Transcript H.C.A TRAINING PACKAGE SUTURE AND CLIP REMOVAL

H.C.A TRAINING
WOUND MANGEMENT
Sally Panto
Aug. 2006
AIM
• H.C.A will undertake training in
management of a variety of simple
wounds
OBJECTIVES
• To have awareness of stages of wound
healing
• To demonstrate knowledge of factors
affecting wound healing
• To develop knowledge in wound
assessment
OBJECTIVES
• To accurately complete wound
assessment chart and evaluations
• To demonstrate ability to select the ideal
dressing
4 Stages of Wound Healing
• Haemostasis
• Inflammatory response
• Proliferative response
• Maturation
Diseases affecting wound healing
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Anaemia
Diabetes
Venous disease
Oxygen deficiency
Arterial insufficiency
Rheumatoid arthritis
Malignancy
Immunosuppression
OTHER FACTORS
affecting wound healing
• Wound specific
slough/necrosis
wound infection
oedema
Poor wound management
traumatic cleaning/
dressing removal
Further Factors affecting Wound
healing
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Too frequent dressing changes
Inappropriate choice of dressing
Systemic Factors
Nutrition fluid intake
Stress Drugs e.g. cytotoxic or steroids
Radiotherapy
immobility
• Smoking
• Incontinence
• Age
• Ischaemia
Wound assessment
• Allows for wound care to be evaluated
• Monitor progress
• Communication between team
• Documentary evidence
When to Assess
• Initial Visit
• Evaluation date
• Change in wound condition
• When healed
Wound Assessment
• Type of Wound
• Useful and standard terminology - refer to laminate
sheet
• Granulation tissue
• Overgranulation
• Epithelialisation
• Necrosis
• Eschar
• Slough
• Exudate
• Odour
Wound Assessment
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Site of Wound
Wound Measurement
Wound bed
Surrounding skin
Skin edges
Pain
Cavity wounds
Example Pilonidal sinus
• This type of wound often requires daily dressing
• Wound heals by secondary intention
• Wound encouraged to heal from base & aim to
prevent premature closure of wound edges
Important to adequately but loosely insert packing
into cavity
To remeasure at least weekly
Appropriate equipment in dressing these wounds
Infection Control
& Safe Disposal of Waste
• Discuss Policy for the Management of Waste –
Newark and Sherwood PCT(2003)
• Aprons
• Gloves
• Clinical Waste disposal in patients home
clinic setting
care home
When to arrange council clinical waste- yellow bag
Wound Assessment
& Documentation
• Consulting nursing notes and care plans
• Completing wound assessment chart
• Evaluation sheet in Nursing notes
• All notes to be recorded at time of visit
• Any concerns to be promptly reported to nurse in
charge
Wound Photography
• Patient consent and explanations
• Consent form
• Best practice in taking photographs
• Is a photograph appropriate
• Frequency
MRSA
• Carried on either skin or in nose of 30-50% of population
(Colonisation)
• Good hand hygiene is essential for the prevention of
transmission of MRSA
• Treat all patients as potentially infectious
• How is MRSA spread
• Educate patient on importance of hand washing and
discourage from touching broken skin or wounds
• Use of alcohol hand rub
• Ensure scissors are washed before each patient use
steri swabs if dressings need to be cut
MRSA
• Whenever possible visit infected patients
at end of list of patients
• Principles of good infection control apply
to all patients not just those with known
infections
Ideal Dressing
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Moist environment
Manages exudate
Low or non adherence
Insulation
Protection
Acceptable
Cost effective
Treat symptoms