Mepilex Border Self-Adhesive Foam Dressings 4""x4"", Box of 5

How to Improve Cutouts Easily and Naturally?

A cut on your skin hurts, so you probably want it to heal quickly. Fortunately, you can use natural antiseptics to treat your cut at home in natural ways. In order to support the rapid healing of your incision, you need to clean the wound, dress and care for it. However, if the cut is too deep, long or in a sensitive location, or if you have signs of infection, you should see a doctor. You should also go to the emergency room for a very deep, non-bleeding cut.

Portion
one
Cleaning the Cut

one
Wash your hands with soap and warm water to prevent infection. You should always wash your hands with soap and water before cleaning the incision. This reduces the chance of infection. [1]
Wash your hands with lukewarm water and allow them to dry spontaneously or dry with a clean towel, preferably a paper towel.
In the hands of the cut, try not to touch the cut with soap because it can irritate the wound. [2]

2nd
Wash with mild soap and water to clean the incision. Hold the cut skin under running water of warm water, and then apply some mild soap to the cut to remove the cut. Gently rub the soap around the cut and wash the cut with warm water [3].
When washing the wound, see if there's anything like gravel or splinter in it, and make sure you remove any foreign matter you saw. You can use a pair of tweezers disinfected with toilet spirits to remove impurities.
For many superficial cuts that require only home intervention, natural cleaning is sufficient.
For deep cuts or cuts containing embedded substances, seek medical advice.
3
If necessary, stop bleeding by applying pressure with gauze. If the cut continues to bleed after washing, apply a piece of sterile gauze and pressure to the cut. When the incision stops bleeding, you can remove the gauze or wrap the incision with a piece of gauze, lint-free wound napkin, or a sterile material. Do not apply a “wipe” gesture on the cut, because this may open the cut further.

4
If possible, wash the cut with saline. A mild, normal saline solution cleans the cut area and helps prevent infection. Normal salt solution is the safest solution to use. [4] This solution has approximately the same salinity as blood, tears and sweat. In other words, the salinity rate is approximately 0.9%. [5]
To prepare their own normal salt solution, add half a teaspoon of salt to about 250 ml of boiling water and stir until dissolved. [6] Wait for the solution to cool, then pour the solution over the incision and gently wipe off any moisture formed with a piece of sterile gauze.
Use a new salt solution for each rinse. Pour unused solution into the sink. [7] Bacteria can grow in as little as 24 hours in salt solution. [8]
Keep the cuts clean and disinfect the cut at least once a day until it is completely closed. If the cut becomes red or inflamed, see a doctor.

5
Do not use hydrogen peroxide and iodine as this will slow down the recovery. Although hydrogen peroxide is often recommended for the treatment of wounds, it does not actually kill bacteria effectively. Hydrogen peroxide can slow down the normal healing process and irritate the wound. [9] Iodine may also irritate the incision. [10]
Use pure, tap water or normal saline to wash the wound.


Portion
2nd
Dressing the Cuticle

one
Apply colloidal silver ointment to prevent an infection. Silver is a natural antimicrobial agent that has been used for a long time. 0.5 to 1% colloidal silver ointment may reduce the risk of infection. [11] Antibacterial colloidal silver ointments are available in most pharmacies.
Apply a thin layer of antibacterial silver ointment to the incision, then glue the band-aid.
Remember that antibacterial ointments do not accelerate the healing time of cuts. However, it can prevent infection and support the healing process of the body. [12]

2nd
Use a natural antiseptic to kill germs and bacteria. Some plants have a natural antimicrobial effect to reduce infection. Herbal treatments may affect other health problems or may interfere with prescription drugs. So consult a doctor or pharmacist before using them.
Calendula. Calendula has antimicrobial properties and has been shown to accelerate healing. [13] Apply an ointment incision containing 5% calendula. In animal studies, this concentration has been shown to accelerate wound healing. [14]
Tea tree oil. Age tree oil is a natural antibacterial and antifungal. Apply a few drops of 100% tea tree oil to the cut with the help of gauze. [15]
Echinacea. Echinacea may help to heal the wound in high-stress processes, but not in low- or moderate-stress processes. [16] Apply a cream or ointment containing echinacea to the cut to aid healing. [17]
3
Use aloe vera for small wounds. If the wound is a superficial wound, apply pure aloe vera gel several times a day. Apply aloe vera to deep sores, including surgical wounds, because aloe vera can slow healing when applied to deep sores in the body. [18]
Aloe vera can reduce inflammation and moisturize the affected area.
Individuals may occasionally have allergies to aloe vera. If deep redness or irritation occurs, stop using aloe vera and see a doctor.

