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Wound Care Principles

Acute traumatic wound care is the most common intervention in emergency medicine practice. Every year over 10 million wound care is performed in the USA.

Objectives of wound care

1. Live tissues are preserved

2. Restoration of tissue continuity and function

3. Optimizing the conditions in the development of wound resistance

4. Prevention of long and excessive inflammation

5. Avoiding infection and other disruptive causes

6. Minimizing scar formation



First Inspection

History: The mechanism of injury, the time of injury, the environmental conditions of the wound and the immune status of the patient are learned.

If the wound is cleaned and closed, contaminated bacteria will proliferate in the wound. Treatment of contaminated wounds results in infection when delayed by up to 3 hours. The time between injury time and the safe closure time without risk of infection is the golden period and does not have a fixed time. While the well-blooded facial skin can be closed within 48 hours, the wound on the foot nail bed of an elderly patient should be closed immediately.

Other important issues in terms of infection risk are the patient's age and health status. Advanced age, chronic diseases and drug use, shock, recurrent traumas, infection, bacteremia, denervation and peripheral vascular diseases slow down the healing rate.

In addition, the presence of special treatments, allergies, tetanus immunization status, potential rabies contact, foreign body and previous traumas and deformities should be learned.

Physical Examination: All wounds should be examined for tissue destruction, degree of contamination, and damage to underlying tissues. The examination should be carried out in accordance with the aseptic technique.

Injury mechanism and classification of wounds: 3 types of mechanical force damages soft tissues. Tear, stress and compression. Wound is defined according to tissue separation or loss. It is classified into 6 categories: Abrasion, laceration, crush wounds, penetrating wounds, avulsion and combined wounds.

Contaminated bacteria and foreign bodies: The presence of bacteria and dead tissues in the wound and local tissue ischemia or hypoxia cause wound infection. Traumatic injuries are divided into two categories according to the degree of bacterial contamination of the wounds. Contaminated wounds: Traumatic wounds older than 12 hours. Dirty wounds: Devitalized or traumatic wounds older than 12 hours are accompanied by a significant number of bacteria and are predominantly contaminated with pathogenic organisms.

Wound localization: The number of bacteria (> 105 / cm2) in the scalp, neck, axilla, perineum, penis, vagina, mouth, intertriginous areas and nail endogenous microflora is sufficient to infect the wound. Well-blooded areas such as scalp and face are more resistant to bacterial entry. Distal extremity wounds are more susceptible to infection than injuries to other parts of the body.

Devitalized tissue: An important part of the wound examination is the identification of dead tissues. Tissue damage reduces resistance to infection in the wound.

Underlying tissues: It is important to investigate the injury of the underlying tissues during the examination. Irrigation of the joint space, debridement and reduction of fracture fragments, neurorrhaphy, vascular anastomosis and flexor tendon repair should be performed in the operating room with the help of appropriate light, necessary instruments and assistants.

Cleaning

The cornerstones of wound care are cleaning, debridement, sealing and protection. While most of the wounds are contaminated with less than the infective dose of bacteria, they reach the infective level if the time is prolonged and the appropriate environment is provided. Wound cleaning and debridement have common goals. 1. Remove bacteria and reduce them below the level of infection 2. Remove particles and bacteria from the tissue during the inflammatory period of healing or beyond the critical threshold. Wound cleaning methods: mechanical wiping, antiseptics, irrigation, irrigation with antibiotic solutions. Appropriate sedation, local anesthesia and appropriate substance should be chosen for these patients. Irrigations should be done with high pressure and scrub solutions should be applied by applying a sponge. Hydrogen peroxide should not be used on open wounds.



Wound closure preparation

It should be prepared and covered before the wound is closed or debrided. Hair and hair should not be shaved. If it is to be worked between the hair, the hair should be separated from the wound and collected. The hair and hair which may enter the wound can be laid aside with petrolatum gel or water-soluble ointments. Eyebrows should never be shaved.

10% povidone iodine solution is used as standard for skin disinfection. Only a large area around the wound should be stained and no solution should be applied into the wound. After washing the hands, remove the powders from the gloves before touching the wound with sterile gloves. If a URI is present, it is recommended to use a face mask. Perforated cover is covered on the wound. If anesthesia is still not achieved, it is repeated. The wound is opened in depth and examined for any damage to foreign body, particulate material, bone fragments and underlying tissues for repair. Lacerations extending down to the subcutaneous adipose tissue are important because a large amount of particulate material can be hidden within the deep layers of the tissues. With careful examination, these contaminants should be removed from the deep tissues and sutured. If so, infection is monitored.



debridement

It is important in the treatment of contaminated wounds. With this technique, the doctor removes tissues such as foreign bodies, bacteria and devitalized tissue that prolong the period of inflammation and impair the resistance of the wound to infection. Very dirty wounds, irregular wounds, defined devitalized tissues are prepared by this technique. This requires 1 or 2 hooks of appropriate size, scalpel and handle 15, tissue scissors, hemostats and small forceps. Grasping the edge of the blackened tissue with hook or forceps or scissors or tissue scissors to the other end of the devitalized tissue is cut away. After debridement, the missing part is irrigated outside the wound. Since tissues that have lost viability such as dura, fascia and tendon cause significant functional losses, these tissues are not debrided and cleaned properly.

excision

If the tissue has a certain elasticity or tension and does not contain important tissues such as tendons, nerves and is contaminated, the entire wound can be removed. It is a more effective technique than debridement. The trunk, gluteal region and thigh are suitable for this technique. It is made with the materials used in debridement and similar technique.



Selective debridement

Selective tissue debridement technique is used in the wounds of tissues with insufficient skin elasticity or loss of tissue, or tissues with important functions that need to be protected (such as dura, fascia, nerve, tendon).

After excision or debridement, the tissue is irrigated and the remaining tissues are removed.



Bleeding control

Bleeding from the wound is common and should be checked before examination, cleaning or debridement. Sometimes wound exploration and cleaning can cause bleeding. Hemostasis is required at any stage of wound care. Hematoma that will occur in the wound causes suturing at the edges of the suture, delaying healing and infection.

There are many methods for bleeding control. Pressure control with glove finger, sponge or compress are effective methods for emergency control of a small number or from one place of bleeding. At least 5 min. pressure should be applied. The pressure is more effective if the bleeding wound is raised above the heart level.

Bleeding can be controlled with compression dressings in patients with multiple injuries and various emergency problems.

Another method used in hemostasis is the ligation of the blood vessel with a well absorbed suture material. A common mistake is to spend too much time to connect small blood vessels. Hemostasis is achieved by carefully holding only the vessel with the tip of a hemostasis clamp. A 5-0 or 6-0 synthetic absorbable suture material is wrapped around the hemostat to remove the knot. Once the suture on the vessel is secured, the hemostat is removed. It is cut so that at least the suture material is left behind. In cases of hemorrhage from the wound wall that cannot be held with hemostat, a horizontal matres or 8 sutures are placed around the bleeding point and ligated.

