some people with chronic health conditions such as diabetes do not heal their own wounds as effectively as other people. For diabetics, poor blood flow can mean that wounds heal more slowly. This can lead to festering or tissue damage. Even minor scrapes and cuts can require immediate medical attention if it happens to someone with compromised immunity or wound healing.

Other common complications from untreated or mismanaged wounds include pain, scar formation and mobility issues. If in doubt, always seek medical advice on how to treat your wound or that of someone you love. The purpose of wound care is to get you healed as quickly as possible, so you can get back to doing the things you love.

What Causes Wounds, Cuts and Grazes?

There are many different types of wounds, including cuts, abrasions, lacerations and punctures. Many different things can cause a wound, including:

• Cuts are often caused by sharp objects or edges such as knives, paper or some metals.
• Abrasions are also known as grazes. Grazes are usually shallow injuries to the outer layers of skin caused by friction. Common causes include road crashes and bike accidents, where the rough surface of the road or pavement scrapes away layers of skin.
• Lacerations are deep cuts to the skin. They often have jagged edges and can be caused by blunt trauma.
• Puncture wounds are most often caused by a sharp, narrow or pointed object like a nail, sharp shard of glass or an animal tooth.
• Surgical wounds are made during surgical procedures and are usually closed with sutures following the surgery.
• Ulcers and bed sores are often caused by inactivity. They commonly affect those on bed rest or with low mobility.

Types of Wounds

Different types of wounds need to be treated differently. When deciding on a course of action to treat a wound for yourself or a loved one, it’s important to first understand what type of wound has occurred. Wounds are often categorised into open wounds, closed wounds, and ulcers or pressure wounds.

Types of Open Wounds

Open wounds are injuries that break the skin. Open wounds involve broken skin and exposed body tissue. Common types of open wounds include the following.

• Penetrating wounds
  • Puncture wounds (such as animal bites, injuries from needles or nails)
  • Surgical wounds and incisions
  • Thermal burns (caused by temperature)
  • Chemical burns (caused by exposure to harmful chemicals)
  • Electrical burns (caused by direct exposure to electrical currents)
  • Bites and stings (from animals or insects)
  • Gunshot wounds or other high-velocity injuries such as debris from explosions or arrows
• Blunt force wounds
  • Abrasions (grazes, such as road rash)
  • Lacerations (deep cuts)
  • Skin tears (cuts)

Types of Closed Wounds

Closed wounds involve damage to the tissue beneath intact skin. Closed wounds present their own unique challenges in diagnosis and treatment. Common types of closed wounds include the following.

• Contusions (pressure damage to the skin and underlying tissues from blunt trauma)
• Blisters (from heat, cold or other injuries)
• Seromas (a fluid-filled wound that develops under damaged skin or tissue)
• Hematoma (blood-filled area under the skin or tissue caused by internal blood vessel damage to an artery or vein)
• Crushing injuries (damaged bone, muscle or tissue underneath intact skin)

Ulcers and Pressure Wounds

Ulcers are their own type of wound. Ulcers are categorised into four main types: pressure, venous, arterial and neuropathic ulcers.

• Venous ulcers are vascular wounds caused by poor circulation and insufficient blood flow to the veins. Venous ulcers are often found on the legs and feet and are often painful.
• Arterial ulcers are vascular wounds caused by poor circulation and insufficient blood flow to the arteries. Arterial ulcers are often found on the legs and feet and are often painful.
• Neuropathic ulcers are characterised by a loss of sensation, known as peripheral neuropathy. Peripheral neuropathy prevents the person from feeling the injury, and so they may continue to put pressure on the injury site. Neuropathic ulcers are most common among people with diabetes and are often painless. Left untreated, neuropathic ulcers can pose a risk for infection and further injury.
• Pressure ulcers are also known as pressure sores or bedsores. They involve damage to the skin or underlying tissue as a result of prolonged pressure. Anyone can get a pressure ulcer, but they are most common among people on bed rest or with poor mobility who spend extended periods in a chair or bed. 

Healing Wounds: The Four Stages of Wound Healing

Your body has an incredible natural ability to heal from wounds, cuts, abrasions and ulcers. When you experience a wound, your immune system immediately starts working to help you heal from the wound as quickly as possible. There are four main stages of healing from a wound.

Stage 1: Hemostasis Phase

The first stage of wound healing is the hemostasis phase. This phase begins when blood leaks out of the body. This causes the blood vessels to contract, causing a clot to stem the blood flow and prevent excess blood loss. Your blood clots create platelets that block the opening of the wound. This phase of wound healing happens quickly and is important for keeping the blood cells and platelets trapped at the injury site. Some risks can occur during the hemostasis phase, including blood clots detaching from the wound site and travelling to another part of your body where it can restrict blood flow. In serious cases, this could cause a stroke, pulmonary embolism or heart attack.