4
Try honey to kill the germs and keep the cut moist. Many honey has natural antibacterial properties, and also helps keep small-scale wounds moist and protected from bacteria. [19] Find manuka honey, which has been shown to be one of the most effective in the treatment of wounds. [20]
After cleaning the incision, apply a thin layer of honey. Glue the band-aid. Change the band-aid frequently.
You can also try coconut oil, which has natural antibacterial and antimicrobial properties. [21] [22]

5
Protect the cut area with sterile bandage. Put sterile gauze on the incision and cover the area with the bandage of your choice and secure the bandage with a medical tape. Ensure that the dressing is sterile, such as sterile gauze or band-aid. [23] Maintain the incision until the incision is greatly healed and new skin appears.
When you need to replace the dressing, remove the old one and wash the cut with saline, then apply a clean dressing. [24]
Change the dressing every day or when the dressing pad is filled with blood.
Always wash your hands before changing the dressing or touching the cut.


Portion
3
Helping You Heal Faster

one
Get more protein and vitamins to support healthy skin development. You can take more protein and increase the intake of vitamins such as vitamin A and vitamin C, which supports healthy skin formation. Zinc may also aid in wound healing. [26] If you have nutrient deficiency, it takes more time for the skin to heal. Consume plenty of the following foods to get enough nutrients, vitamins and minerals: [27]
Lean meat protein: lean meats such as chicken and turkey, fish, eggs, yogurt, beans
Vitamin C: fruits such as citrus fruits, melon, kiwi, mango, pineapple, strawberry and cherry, broccoli, pepper, Brussels sprouts, cauliflower [28]
Vitamin A: eggs, fortified cereals, orange fruits and vegetables, broccoli, spinach and dark green leafy vegetables, fish oil [29]
Vitamin D: fortified milk or juice, fatty fish, eggs, cheese, liver [30]
Vitamin E: nuts, seeds, peanut butter, spinach, broccoli, kiwi [31] [32]
Zinc: Beef, pork, lamb, black chicken, nuts, whole grains, beans [33]

2nd
Apply green tea extract to help heal the wound. Studies have shown that green tea extract can heal wounds faster. [34] [35] Find 0.6% green tea concentrate ointment. Read the instructions on the packaging to apply.
You can also make your own ointment by mixing green tea extract with vaseline. [36]

3
Apply hamamelis to reduce inflammation. Try using hamamelis to reduce inflammation and redness. [37] Put a small amount of hazelnut into the cut with a clean cotton.
You can find it in almost every pharmacy.

4
Drink too much water to avoid dehydration. Drink about 250 ml of decaffeinated, soft drink every two hours. In this way, you can recover the water lost in the event of bleeding at the time of injury or sweating at the time of fire. If the body is dehydrated, the following complications may occur:
Skin dryness
Headache
Muscle cramps
Low blood pressure

5
Do low-intensity exercises to improve circulation. When moderate exercises are performed, the body's ability to fight infections may increase, inflammation may decrease and recovery time may be accelerated. [38] Don't use that part of the wound. Exercise at least three days a week for 30-45 minutes each. Consult your doctor to find out which exercise is right for you. Some easy, low intensity exercises include:
Brisk walk
Yoga and stretching
Light weight exercise
8-15 km / h cycling exercise
Swimming

6
Use an ice pack to reduce pain, swelling and inflammation. If blistering and redness persist or disturbing, apply an ice pack to that area. The cold numb the cut area, prevents further bleeding and reduces pain. [39]
You can also make your own ice bag by moistening a towel and putting it in a locked fridge bag. Freeze this bag in the freezer for 15 minutes.
Wrap a moist towel in an ice bag and apply to the cut area.
Apply ice pack to open or infected wounds.
Apply ice directly to the skin as it may be harmful.