Core diameter 2 mm. if it is larger than that. 2 mm. veins under the direct compression or cautery bleeding is controlled.

1: 100000 epinephrine is a good topical vasoconstrictor agent and reduces bleeding from small vessels. When combined with local anesthetics, it provides hemostasis in well-blooded areas. Topical or intradermal administration may increase the risk of wound infection.

Fibrin foam, gelatin foam and microcrystalline collagen can be used as hemostatic agent.



Tourniquet

They are used to temporarily control bleeding in wounds on the extremities that are resistant to direct compression, electrocautery, or ligation. It also facilitates the examination of small foreign bodies, partial laser tendon or joint capsule in bleeding areas in lacerations.

The tourniquet causes injury in 3 ways: It causes ischemia in the extremities, pressure and damage to the lower vessels and nerves, threatening the survival of the viable tissue at the border. To avoid these injuries, attention should be paid to tourniquet pressure and duration. For this, systolic pressure (250-300 mmHg according to some authors) at a pressure of 30-45 min. (max 1 hour) should be applied. Veins should be evacuated before tourniquet application. A tourniquet should not be applied with thin materials. When the process is completed, the tourniquet should be removed. A tourniquet can be applied to the finger with the help of a penren drain or glove finger.

CLOSING



Open wound care and delayed closure

If the skin in the defect area is immobilized, such as the scalp or pre-tibial area, it is impossible to close the defect completely. In very dirty wounds, the risk of wound infection increases as a result of closure. Therefore, the general rule is to close the wounds that you believe are clean or that you believe will be cleaned by brushing, irrigation or debridement. Wounds to be left open for wound healing are cleaned and, if necessary, debrided and covered with sterile, SF moistened sponge. The wound is wrapped with a thin, absorbent, sterile drape. If fever does not develop, the wound is not mixed for 4 days, unnecessary inspection increases the risk of contamination and infection. At the end of the 4th day, the wound is re-evaluated. If there is no infection and the wound edges are appropriate or the wound is excised, delayed closure is performed.

Wounds requiring open maintenance and delayed closure: wounds contaminated with soil, organic matter, saliva, faeces, vaginal secretions and purulent materials, wounds with extensive tissue damage, and many animal bites. In animal bites, the wounds on the face are completely excised and sutured. Dog bites outside the extremity can be sutured.



methods

The appropriate closure technique is selected according to the location and configuration of the wound. These techniques are suturing, tape bonding and metal stapler. The tapes are easy to apply and are preferred for non-cooperating and fearful patients. It causes minimal skin reaction, no suture marks on the skin, and the lowest risk of infection is the technique. Metal staplers can be applied quickly in suitable places but can be used in non-cosmetic areas and linear wounds. In many cases suturing is the most preferred method.



Equipment

Tools: Needle holder (suture) and suture scissors are required in addition to those used in debridement. The portugal size is selected according to the needle to be used. New instruments should be used for debridement of highly contaminated wounds. If the instruments have clotted blood contamination, they should be used after flushing with hydrogen peroxide.

Suture Materials: Many suture materials are available. They can be defined by 4 characteristics.

1. Chemical and physical properties

2. Structure and mechanical performance

3. Absorption and reactivity

4. Persistence and magnitude of tensile strength

Suture materials are of various compositions. They can be grouped as natural, synthetic, monofilament, multiflorant. Depending on the structure and performance, it is important that the suture is preferred to pass through the tissue smoothly, to be easily knotted and to be stable. Multiflatable sutures have the best structural properties.

If the knot 3 mm. 3 sutures in silk or other braided, nonabsorbable materials, 3 synthetic monofilaments absorbable and nonabsorbable sutures should be discarded.

Absorption and reactivity: Those that break down rapidly in tissue are called absorbable. Those who maintain the tensile strength for more than 60 days are called nonabsorbable. Plain catgut absorbs in 10-40 days, chrome catgut 15-60 days, ethikon 10-14 days, vicryl 60-90 days and dexon 120-210 days. Plain catgut in the oral cavity 3-5 days, chrome catgut 7-10 days, polyglycolic acid disappear in 16-20 days. The complete absorption of silk from the skin is approximately 2 years. The absorption rates of synthetic absorbable sutures are independent of suture size.

The sutures lose their resistance before being fully absorbed from the tissue. Braided absorbable sutures lose all of their resistance in 21 days, monofilament absorbable and PDS, ethikon lose 60% of their resistance in 28 days. In a study comparing suture resistance and wound resistance catgut 7 days; chrome catgut, dexon, and vicryl remained intact for 10-21 days and nylon, silk and wire for 20-30 days.

All sutures provoke host defense and inflammation with tissue damage. The size of the reaction is characterized by the nature (diameter and length) of the material placed in the tissue and the chemical structure of the suture. Among the absorbable sutures, polyglycolic acid and polyglactin sutures are the least reactive. Nonabsorbable polypropylene is less reactive than nylon and dacron. The reaction with catgut, silk and cotton sutures is more pronounced.

The chemical structure of the suture is important in identifying early infection. The infection rate in polyglycolic acid sutures is lower than catgut. Lubricants coated on sutures do not alter suture reactivity, absorption characteristics, decreased resistance or risk of infection.

Size and resistance: The size of the suture material (yarn diameter) is the measurement of the tensile strength of the suture. The greater the yarn diameter, the greater the durability. The correct suture size depends on the tensile strength of the tissue layers to be applied.

The most necessary suture materials for wound closure to the emergency physician are dexon and coated vicryl for subcutaneous tissues and synthetic nonabsorbable materials (nylon or polypropylene) to close the skin. The fascia can be repaired with any material absorbable or nonabsorbable 3-0 or 4-0. 4-0 or 5-0 absorbable subcutaneous tissues, 4-0 or 5-0 nonabsorbable materials are used on the skin. 6-0 for wounds on the face, 3-0 or 4-0 sutures are used in areas exposed to dynamic stresses such as the articular surface or static stresses such as scalp.

Needles: Needless eye is used in most emergency departments. The selection of the appropriate needle size and curvature is based on the characteristics of the tissue to be sutured and the size of the wound. When the repositioning motion is made by holding the needle with the holder at the distal end of the needle, it should be deep enough to move through the tissue and come out from the opposite skin. In wound repair, the needles should be strongly penetrated and the fibrous tissues should be able to pass with minimal resistance or trauma without breaking. Needles are used to close subcutaneous tissues with ½ or 3/8 twisted needles. In percutaneous closure, conventional needles provide precise insertion and require less penetration power.


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How do wounds heal?

The largest organ in your body is not your liver or brain. It is your skin with a surface area of ​​approximately two square meters in adults. Although different areas of the skin have different properties, most of the surface has similar functions, such as sweating, feeling heat, or pubescent. However, after a deep incision or wound, the newly healed skin appears different from its circumference and cannot have all of its properties for some time or permanently.

