Wound Care and Treatment
Wound care and treatment is aimed at the care and treatment of tissue defects that occur in different parts of the body and which are difficult to heal or not.
How do acute and chronic wounds differentiate?
We evaluate wounds in two parts as acute wounds and chronic wounds. Acute wounds are cuts, abrasions and burns that are expected to heal within 3-4 weeks. Chronic wounds are persistent wounds that have not been healed for 6-8 weeks and are caused by bed dependency, vascular insufficiency and diabetes.
How do chronic wounds occur?
As a result of chronic discomfort - heart failure, renal failure, and so on.
As a result of advanced malnutrition
As a result of advanced diabetes affecting the vascular and nervous system
As a result of circulatory disorders
Prolonged hospitalizations and exposure to pressure after wheelchair use
As a result of disruption of tissue healing and blood supply after radiotherapy
What are the types of chronic wounds?
The most common chronic wound types are bed sores, pressure sores, diabetic foot and varicose wounds.
What is a bed sores?
Bed or wheelchair-bound persons have pressure on soft tissues due to the pressure of body weight. The circulation of these tissues trapped between the bone protrusion and the bed is impaired, resulting in damage to the tissues. When this damage reaches a certain level, a pressure ulcer or decubitus ulcer occurs with its name in medicine. Advanced age, malnutrition, inadequate fluid intake, obesity, high blood pressure, diabetic sensory loss, and incontinence are risk factors for the development of pressure sores. Friction is high and the skin stays taut, body temperature is high and leaving the skin wet makes the formation of wounds easier.
When does pressure sores occur?
Sitting (on coccyx, shoulder blades, rough meats, elbows, heels)
Lying on his back (on the back of the head, shoulder blades, hips, elbows, coccyx, heels, toes)
Lying on the shoulder (in the ears, on the side of the shoulder, on the pelvic side, on the hip, on the knee, on the side protrusions of the ankles)
It may occur while lying on your face (face, shoulder, pelvis, knee, protrusions of the wrists).
Stages of pressure sores:
There are 4 stages in the formation of pressure sores:
Stage 1: There is redness that does not disappear when pressure is applied, the person feels pain but the integrity of the skin is intact.
Stage 2: Tissue disruption and injury on skin surface or upper layers of skin
3 stage: All tissues including subcutaneous tissue are affected and necrosis. The wound appears to be a deep crater to the underlying tissues, usually not feeling pain.
Stage 4: All layers of the skin are affected, there is damage to the muscle and bone tissue. The wound is usually infected, no pain is felt.
Treatment of pressure sores (bed sores) according to stages:
Stage 1: If the person's bed or wheelchair is used, it is recommended that the wheelchair cushion be replaced with a mattress or cushion capable of reducing the pressure and spreading the pressure. In the same way, an air bed can be placed on the patient bed that circulates the air continuously. Attention should be paid to the hospitalization position of the patient and changing the position every 2 hours during the day, ensuring body hygiene, reducing moisture and improving the patient's diet.
2 stages: Careful evaluation of the wound is very important because in many bed sores, the wound may appear to be on the surface, but may have splashed into deep tissues, ie it may have passed to stage 3. At this stage, the pressure causing the wound should be removed as in the first stage. However, the wound should be protected from infection and dressed regularly.
3 stages: In this stage, firstly, the infection in the wound bed is terminated. Antibiotic use, removal of dead tissue around the wound and regular dressing with the right materials is necessary. Surgical intervention is usually necessary as the wound closes spontaneously and takes a long time to heal. At this stage, the patient's application of a diet rich in protein and energy is very critical.
Stage 4: Treatment of the wound is as in stage 3, but since bone tissue is also affected, more extensive procedures may be required for surgical removal of damaged and infected tissues and cleaning of the wound.
How to prevent the occurrence of pressure sores (bed sores)?
Patient-related factors such as decreased mobility and inactivity, inadequate and unbalanced nutrition, urinary or faecal incontinence, and inadequate fluid intake should be controlled by a physician. Control of the pressure to which the skin is exposed due to sitting or lying, managing room and body temperature, keeping the skin moist, and correcting the lying and sitting position should be shown to the subjects of care of the patient, and professional support should be obtained before more serious complications occur.
Pressure sores (bed sores) nursing care
We use internationally accepted scales and detection and treatment facilities for pressure wound care and treatment. Changes in these scales according to these scales and visual evidence are systematically reported during the treatment process and include the treated person and their family.
Today, a wide range of dressing materials and dressings are available, while our team is choosing the most ideal product for care and treatment, while also opting for economical solutions from the existing product range.
You can call Gamze Demir on 0506 480 5025 for information about wound care and treatment services that we can offer at your home. Our home wound care service is only available in Istanbul.
What are the wounds in diabetic foot - diabetes?
Diabetes is a chronic disease in which blood sugar is elevated due to deficiency of insulin hormone or impaired effect of this hormone. Circulatory disorders that come with the disease can cause wounds on the feet of people and also a foot wound due to susceptibility to infection may result in “Diabetic Foot Infection”. Risk factors for diabetic foot are advanced age, obesity, having previously opened a wound, kidney damage due to diabetes and fungal infection of the foot and nail.
When do varicose veins occur?
Leg venous insufficiency, namely venous insufficiency, is usually caused by injuries to the ankle circumference and leg. The deterioration in the structure of the valves in the veins deteriorates the return of blood to the heart and begins to pool in the leg veins. This causes an increase in pressure within the vein. Due to continuous high pressure, disruption of the tissues and especially the skin of the leg, varicose veins, swelling, and finally sores, that is, venous ulcers. Advanced age, obesity, high blood pressure, diabetes, heart failure, renal failure are risk factors for the development of varicose veins.
What kind of support does the home care company provide for wound care and treatment?
The goal of wound care is to prevent tissue loss, to regenerate the tissue and to prevent the risk of infection. Factors such as whether the wound is acute or chronic, the extent and depth of the wound lesion, as well as the age of the person, nutritional status, systemic diseases and individual treatment status affect the wound care process.
Our wound care and treatment services are provided by the wound care nurse and under the supervision of our consultant physician who is an Intensive Care Specialist. Surgical methods such as debridement and different types of dressings, wound healing stimulants and antibiotics are used in wound care and treatment. Where necessary, the opinions of the wound specialists of the manufacturers are taken and included in the treatment process.
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