7
Use moisturizing device to keep skin moist. A moist environment can help the wound heal faster. [40] Use a humidifier to moisten the air of the room and prevent the skin from drying out or cracking. Make sure the humidifier is clean to prevent the spread of bacteria that may cause infection. [41]
If moisture is too high, mold and mite may form.
If the humidity is too low, the skin of the households may dry and throat and sinus disorders may occur.
Measure the amount of moisture with a moisture meter that you can buy from many hardware outlets.


Portion
4
Dealing with a Serious Cut
one
Take care of the wound to see if you can control the bleeding and close it. You can handle serious cuts at home. If you can stop the bleeding and see that the skin hasn't separated, you can try to care for it yourself. However, it is best to see a doctor if you have a serious incision. [42]
Monitor the incision for the next 24 hours to ensure that you do not need medical attention. If there is any change or if it starts to bleed again, go to the doctor.

2nd
Stop the bleeding. No matter how serious the cut is, you should stop the bleeding before you lose more blood. Place a clean piece of sterile gauze over the incision and apply a firm and constant pressure until bleeding stops. [43] When the wound stops bleeding, it may begin to heal.
Multi-pressure application. If you apply too much pressure, you can block circulation. This prevents the blood from clotting, thus causing the incision to bleed longer.
If the blood leaks out of the gauze, place another gauze on top of the gauze to pull it out. Remove the first track. Keep applying pressure to the cut.
If the blood immediately makes the gauze soaked and the pressure does not stop the bleeding, go to the emergency room or a doctor.

3
Only do tourniquets in very serious situations. The only time you will have a tourniquet at home should be when you lose a significant amount of blood. Improper use of tourniquets can cause serious damage to limbs and blood flow, and may even result in the cutting of a limb.


Portion
5
Knowing When to Get Medical Assistance

one
Get immediate help for a cut in a long, deep or delicate place. You can usually deal with a cut at home. But sometimes you may need medical treatment. In addition to cleaning the wound, the doctor may decide that sutures are required to close the incision. Sutures may help the incision to heal faster and minimize scarring. [44]
If the cut is on your face, hands, feet, joint or unobstructed area, you probably need medical treatment.
If you see dirt in the cut and cannot clean it, see your doctor for treatment. It will help clean the wound.

2nd
Go to an emergency room for a very deep cut or uncontrollable bleeding. You don't have to worry, but if you have a cut that's too deep or doesn't stop bleeding, you might need emergency medical care. Failure to do emergency medical care may cause serious complications. If you notice any of the following serious symptoms, go to the emergency room immediately: [45]
If you still can't stop the bleeding in 20 minutes.
If the blood is bright red and gushing (indicating that the blood may be coming from an artery)
If you see red muscle or yellow fat.
The cut remains open when you try to keep the cut closed.

3
If fever rises or you notice signs of infection, see a doctor. Your incision will probably heal with proper treatment. However, sometimes a cut infection can get infected, which requires medical care. See your doctor or go to an emergency room if you show the following signs of infection: [46]
Fire
Redness
Swelling
Temperature in that area
Increased pain
Pus discharge

Tips
Removing the scab from the wound. Wait for it to fall by itself.
Try to keep the cut and the skin around the incision moist. When the skin is dry, the scab is exfoliated, preventing the skin from healing effectively, resulting in scarring.
If he's home, put some petrolatum.
Don't hit the incision or touch the incision. The skin or the shell of the wound may tear.
If you're a self-destructive person, make sure that your wounds are in a prime position for you and that they are well healed because self-harm causes stress in the body and mind. Please share this with someone and keep yourself safe.
To find out if you have an allergic reaction that could make the wound worse, try a small part of your skin before applying any natural treatment.

Warnings
For severe, infectious burns or cuts, follow these instructions to treat them. Get medical attention instead of applying them.