To understand why we need to look at the structure of human skin. The first layer, called epidermis, generally consists of hardened cells called keratinocides and provides protection. Since it is an outer layer, it is constantly poured and renewed. But sometimes a wound can go deep into the dermis, the layer that contains the blood vessels, various glands and nerve endings that provide many functions of the skin. This type of event triggers the start of a four-tiered regeneration process. The first stage, hemostasis, is the reaction of the skin to two immediate threats: you are losing blood now and the physical barrier of the epidermis is broken. As the vessels narrow, to minimize bleeding, in the process known as vasoconstruction, both threats are suppressed by forming a blood clot.

A special protein called fibrin forms cross-links that prevent blood from flowing out and bacteria and pathogens entering. The skin that turns red after three hours in this way signals the next stage of inflammation. By controlling the bleeding and closing the barrier, the body sends special cells to combat pathogens that may have entered. The most important of these are white blood cells known as histiocytes. These cells produce growth factors to consume bacteria and damaged tissue and accelerate healing by phagocytosis.

As these small soldiers must travel through the blood vessels to reach the injured area, the previously narrowed vessels begin to expand again through the vasodilation process. Two to three days after the injury, the prolifertive phase begins with the introduction of fibroplast cells. During the collagen storage process, a fibrous protein called collagen is produced in the wound by forming connective tissue to replace the previous fibrin. As the epidermal cells divide to reshape the upper layer of the skin, the dermis shrinks to close the wound.

Finally, in the fourth stage of the regeneration process, the wound matures by converting the accumulated new collagen into special types. In this process, which can last up to a year, the flexibility of the new skin develops and the vessels and other connections are strengthened. Over time, the new tissue can reach up to 50-80% of the original healthy function, depending on the severity of the initial wound and the function itself.

However, the scars remain a major problem for doctors around the world as the skin has not completely healed. Although researchers have taken important steps in understanding the healing process, many mysteries remain unresolved. For example, do fibroplast cells come from blood vessels or skin tissue close to the wound? Why do other mammals such as deer heal wounds more effectively than humans? By finding answers to these and other questions, perhaps one day we can heal ourselves well enough to remain in memories only.
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Latest Wound Treatments

Wound is the disruption of the integrity of the skin for various reasons and the inability to maintain the structure and functional function of the living tissue. The history of wound care began with the history of humanity. Purpose of wound care; to provide tissue repair in the shortest time possible, to correct the impaired skin structure or functional condition, to prevent infection, ie to catch microbes, to reduce discharge and edema, to reduce pain and to achieve the best aesthetic result. In recent years, studies on the wound mechanism have been intensified and many different options are offered for wound care.

In the past, linen, gauze and cotton products used in wound care were aimed at absorbing the wound discharge, keeping the wound dry and thus preventing the growth of bacteria. It was recorded in the papyrus which was determined to belong to 1500 BC leştir If the wound is disturbing, calm down, soften if hard, cool if hot, extinguish if swollen, relieve if painful 'summarizes the approach in wound care.

It is now known that heat and moisture are directly proportional to wound healing, and when there is sufficient heat, moisture and oxygen, the restructuring of cells in tissues is accelerated. The concept of Wound Bed Preperation (WBP) stands out on the basis of current approaches in wound care.

The preparation of the wound bed is the preparation of the most favorable conditions for the already self-healing wound.

It was previously known that the healing of the wound bed would accelerate the healing and the bad side effects would decrease. Nowadays, by eliminating the factors preventing the wound healing, leaving the wound to heal according to its natural process is the basis of current approaches.

In the preparation of the wound bed;

Control of wound causing diseases

Removal of dead tissue from wound

Reduction of germ load

Wound management

Correction of cellular functions are included in the steps.

In wound care, the first step is to evaluate the cause of the wound and the patient's history and to eliminate the causative agent.

The preparation of the wound bed will then bring with it a well-blooded, ready-to-heal wound.

There are many approaches to this:

ADVANCED AND BEST WOUND DRESSINGS
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Modern dressings have more functions than covering the wound. They are products used to cover wounds to protect the wound against infection, to absorb blood and wound fluid, to provide wound healing and to apply medication on the wound.

Nowadays, the most important innovation in dressings is the development of "moist healing" materials that can protect the wound from moisture. In the 1980s and 1990s, many moist-healing products such as hydrocolloid, alginate, polyurethane foams and hydrogel were developed.

These improved dressings are more painless and comfortable, provide faster healing compared to old dressings, and require less frequent dressing changes, as well as cheaper costs and prevent germ contamination to the wound.

Ideal wound dressings should include;

1. Should form an obstacle against microbes,

2. Should not cause trauma to the tissues around the wound,

3. Must have heat insulation,

4. Gas permeability should be ideal,

5. Provide optimal moisture instead of wound,

6. Dispose of excess fluid and harmful tissue,

7. Compatible with body tissue,

8. Fully fill the gaps existing in the wound,

9. Reduce pain,

10. Should be aesthetic and ergonomic,

11. Should not remove the wound tissue during removal,

12. Should be economic,

13. No odor formation.

Modern dressings can be classified under five main groups. These products are usually applied on a variety of wounds, either alone or in combination, in different healing processes. These dressings:

1. Alginate covers

2. Polyurethane transparent films

3. Hydrogels covers

4. Hydrocolloid covers

5. Foams.

ALGINATE WOUND DRESSINGS
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Calcium Alginate fibers are commonly used, absorbent and have unique ion exchange properties. When applied to the wound, calcium ions in the fiber are replaced with sodium ions in the body, and some of the fibers are converted to alginate. They can absorb the discharge from the wound by 20-30 times their own weight.

The fibers swell and gel is formed on the wound surface. This formed hydrophilic alginate gel provides a moist wound environment for wound healing. However, if they are not immediately removed when saturated, they can cause moisture damage in healthy tissues.

The microbicide effects are low and the bacteria can be passively trapped in the gel and removed by cover change. Alginates also have pain-reducing and anti-bleeding effects. Alginate varieties with different properties obtained from different seaweeds are used today. In addition, many salts of alginate, such as zinc-containing and silver-containing alginates, can also be used in humans suffering from zinc deficiency and to provide germicidal properties, respectively.

Also; zinc can also be added to the alginate dressings in order to improve the bleeding property. As the connective tissue develops in the wound in alginate dressings, the amount of fluid absorbed decreases. When the gel reaches saturation, leakage occurs. There are varieties of alginates that can be used dry or wet and also developed for wounds with cavities. Alginate covers; and full-thickness wounds, hollow wounds, moderate and severe leakage wounds, infectious wounds, some are suitable for low-bleeding wounds. In dry wounds, it requires a second cushioned cover to prevent drying.

POLYURETHANE TRANSPARENT WOUND DRESSINGS
Acrylic on one side and polyurethane on the other, these transparent synthetic dressings are semi-permeable. In this way, it prevents the airborne microbes from reaching the wound while providing oxygen to the wound from the air.