Stage 2: Inflammatory Phase

The second stage of wound healing begins right after the injury occurs. The damaged blood vessels leak a substance called transudate, made up of water, salt and protein. This fluid creates localised swelling and inflammation. The inflammation phase of wound healing is important as it prevents infection and controls bleeding. The swelling creates space for repair and healing cells to move to the wound site and promote recovery. The inflammation phase can be uncomfortable but is a normal and important part of the wound healing process. During the inflammation phase, damaged cells, pathogens, and bacteria are transported away from the wound site to allow for tissue regeneration. If you are experiencing severe or prolonged inflammation from a wound, see your medical professional.

Stage 3: Proliferative Phase

The third stage of wound healing is called the proliferative phase. It is named this because, during this phase, your cells are rapidly reproducing to replace damaged tissue in your body. Inflammation may reduce during this phase, causing the wound to contract. Your body starts creating new tissues, as well as a new network of blood vessels to ensure a sufficient flow of blood, oxygen and nutrients to the injury site. In the proliferative phase, the wound site may appear granulated with pink or red skin that looks blotchy. Very dark granulation can be a sign of poor healing or infection. During the proliferative phase, epithelial cells travel to the surface of the wound site to repair the cells. 

Stage 4: Maturation Phase

The fourth and final stage is known as the remodelling phase or the maturation phase. During this stage, collagen is remodelled and the wound is fully closed. The cells that were used to repair the wound are removed by apoptosis (programmed cell death). The collagen that is laid down is often thick and tougher than your normal skin. Over time, the collagen fibres cross-link to reduce scar thickness and strengthen the skin. This process can take anywhere from 21 days to a year to fully heal the wound. Even if the wound is fully closed, it is important to take extra care with the wound site throughout this phase as the skin is likely not as strong as it was pre-injury.

Wound Care Professionals: Who Performs Wound Care?

The right wound care professional depends on the severity, cause and nature of your wound. Wounds are often caused by a complex range of factors, including some chronic illnesses. Wound care often requires a holistic approach from a multidisciplinary team of health professionals. Some health professionals that may support you or a loved one with wound care include the following:

• General practitioners or your family doctor
• Pharmacists

• Specialist wound care nurses
• Diabetes educators (if the wound is related to diabetes)
• Aboriginal and Torres Strait Islander health workers
• Podiatrists (for foot wounds).

What Does a Wound Care Nurse Do?

Wound care often requires a specialist nurse with specific training in treating and managing a wide range of wounds. Wound care nurses are medically qualified nurses with specialist training in treating wounds. They work with doctors and other health professionals to create wound treatment plans that meet the patient’s unique needs. Wound care nurses can support patients with many aspects of wound care, including the following:

• Cleaning and dressing wounds
• Determining the best treatment plan for complex wounds
• Educating patients and caregivers on wound care strategies
• Creating a wound care plan to follow at home
• Checking on the wound healing progress and maintaining up-to-date medical records.

To become a wound care nurse specialist in Australia, you need to follow the below steps to get qualified.

1. Get a nursing degree 
2. Get a registered nurse licence
3. Gain work experience as a registered nurse
4. Complete a wound care course
5. Earn wound care certification.

At Homage, we are always looking for more dedicated, passionate health professionals. To find out more about working with Homage as a nurse or specialist wound care professional, check out our recruitment page on our website. 

Potential Risks or Complications of Wound Care

Caring for a wound has the potential to go wrong. Even with our best efforts, complications can arise during the wound healing process. If you have a wound and experience any of the following signs of complications, seek urgent medical advice.

• Chills or a fever of more than 101 degrees Fahrenheit (38.33 celsius)
• Warmth, swelling, redness or increased pain at the wound site
• Increased drainage, foul odour, or puss secreting from the wound
• Sudden, excessive bleeding
• Sensation of hardness or fullness around the wound site
• Opening of stitches, staples or sutures
• Read more about the dos and don’ts of wound care here.

Healing with Homage: How Homage Can Support Wound Healing

Wound care can be a complex, challenging and frustrating process, so don’t try to do it all alone. Our team of nurses at Homage can help to change wound dressings and provide proper wound care to promote better wound healing. Travelling to and from doctor’s offices can be a burden, especially if you are unwell or exhausted from recovering from your wound. If you or your loved one require professional wound care at home by nurses, we can help.

Experienced nurses at Homage can visit your home to help assess and provide the appropriate care and treatment for your wound. Besides changing wound dressing, they can also advise you on what to look out for and share tips on how you can speed up healing.

While minor wounds can usually be managed with home remedies, more serious, deep or dirty wounds should be assessed by a nurse or doctor. Chronic wounds — those that take a long time to heal — may also need to be dressed regularly by nurses or trained caregivers.

Common types of wounds that Homage nurses can help with include bedsores, diabetic wounds and surgical incisions.

Have an obligation-free conversation with our Care Advisory team today and learn why thousands of families trust Homage to deliver the best care in their homes.