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Wound Care

The wound is the deterioration of the normal structure and function of the tissue. Wound healing is a highly controlled sequence of cellular, humoral and molecular events that begin with trauma, resulting in time-dependent and predictable new tissue formation. This new tissue does not necessarily be the subject of injury. For example; traumas leading to major skin loss can heal with granulation tissue. Any deviation from this wound healing process results in chronic wound formation that does not heal.

Wounds can be divided into traumatic (surgical) and chronic. Traumatic wounds include surgical incisions, lacerations, abrasions, wounds left open for secondary healing, necrotizing fasciitis and burns.

Laseration is the rupture of the skin and underlying tissues after blunt trauma. If such wounds are clean, the edges of the wound may be approached primarily. Abrasions, on the other hand, are the abrasion of the epidermis as a result of rubbing on a hard surface and they need dressing just like the wounds left for secondary healing.

Chronic wounds include pressure sores, arterial and venous ulcers, diabetic foot, ulcers due to vasculitis, and malignant skin wounds. Determining the etiology and initiating appropriate treatment is critical in the management of chronic wounds. For example; One of the treatments for a venous ulcer is elastic bandages or intermittent compression, whereas this approach is contraindicated in arterial ulcers with poor circulation. Therefore, it is necessary to know the basic physical properties of chronic wounds.

Pressure sores are round or oval shaped, usually full-thickness wounds on bone protrusions with little tunneling. Although it is most commonly seen in the sacral region, all bone contacting the bed may be over the protrusions. Frequent change of position and pressure reducing surfaces should be used to prevent these injuries.

Venous ulcers are ulcers in the lower extremities adjacent to the malleolus due to venous return failure. These ulcers are dark colored and exudate abundantly. In addition to local wound care, compression or elevation is helpful in the treatment. Arterial ulcers are usually accompanied by peripheral cyanosis and weak pulses. The wound bed is necrotic. These wounds often benefit from additional treatments such as smoking cessation, heating hydration.

The second important point in the care of patients with wounds is to provide appropriate systemic support to patients. Nutritional support is critical in this regard. Patients should receive 30-35 kcal / kg / day energy, 1.2-1.5 g / kg / day protein and daily vitamin supplements.

In the topical treatment of wounds, the priority is to evaluate the wound in terms of tissue viability, infection, moisture balance and wound environment. One of the neglected points in wound care is the pain of the patients. Pain is inevitable as nerve endings will be exposed in open wounds. For this reason, it is appropriate to give analgesics to the patients half an hour before the dressings, to interrupt the dressing when the patient has pain and to avoid unnecessary stimuli. In addition, cleaning the wound with soap will cause pain.

Debridement is the removal of dead tissue from the wound. The dead tissue in the wound contains a high amount of bacteria, thus delaying wound healing. In addition, platelets released during debridement may initiate a new healing cascade. Most debridement methods should be chosen for the patient.

It is very important to recognize the infection in the early period and to start appropriate treatment. Infection symptoms in chronic wounds are not healing, granulation tissue is bright red and easy to bleed, increase in exudate amount, bad smell, new necrosis areas in the wound and cellulite around the wound.

The presence of reproduction in the swabs taken from the wound surface is insignificant in showing the presence of infection. The gold standard for demonstrating the presence of infection in the wound is tissue culture.

Excessive exudate delays wound healing. The concentration of matrix metalloproteinase in the exudate leading to collagen degradation in the wound is high, and the exudate also inhibits growth factors in the wound. However, the dryness of the wound also inhibits epithelialization. Therefore, in dressing changes, products that will absorb the exudate in the wound but do not leave the wound dry should be selected.

Since epithelization of the wound will begin at the wound edges, healthy wound edges are an indispensable part of wound healing. If the wound edges are unhealthy, it should be debrided and if there is maceration, it is necessary to choose care products to reduce it.

Gauze is the cheapest method to close the wounds left for secondary healing. In terms of wound healing, gauze is no different from new wound care products. However, gauze dressing requires more nursing time and causes more pain compared to new wound care products.