These dressings are mostly used in dry wounds and can create a moist wound environment. As they are transparent, it provides the opportunity to observe the wound area. Modern semi-permeable dressings are generally made from various mixtures of polyurethane. These films can supply moisture vapor to the wound at a rate of 3000 g / m2 / 24 hours or more. It can be used in postoperative wounds, burn wounds, pressure wounds, areas where skin is taken for surgery, and intravenous catheter applications. In addition, these dressings help to remove wounds that contain dead tissue.

It is light and flexible, good compatibility with the wound surface, prevents skin damage against friction and does not adversely affect the comfort of the patient. These covers; hydrogel, hydrocolloids and alginates.

The disadvantages of these covers are; they need to be replaced frequently and there is a need for a solid skin around the wound to be applied.

WOUND DRUGS WITH HYDROGEL
Hydrogels consist of polymers containing 90-95% water. It absorbs the discharge of the wound which is found in high degree. Does not stick to the surface of the wound. They reduce the fever of the wound and have a cooling effect.

As their ability to resist microbes is poor, they require a second cover for protection.

Although hydrogels used today have many of the ideal dressing properties, they can cause weakening of sensitive skin. When applied to the dry wound surface, the hydrogel covers moisten the wound to form a moist wound environment for wound healing. These covers can absorb some amount of wound fluid. It is water and vapor permeable and can be easily separated from the wound because the moist interface between the dressing and the wound prevents the dressing from sticking to the wound. In addition, the wound can be treated with hydrogel dressings.

HYDROCOLLOID WOUND DRESSINGS
The hydrocolloid dressings consist of dissolved hydrophilic polymer particles. When in contact with the wound discharge, the hydrophilic particles absorb the excess liquid and turn into gel and remain on the wound for 7 days. These covers tend to adhere to both wet and dry tissues.

They also increase the rate of skin lining of the wound and connective tissue production. They do not require a second dressing as they adhere directly to the wound. It also has features such as reducing pain and keeping germs out of the wound. It is used in partial and complete wounds, mild and moderate discharge wounds and is not preferred in case of infection. They are sticky and can damage sensitive skin during removal.

FOAMS
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The foams are polymeric and silicone based dressings that are both flexible and have high absorption capacity. They are used in combination with sponges. In deep wounds, they fill the gaps and expand over time to fully adapt to the wound. By applying a gentle pressure to the wound, they reduce the edema by increasing wound closure and oxygenation. When placed on the wet wound surface, the wound fluid is sucked into the foam and sent to the other side of the dressing.

When placed on a relatively dry wound surface, moisture reduces vapor loss and prevents drying of the wound surface. These coverings allow air to pass and do not seal the liquid. It can be easily removed from the wound, but its ability to prevent the germ is limited. They are used in wounds with dead tissue and moderately leaking wounds. It is not suitable for dry and crusted wounds. Reinforcing the cover

extra product is needed for.

It is used in some foams to infect microbial, inflammatory wounds by impregnating silver or placing it in a sheet to improve germ killing performance.

GROWTH ENZYMES AND GROWTH FACTORS
It is known that growth factors are involved in all stages of wound healing. Especially

growth factors in the process of impaired wound healing are drugs used to restore the wound to its normal course.

At the beginning of the injury, the cells in our blood secrete TGF-β (Transforming Growth Factor) enzyme, which provides blood clotting in the blood. This substance helps in the development of new veins in the wound and draws repair cells into the wound. Platelets also secrete PDGF (Platelet Derived Growth Factor).

PDGF; growth factor. PDGF increases the formation of connective tissue in the wound. Becaplermin is the first growth factor that has been approved for the use of PDGF in wound treatment in humans.

Other cells in the blood secrete factors such as TNF-α (Tumor Necrosis Factor) and FGF (Fibroblast Growth Factor) and play an important role in vascular increase.

Epidermal growth factor (EGF) is the growth enzyme responsible for covering the outer surface of the wound.

FGF (Fibroblast Grovth Factor) and KGF (Keratinocyte Growth Factor) also stimulate skin development.

They are used in the treatment of chronic wounds along with growth factors to stimulate wound healing.

Angiopoietins allow the continuation or remodeling of vessels with. Blood flow in wound

is an important step. Because despite all the wound treatments, the weakening of the vascular development in the wound is a problem that can turn the wound into a chronic wound.

PRP (platelet-rich plasma, Platelet-rich plasma) has been used in wounds for more than 20 years and is one of the cheapest and fast techniques for reintroduction of wound factors.

Because PRP contains growth factors. Response to normal wound healing

similarly, it produces platelet stimulation.

OXIPLASMA and OXIPRP is a system that is used recently and gives all growth factors in need of wound with oxygen. OKSİPLASMA and OKSİPRP are registered products and Dr. It belongs to Ahmet .

BIOMECHANICAL WOUND CARE (ACTIVE CLOSING PRODUCTS)
In recent years, the use of Biosurgical Mechanical Wound Care has come to the fore in wound treatment and care. The disadvantages of these tools are that they are expensive and their use requires expertise. However, it is an advantage that it is suitable for re-use. The most important applications in this field are;

-VAC (Vacum Assisted Closure) Treatment,

- Larval Treatment (Biyosurgery, Maggot Debridement System),

- Electrical Stimulation,

- Laser Beams,

- Ultrasound Therapy,

- Hyperbaric Oxygen Therapy,

- Topical Oxygen Therapy,

- Topical Ozone Therapy.

VAC (VACUM ASSISTED CLOSURE) TREATMENT
The application of negative pressure in wound treatment was first described in the 1940s.


The VAC application consists of sponges of polyurethane and polyvinyl for filling the wound, semi-permeable wound dressings to cover the wound, a device for regulating and connecting the wound with the device, a collecting vessel and a device for providing negative pressure. The pump system on the wound absorbs the wound discharge by applying a negative pressure in the range of -75 to -125 mmHg intermittently or constant, and heals the wound bed.

The application of VAC increases blood flow and skin development in the wound area, decreases microbes by controlling excessive discharge and inflammation and accelerates wound healing.

The most important disadvantage of VAC is that the patient is hospitalized or requires home monitoring.

It is also not recommended for use in patients at high risk of bleeding and in patients receiving blood thinners.

LARVA DEBRIDMAN THERAPY- LDT (MAGGOT DEBRIDMAN THERAPY, WOLF TREATMENT)
It is a form of treatment that can be used only during the "debridement" process of wound treatment. Calliphoridae family of the genus of Lucilia fly larvae attack only dead tissues and necrotic and microbial tissues by cleaning the wound by cleaning the wound is called Larval Debridement Treatment (LDT) or WOLF TREATMENT. The larvae dissolve the dead tissue on the wound with the enzymes and antimicrobial agents they produce, as well as disinfect the wound and stimulate the tissue to heal.

In recent years, LDT has been used successfully in the treatment of pressure sores, venous stasis sores, temporal mastoiditis, Fournier's gangrene, necrotizing tumor masses and other soft tissue wounds. It has been reported to be particularly successful in the treatment of infected wounds and diabetic wounds and to reduce amputations, especially in those with resistance to antibiotics.

The disadvantage of this treatment is the tickling and disturbing sensation caused by the movements of the larvae. Sometimes pain can be experienced during the treatment of superficial wounds.

It is possible to apply it in small packs ready to pack.

WOUND THERAPY WITH ELECTRIC WARNING
Electrical warning; It can be used for chronic wounds in the treatment of pain and edema with electromagnetic vibration technology that does not disturb the patient and does not cause pain. Splints, dressings, dressings and clothes can be applied on the wound or can be applied directly. This application creates micro-current in the injured tissues and increases the normal electrochemical activity in the body.

Electrical stimulation, easy to use, easy to carry and applicable by the patient, hospitalization at home, such as providing the continuation of treatment in addition to features such as accelerating the healing of chronic wounds. It increases blood vessel formation especially in inflammatory wounds and anemia.

WOUND TREATMENT WITH LASER
At a low level (640 to 940 nm wavelength) and at appropriate doses, it is stated that the laser beams given by a specially developed laser device stimulate cellular functions. It also has inflammation and inflammation and pain relief in the tissue.

WOUND TREATMENT WITH ULTRASOUND
The effect of ultrasound on tissues is two groups, thermally and thermally. Accelerates wound healing. Increases blood flow in the wound area. Ultrasound therapy, dressing

can be applied directly to the wound or around the wound.

WOUND TREATMENT WITH HYPERBARIC OXYGEN
Hyperbaric oxygen therapy is a method of breathing oxygen in a closed pressure chamber by breathing oxygen through a mask, hood or tube placed in the patient under a pressure higher than 1 atmosphere (1 ATA = Absolute Atmosphere = 760 mmHg). The aim here; increase the solubility of oxygen in blood and body fluids. In this way, wound healing is increased by increasing the oxygenation of the wound area. However, in order to apply this method in chronic wound, it is necessary to have an appropriate vascular structure in the wound.

Hyperbaric oxygen therapy is used in crush injuries and acute trauma wounds, compartment syndrome, diabetic foot wounds, recurrent osteomyelitis, gas gangrene, necrotizing soft tissue infections, skin grafts and reimplantations, osteonecrosis and sports injuries.

This treatment can be preferred especially in difficult wounds that cannot be healed by medical and surgical treatment methods, shortens the length of hospital stay and reduces the cost of treatment. It should NOT be used in patients with a history of pneumothorax, upper respiratory tract infection, epilepsy, chronic obstructive pulmonary disease (COPD) and thoracic surgery.

OXYGEN TREATMENT TO WOUND
It is a system that takes 21% oxygen in the air and converts it to 100% concentration oxygen. Seven days 24 hours with preferred dressing material or compression

available.

It can be used in addition to other wound care treatments in chronic wounds.

WOUND OZONE (O3) TREATMENT
Ozone application is the use of 5% (O3) + 95% (O2) mixture in the wound. While ozone is disinfected at high concentrations, it provides wound healing and RESTORATION when applied at low concentrations. The wound is applied with bags. Ozone destroys both bacteria and fungi.

It can be used especially in chronic wounds and diabetic foot wounds.

HONEY APPLICATION
Use of honey in wound treatment; Although it has been known since the past, it has been re-introduced with Australian manuka (Leptospermum scoparium) in recent years. The efficacy of antibiotic-resistant bacteria in inflammatory wounds reintroduced the importance of honey in wound treatment.

Effect of honey on wound; The density in the structure is due to the hydrogen peroxide enzyme it contains, its acidicity, and its antimicrobial effect.

Honey's water is low and microbes cannot develop in this case. The pH of honey is between 3.2-4.5 and this value is so acidic that bacteria cannot develop in the wound. The most important antimicrobial effect in honey depends on the hydrogen peroxide enzyme that occurs in honey.

A small amount of water in the honey provides the moisture required for the wound and absorbs liquid

With the effect of the wound gets the discharge. It also prevents the wound from sticking to the dressing material, reducing pain in dressing change. Honey is an additional source of nutrition for tissues.

By reducing edema and pain, honey accelerates circulation through the capillaries and increases oxygenation in the wound area.

WOUND TREATMENT WITH ARTIFICIAL LEATHER
Making human skin or equivalent skin takes place in two ways.

These; containing keratinocytes and dermal elements

collagen matrix fibroblasts. The basic mechanism in artificial skin applications is to provide epithelization by stimulating and releasing growth factors in the wound. They also provide skin-like protection on the wound and provide protection against trauma and infections. Artificial leathers are used in diabetic foot wounds and venous leg ulcers.

The forms available today; Alloderm containing normal human fibroblasts; and Integral containing collagen, chondroitin sulfate and silicon designed as artificial skin.


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How are Open Wounds Treated?

Accidental injuries to the skin are important as they cut our skin and open the protective layer. There may also be a scar after these injuries. We will also provide you with some information about both wound care and post-wound scars.
Home Care for Small Wounds
open wound
Minor wounds, ie minor injuries, can be treated at home. First of all, it is necessary to disinfect the wound in order to avoid microbes and infection from the injury and to pressure directly with a clean cloth or napkin for bleeding and swelling control. When dressing the wound, care should always be taken to use a sterile dressing or bandage. Very small wounds can heal without a bandage. However, wounds large enough to cause bleeding should be bandaged. You must keep the wound clean and dry for five days. If the injury is in a moving area, the movement may delay the closure of the wound. Pain accompanies the wound. You can take acetaminophen (Tylenol) according to the package. Avoid aspirin products because they may cause bleeding or prolong bleeding. If there is bruising or swelling, apply ice. Your wounds should not be exposed to the sun's UV rays. For this you can use sunscreen on your wounds. You can also reduce hardening by using moisturizers to the wound area.
Critical Injuries

Although you can treat small wounds at home, you should see a doctor if:
An open wound is more than 1/2 inch deep
bleeding cannot be stopped by direct pressure
bleeding lasting longer than 20 minutes
If bleeding occurs as a result of a serious accident, you should immediately go to the emergency room or call 112.


Medical Treatments
Your doctor may use different techniques to treat an open wound. After cleaning and possibly anesthetizing the area with anesthesia, your doctor may close the skin with a suture. You may get a tetanus vaccine if you have been injured by a rusty iron or if you are suspected of catching a germ. Depending on where the wound is located and the likelihood of infection, your doctor may choose not to close the wound and wait for it to heal naturally. This may mean wrapping your wound with gauze. Although healing is not cosmetically attractive, it prevents infection of the wound and the formation of abscesses.
Other treatments for an open wound include painkillers and penicillin. Your doctor may give you a penicillin vaccine or prescribe another antibiotic to avoid the development of an infection. In some cases, surgery may be required. If a body part breaks, it should be brought to the hospital for possible reconnection. The body part should be wrapped with moist gauze and put on ice. When you leave the doctor's office, you may have bandages and dressings. When changing bandages and dressings, it is important that you always wash your hands and work on a clean surface. Before disinfecting the dressing, disinfect and dry thoroughly. Discard old wraps and bandages in plastic bags.