The presence of a large number of wound care products on the market leads to instability in healthcare personnel. It should be noted that there is no single product that is suitable for all wounds. It is important to choose the best product for each wound. Turkish sources Wound most detailed classification of products Wound Care and Tissue Repair Society (www.yaradernegi.org) wound care products is available on the website coding system Turkey. This site features the properties of most of the wound care products available on the market.

The hydrocolloid wound care products are produced from gelatin, pectin or carboxymethylcellulose. There are sticky cover, powder or paste forms. They absorb the exudate and turn into gel. Their absorbency varies from product to product. One's experience is important when choosing one of the hydrocolloid products.

The hydrofiber covers are non-woven fibers in the NaCMC structure and have high absorption capacity, as well as the risk of maceration on the wound edges as it traps the liquid. The foams are hydrophilic polyurethane and expand as the liquid absorbs the wound's three-dimensional shape and is easily separated from the wound during dressing change. Alginates, on the other hand, may cause maceration of the wound edges, although they have high absorbency.

The most important criterion in the selection of dressing material is whether the wound heals. For healing wounds it would be appropriate to continue with the same wound care product. Wounds that do not show any signs of healing within two weeks should be evaluated in terms of etiology, bacterial load, pressure, friction, circulation, maceration in terms of nutrition and comorbidity.

Objective methods should be used in the monitoring of wounds. The easiest of these is to take a digital photo of the wound. The size of the wound should also be noted. It is recommended that the wounds be evaluated in terms of the presence of infection and healing once a week.

Nevertheless, the easiest way to treat wounds is to prevent the formation of wounds.


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Let's Test Ourself

Wound Care
The wounds may be caused by a large number of objects, all of which can cause different types of damage. Wound treatment is best performed with a systematic approach. Especially children may have difficulty in wound care because they may be scared. 11 questions that will provide a systematic approach to wound care (Table)

Table 1: Questions to be asked about any wound:
1. Is there any combined damage?
2. What and how caused the wound?
3. What type of wound is this?
4. Is there any foreign material?
5. How deep is the wound and what other deep tissue has it landed on?
6. Is it safe to close the wound urgently?
7. How is this wound best closed?
8. Which dressing should be used?
9. Does this site need to be immobilized?
10. Are antibiotics indicated?
11. Does the child have tetanus immunity?

Any combined damage?
1. Is there any life or extremity threatening damage that requires priority?
2. Is there any damage related to the wound (eg arterial bleeding or an underlying fracture)?
If the answer to these questions is no, further treatment of a wound is performed.

What caused the wound and how?
A detailed history is required. Information on the injurious agent and the force applied may affect the treatment. This is especially true for penetrating injuries reaching deep tissues (Figure 1). The possibility of a foreign substance in it should always be considered. It can be extremely difficult to identify any foreign matter remaining in the wound.
Human and animal bites tend to develop infections, especially if they are not recognized early (Figure 2).

Picture 1: A penetrating wound on the left palm. Possible structures at risk include: digital nerves, tendons, tendon leaves and bone.


Picture 2: Dog Bite. The concentric lines reflect the original width of connective tissue inflammation (cellulite) and show progress over time.

What kind of wound is this?
When applying with a wound, the doctor must determine the type of wound. This will help in general wound treatment. The typical classification is:
* Abrasion
* Dents (contusion)
* Torn (laceration)
* Piercing damage

A abrasion occurs as a result of contact with a rough surface and the skin areas are peeled off. Dirt, small stones and dust, which usually enter the skin, make full cleaning difficult without general anesthesia. If these particles are not completely removed, they result in a permanent scarring in the form of a tattoo (Figure 3).
A bruise is caused by contact with a blunt object. Not only the skin is crushed, but the surrounding tissues are bruised, resulting in an additional swelling (Figure 4). This results in a swelling in proportion to the force applied and the affected area.
Tears are defined as simple (Figure 5) and complicated (Figure 6).
Simple wounds are sharp wounds such as knives and razors; they cause surgical type injuries. If the wound is caused by falling onto, for example, a barbed wire or a tree branch, it may be of various shapes and depth. Thus, a wound in the form of dirty, shattered tears can be formed and their treatment can be difficult. To achieve the best results in such complicated wounds, complex plastic surgery is often required.
Perforating injuries are caused by a sharp object puncturing the skin in various thicknesses and in an unknown direction (Figure 7). The problem with penetrating injuries is the unseen portion of the wound which can be unpredictably larger than the visible part of the wound. The foreign material may be buried deep in the wound.