Are there any problems with the occurrence of an open wound?
The main complication of the open wound is the risk of infection. If you show severe bleeding (bleeding) or signs of infection in a deep injury or serious accident, call your doctor immediately. Bleeding symptoms include continuous bleeding that does not respond directly to pressure retention. In cases where the wound shows an infection:
an increase in drainage
Thick green, yellow or brown haze
bad smell
Infection findings include:
Fever lasting more than four hours
soft lump in the groin or armpit
non-healing wound
Your doctor cleans the infection sites of the wound and prescribes antibiotics. In severe cases, surgery may be necessary to remove infected tissue and sometimes surrounding tissue.
Conditions that may result from an open wound include the following.
Lockdown is caused by an infection caused by bacteria causing tetanus. It can cause muscle contractions in the jaw and neck.
A necrotizing soft tissue infection (gas gangrene) may develop. This is a serious infection caused by various bacteria, including Clostridium and Streptococcus, which can lead to tissue loss and sepsis (a systemic infection).
Cellulite is an infection that does not come into immediate contact with the skin.


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Disinfecting Your Dog's Wound At Home

You can treat your dog's wounds at home, but for this to happen, you need to make sure that the animal does not lick or scratch the wound. First, you should check the severity of the wound; if the condition is serious or the bone appears, you should go to the vet immediately.

Incisions are small wounds that are common in all animals. It happens to people, cats, and of course dogs. Many of the cut wounds are small and require no maintenance, but in the case of very large cuts it is necessary to disinfect your dog's wound at home and then treat it.

Thus, these wounds do not become a bigger problem. In this article we share today, we will talk about how to understand the severity of your dog's wound and how to disinfect it at home. Continue reading!

You may also be interested in: The Indispensable 5 of Dog Helper Bag Natural Oil

Disinfecting Your Dog's Wounds At Home
Infections are one of the most common diseases in animals, which makes them the main cause of complications. A poorly treated wound can make your pet's life difficult.

However, you should not be too worried, the main way to heal and disinfect wounds is to stay calm, assess the situation and see if you can manage to treat your dog's wound.

Once you have verified the severity of the wound, you can continue to treat it. You can find the products you need to do this at any pharmacy. You do not need a special medicine for pets only.

How to assess the severity of the wound
When pets play or work, you might think they complain about certain things throughout the day. If your dog is crying or whining too often, you should check your pet to see what bothers him.

When checking a wound, you should never touch it or wash it with water. This can cause an infection and make the animal's condition worse.

Most experts recommend wearing a dog mouthpiece to prevent the animal from biting the wound during the treatment process. This way, treating your dog can be less complicated and you can focus more on your work. In addition, your veterinarian may recommend cutting the hair around the wound with a small pair of scissors.

If you see any tendons, bones, or ongoing bleeding, disinfecting this wound at home is beyond your ability. Therefore, it is best to take your pet to your vet as soon as possible.

It is a good idea to put pressure on the wound when taking your dog to the vet, so that you can avoid excessive bleeding. However, if the wound has stopped bleeding and you only see the meat under the skin, you can effectively treat it at home. But first you need to know how to disinfect the wound.

Also take a look at this article: How to Treat Domestic Wounds at Home?

Disinfection of your dog's wound at home
First, you should clean the affected area and any surrounding area. To do this, use an antiseptic or soapy water containing iodine. This can be done by pouring the liquid directly onto the wound or with an antiseptic gauze.

Warm water will also help keep the dog calm, while the dog's calmness will help you a lot during the rest of the disinfecting wound. This washing should be continued for at least two minutes.

It is a good idea to use gauze because, unlike cotton (cotton swabs may remain on the wound), it leaves no residue on the wound. After doing this, you should apply the solution to help you clean the wound. This solution will help to close the wound and continue the healing process.

The affected area may become inflamed, so it may be useful to put a few bags of ice in the area. If you want to apply other products to the wound, you must first check that they are suitable for animals.

Disinfecting Your Dog's Wound At Home: Conclusion
After disinfecting the wound, it is time to leave it alone and prevent your pet from reopening or scratching the wound. Usually, you may want to let it air for wound healing faster.

However, if your pet is restless during this time, it is best to bandage the wound to avoid unwanted contact. You may also need to use an Elizabethan collar or a special collar to prevent the animal from licking its wound or removing the bandage with its teeth.

You should check the bandaged wound occasionally to make sure it heals. If you notice that the swelling in the animal's wound has not disappeared and there are pus or something that does not appear normal around the wound, you should take your pet to the vet immediately.

However, if the wound is in better condition and does not show any abnormalities, you can remove the collar. Once the wound has healed, your dog will be grateful. Get well soon!


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Wound Disinfection - Disinfection

generality
Wound disinfection is a very important tool to prevent potentially pathogenic microorganisms from entering the body and sometimes even causing serious damage.

In fact, the skin acts as a real barrier to these pathogenic microorganisms, but if it is damaged and damaged, its protective effect is less and it exposes the individual to the risk of infection of various types.
Wound Types
In order to properly treat a wound, it is important to be able to determine the severity of the injury and to act accordingly.

Depending on the severity of the wound, we can distinguish:

When superficial wounds contain only superficial layers of the skin, such as in the case of abrasions and small cuts;
Deep wounds when tears also affect the lower layers of the skin;
Penetrating wounds, lacerations are so deep that they damage the internal organs.
Superficial wounds can be treated at the local level, taking appropriate measures and precautions.

However, when it comes to deep and penetrating wounds, it is necessary to consult a doctor or go to the nearest emergency room where the injured patient will receive all necessary care. In fact, such wounds - in addition to the potential risk of infection - can also result in significant blood loss that can damage vital structures or organs. Therefore, the intervention of specialized personnel is absolutely essential in such cases.

Another classification of wounds can be made according to the object that causes them and determines their appearance. In this case, we can therefore distinguish:

Point wounds;
Discontinuation of injuries;
Torn wounds.
In turn, these wounds can be distinguished as superficial, deep or penetrating.

How to Disinfect a Wound
In order to eliminate the risk of infection and ensure correct healing, wound disinfection should be performed with care and with appropriate products.

As noted, in deep and penetrating wounds, some signs of disinfection of only superficial wounds such as abrasion, abrasions, cuts or minor tears will be given, as the intervention of specialist personnel should be required.

First of all, the first thing to do is to worry about cleaning the wound from foreign objects that may enter the wound; After that, you can continue the actual disinfection process.

For the correct treatment of superficial wounds, the following indications are recommended:

It is very important to wash your hands thoroughly and possibly wear latex gloves or suitable material before any operation on the wound.
Clean the wound and, depending on what caused the injury and how it happened, remove any foreign objects, such as soil debris or splinters of wood or other material.
Foreign bodies can be removed by exposing the wound directly to a jet of drinking water, or tweezers can be used provided that it has previously been sterilized.

The wound can only be cleaned by washing with drinking water.

Disinfect the wound area with the aid of antiseptics for disinfection of intact skin, such as preparations based on ethyl alcohol or propyl alcohol.
Disinfect the wound using antiseptics for disinfection of damaged skin, such as hydrogen peroxide, iodopovidone (Betadine®) or chlorhexidine (Clorexane® 0.5% cutaneous solution).

In addition to the effect of hydrogen peroxide, a disinfectant - thanks to the natural "effervescence" that develops after contact with the skin - could not be removed with water, which can also be useful for removing foreign bodies or dirt particles with deep and normal cleaning.

After the wound disinfection procedure is completed, it may be covered with sterile and hypoallergenic bandages or gauze, if necessary to protect it from the external environment.
Useful advice and information
Below you will find some useful information and some tips to follow during and after the wound disinfection procedure; thus, an optimal recovery is allowed and any complications can be prevented or identified immediately.

When cleaning and disinfecting wounds, it is recommended that you use sterile gauze and do not use cotton wool instead. In fact, the latter can release small fibers within the wound. It is not a coincidence that cotton wool is used above all for disinfection of intact skin (eg before injection).
Regardless of the type of antiseptic used, it is good to keep in mind that disinfectant action is not immediate, but is performed within a few minutes.
Antiseptics - if not properly stored or if packages remain open for too long - may lose their effectiveness, in whole or in part; therefore, caution should be used.
However, although it appears superficial, it is necessary to observe how the healing process of the wound develops, so as to ensure that it occurs correctly and that no infection of any kind has developed. In fact, if the lesion does not heal after a few days, causes pain or burning, or if you notice edema and redness, there may be an ongoing infection. In this case, it is good to contact your doctor immediately, who will take all appropriate measures.


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How fast does the wound heal? Treatment and types of wound

A wound is a disruption of tissue integrity in the skin or in any organ of the body due to a disease or external physical factors. The most common type is external skin wounds and heals easily. However, deep wounds, chronic wounds or diabetes wounds and pressure sores can take a long time to heal. Some types of wounds are deeper, reaching the underlying tissues and even organs, which must be followed and treated by doctors. The wounds are divided into different groups according to their types and the treatment may vary considerably depending on the type. Treating or caring for the wound may require more care than wrapping a dressing. Correct identification of the wound is very important for correct treatment. Some types of wounds may become chronic very quickly or get infected and cause serious health problems or injuries.

What is a wound?
A wound is a damage to the human body due to external physical, biological or chemical effects. Wound does not always mean deterioration of skin integrity. For example, the impact of a non-sharp blunt object may not damage the skin but may cause bone fracture or internal bleeding. When the wound is diagnosed, its etiology, anatomical location, whether it is acute or chronic, the closure method, the symptoms or tissue type are evaluated.

Wound types
Cut wound
A cut wound is a clean cut on the skin caused by a knife, scissors, or a piece of broken glass, and is frequently encountered daily. Surgical incision is also common. Cut wounds heal faster than other wound types due to smooth skin edges. In addition, deep cut wounds are less extensive than other deep skin wounds.

Tearing wounds
Tearing wounds are a type of injury caused by tissue rupture. Your skin is both firm and supple, so it takes a lot of force to create a tear. Due to this applied force, other deep tissues such as bones, muscles, tendons, ligaments, blood vessels, nerves and even internal organs are often damaged. Skin ruptures most commonly occur on bone protrusions such as elbows, knees, and hips.

What is a boil, why? What is good and how is it treated?



Tear wounds are usually caused by accident trauma, such as a car accident or hitting the person with a hard object. Because the skin edges are torn and rough, a tear wound heals more slowly than a cut wound.

Wear wounds
Abrasions are caused by skin rubbing against a rough surface. Common examples are minor and superficial abrasion of the knee or elbow. However, severe wear after falling from a bicycle or motorcycle traveling at relatively high speed can be deep or widespread. These injuries, also known as road burns, are often quite painful and sometimes it may be necessary to perform a skin transplant instead of lost skin.

Wound care should be based on the type
Wound care should be based on the type

Avulsion wounds
It is the rupture of a part of the skin from the subcutaneous connective tissue. It is a serious and bleeding form of injury. Depending on the condition of the injury, the severed tissue can sometimes be surgically re-inserted into the body. When this is not possible, healthy skin tissues are used to replace the lost tissue.

Puncture wounds
Depending on the length of the object, a puncture wound occurs when a sharp, thin object penetrates the skin and possibly the underlying tissues. Unlike a cut wound, the puncture wound is deeper than wider. The penetration site of a puncture wound is usually small and tends to close rapidly. However, this may cause a closed infection.

Tetanus, for example, is a particular concern for puncture injuries. Examples include stepping on a nail, bitten by the animal, or a deep stab wound.

Caries and hematoma wounds
Caries and hematomas are usually caused by non-incisive causes. No special treatment for bruises. The time it takes for the bruises to become clear is very variable, and in some people the color change may take months.

What is anti aging, how is it done? Skin health and aging effects



Caries refers to local blood collection in the tissue. Some hematomas are very large and may require intervention and may present an infection risk.

Firearm wounds
In the case of injuries caused by a low-speed weapon, the entry wound of the bullet is small, but the exit wound is larger, and the bullet causes damage along the way. Serious tissue contamination from clothing, dirt or other foreign matter may occur. High-speed weapon injuries such as modern assault rifles cause widespread tissue damage with explosion and pressure effect. The damage is therefore further away from the projectile's path.

How does the wound heal quickly?
Wound healing is a complex process that depends on many factors. In order for the wound to heal quickly, the amount of blood and nutrients reaching that area must be sufficient. Therefore, in order for the wound to heal quickly, the general health condition of the patient should be good and well-fed.

Studies have shown that in cases of delayed wound healing, there is a lack of nutrients in the patient. So how should we feed?

Since carbohydrates and fats are the energy source of the cell, they play an important role in wound healing.
Proteins, amino acids, arginine and glutamine are essential nutrient sources for rapid wound healing.
What is protein? What foods are available? Benefits and harms



Vitamins that accelerate wound healing
Vitamin A: Mint, arugula, parsley, carrot, spinach, purslane and sweet potato
B vitamin complex: meat, milk, vegetables, fish and yeast
Vitamin C: Vegetables such as parsley, cauliflower, green pepper, paprika and tomatoes
Vitamin K: Green leafy vegetables, parsley, avocado, kiwi, meat, eggs and milk
Minerals required for rapid wound healing
Zinc: Red meat, almonds, walnuts, pumpkin seeds, ginger, eggs, whole grains
Iron: Meat, molasses, eggs, soybeans, dried fruits, green leafy vegetables
Copper: Liver, fish, crustaceans, peas, nuts, walnuts, mushrooms, rye
Magnesium: Soybeans, nuts, walnuts, fish, milk, bread, green vegetables
Selenium: Fish, meat, unprocessed grain products, dairy products, soybeans
Water: Balanced water consumption is very important for wound healing.
Chronic wound care and wound treatment methods in diabetes patients



Other nutritional supplements for wound healing
Bromelain: Found in pineapple
What are the benefits of pineapple? Pineapple diet and detox



Glucosamine: Naturally found in shells and chicken bone marrow of animals such as shrimp and lobster
Why is wound healing delayed?
Circulatory disorders
Some genetic diseases
Hormones
Growth factors
Being old
climacteric
Be woman
Some drugs used
Surgical errors
Lack of oxygen in the tissue
Vascular disorders and tissue ischemia
Infection
Stitched seams and dressings
Sudden increase and decrease in ambient temperature
Hematoma, Edema
Cancer and chemotherapy
To have received heavy radiation
Smoking
Improper intervention in eye injuries leads to blindness



Open wound treatment at home
First aid to wound
Applying first aid to a wound speeds up the healing process and reduces the risk of infection. Wounds, including minor cuts, tears, bites and abrasions, can be treated with first aid.

Control the bleeding. Use a clean towel to apply gentle pressure to the area until bleeding stops. This may take a few minutes.
Before cleaning or dressing the wound, wash your hands to prevent the wound from becoming infected.
To clean, gently rinse the wound with clean, warm water and remove any dirt, such as gravel or soil, to reduce the risk of infection.
Dry the wound. Gently dry the skin with a clean cloth or towel.
Use a non-stick or soft bandage and a light bandage, avoid using tape on gentle areas of the skin to avoid trauma when removing the bandage.
Consult your doctor, nurse, or pharmacist to ensure that you are receiving correct treatment and for further treatment and advice.
The wounds may be painful, so you can use painkillers, but don't use aspirin because of the blood dilution.
When should you go to the doctor?
If you observe any of the following conditions, you should see a doctor.

If there are signs of infection
If the bleeding does not stop
If you can't realign the skin
If the wound has dirt, glass, thorns or other foreign objects
If the wound looks large or deep
If it has passed a long time and is still not recovering
If you have an underlying medical condition such as diabetes
If the injury was caused by a serious accident
What is pressure sores?
Bed sores
The bed wound, seen as an open wound on the skin, is mostly seen on the hips, ankles and back. This open wound, usually seen on the skin covering the bony areas, is a disease that is mostly experienced by people who have reduced mobility and who have to live in bed or in a wheelchair for a long time.

This condition can be easily treated after correct diagnosis.

At each stage of the bed wound, the person may experience different symptoms. Skin discoloration, infection, pain in the injured area are the most common symptoms of pressure sores.
The stage of the wound plays a significant role in the treatment of bed sores.

Anti-bacterial drugs can be used for treatment, your doctor may seek therapy or surgery may be necessary. You will often need to dress your wound. The healing process varies depending on the stage of the wound. It is very important that you eat well and drink plenty of water for your wound to heal faster.

Diabetic foot wound
Diabetes wounds (diabetic foot wound), which occurs as skin tissue breaks down and forms layers beneath it, is a common complication in people with poorly controlled diabetes. Diabetes wounds, which can affect the foot to the bones, can develop in almost everyone with diabetes.

How should medical care be performed in diabetic foot wounds?



Treatment of diabetic foot wound varies depending on the cause of the wound. With good foot care it is possible to avoid and treat diabetic foot wound.

Diabetic foot wound treatment
Measures such as correct shoe selection, surgical removal and removal of dead skin may accelerate the healing of diabetic foot wound. If the wound is infected, the doctor will take a sample of the surrounding tissue and send it to the laboratory to suggest the correct antibiotic, and may even want to x-ray your foot in case of serious infection. People with diabetic foot wounds often need to have their doctor checked.

Treatment of diabetic foot wound at home
Take a foot bath
Thoroughly disinfect the wound and surrounding skin,
Make frequent dressing changes and keep the wound dry,
Can apply enzyme treatments
You can prevent bacterial growth with dressing materials containing calcium alginate
Medicinal plants that are good for the wound
Garlic
Garlic is a great anti-bacterial and anti-fungal and can help heal almost any wound. Garlic can damage your skin, so be sure not to leave it on the skin for more than 20-25 minutes. Mix with 3 crushed garlic cloves and 1 glass of wine, leave for 2-3 hours and strain. Apply to the wound with a clean cloth 1-2 times a day.

What is good for garlic, how should it be consumed? The benefits of garlic



Powerful Pomegranate in Wound Treatment
Kudret pomegranate, which grows in tropical and subtropical regions, is now easily found in our country. This fruit has a unique therapeutic power. Research has shown that potent pomegranate is very effective in the treatment of all kinds of wounds including bed sores and burns.

Might pomegranate is very effective in wound treatment

Chop 1 pot of pomegranate into 1 large jar of extra virgin olive oil and let stand. As you wait, you will find that it is even more useful. You can put this oil on any kind of wound. You can also use the pot of pomegranate to mash the wound treatment.

Aloe vera
Aloe vera, a natural antibiotic, is a miraculous method to accelerate the repair process of damaged skin. To use Aloe Vera for wound treatment, obtain a gel from aloe vera green fresh leaf. Apply the gel on the wound with circular movements as if massaging with your fingertips. Wait 30 minutes then wash the wound. Complete this procedure twice a day until your wound heals.

How to use aloe vera? What are the benefits for health and skin?



Calendula flower
This beautiful little flower is also an anti-inflammatory and anti-microbial. It can be used topically to treat abrasions, skin infections and internal inflamed mucosa. Calendula ointment can be found in herbal. For internal wound infections, you can make tea using 1 cup of warm water and 1 tablespoon calendula flower.

Honey
Honey is a great product to accelerate wound healing, and even according to some findings, honey is actually more effective than antibiotics. In laboratory tests, honey has been found to kill most bacterial cells and prevent infections from occurring. Be sure to use raw honey to dress the wound.

Coconut oil
Coconut oil, which contains plenty of vitamin E; It is another natural ointment which is used in wound treatment and is very effective. First, heat a little oil to liquefy the coconut oil. Then massage the wound with your fingers for 5-10 minutes with this oil.

Immediately after sucking the skin oil, leave it exposed for 1 hour without wrapping the injured area. Repeat this process at least 2-3 times a day until your wound heals.

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Apple cider vinegar
Mix some apple cider vinegar and some water equally. Soak cotton in the mixture and apply this cotton over the scars. After waiting for 5 minutes, rinse the scar with water.

What are the benefits of apple cider vinegar? How to use, what good?



Olive oil
Olive oil, which is rich in vitamin E, has been used for many years in wound treatment. Apply warm extra virgin olive oil over the wound. Wait 30 minutes and then rinse the wound with plenty of water. you can put olive oil on the wound at night and you can keep the olive oil on the wound all night.


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