Picture 7: This wound is caused by the child sitting on broken glass. The possibility of remaining glass in the wound and rectal perforation should be considered.

Is there any foreign matter?
The desire to remove the foreign matter should be countered until it is certain that the patient will not be harmed. Not all foreign substances can be seen with X-rays, especially plastic and wood-based objects can be detected by ultrasound techniques (Figure 8,9).

....
Figure 8.9: Swelling above the center of the wound and medial (black mark).
The foreign material was then removed. This wood material, which was not seen on plain X-ray, revealed ultrasound.

How deep is this wound?
In particular, it is difficult to detect tendon and nerve damage in the hand, and a full investigation under general anesthesia and tourniquet control is required. The problem is even greater in abdominal and chest piercing traumas. Radiological evaluation should be used in the decision.

Is it safe to close the wound immediately?
In penetrating injuries and crushes, it may be safer not to close them until the wound is completely cleaned and debrided.
In cases of penetrating injuries, it is likely that the clothing and other particles will drift deep into the wound (Figure 10,11). They are also potential causes for gaseous gangrene.
There is an excessive amount of decay in the dents, which makes the skin relatively sensitive. Edema and swelling also reduce blood flow to the wound, which slows the healing process. The tension caused by the stitches worsens this process (Figure 12).

Figure 10: This child has a penetrating injury to his right hip as he falls onto the glass.


Figure 11: The broken thread particles in the child's underwear are probably dragged deep into the wound, increasing the risk of infection.


Figure 12: A wound sutured with unsuitable material. Frank from the creator flows, and the swab sample will help in microbiological diagnosis. After sutures were removed, the wound was opened and organic material was found in the pre-patellar bursa.

How should the wound be closed?
There are many wound closure agents; adhesive tapes (Figure 13), staples (Figure 14), tissue adhesive (glue) and absorbable and non-absorbable sutures.
If sutures are selected, non-absorbable sutures (nylon, silk) are the most useful materials for emergency intervention. Nylon sutures lead to less infection and provide a better wound appearance.
Because of the risk of infection, individual sutures should be selected instead of supcuticular or continuous sutures. Layer closure in traumatic wounds is not routinely recommended.
How is this wound closed?
Dry dressings are suitable for all simple incision wounds. Abrasion and bruise-type injuries require as little adherent dressings as possible. The medicated pet is suitable for most of these wounds. It can be dry, antibiotic or antiseptic solutions can be absorbed.
Does this region need to be immobilized? Wounds on the joints heal more quickly and give less pain if fixed for several days.
Is there any indication for antibiotics?
Antibiotics are rarely used. Antibiotics should not be used to cover gaps in an inappropriate surgical technique or inadequate cleaning.
Wounds with fractures, deep penetrating wounds and bites may benefit from antibiotic treatment. In these conditions, it should be borne in mind that antibiotics are not prophylactic since potential infectious organisms already exist.
Organisms that frequently infect the wound are S. aureus and Streptococcus species. Coliforms and anaerobic organisms may predominate in wounds near the hip and perineum. Animal bites, particularly cat bites, may be contaminated by Pasteurella multocida.

Figure 13: A simple wound affixed with adhesive tapes.


Figure 14: A scalp wound fastened with metal staples.

Does the child have tetanus immunity?
Tetanus prophylaxis should be given according to the condition of the wound and the immunity of the child.

A tetanus-prone wound is defined as:
If more than six hours have passed before treatment,
If contaminated with faecal material / foreign bodies,
Is located in an area contaminated with fertilizer,
If there is significant devitalized tissue,
If it's a hole-type wound,
An unimmunized child.


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Wound and care

Chronic wound is most commonly seen in bed-dependent patients with diabetes or varicose veins. In fact, the basic principle is to take precautions to prevent such injuries. However, it is not always possible to avoid it. Care and follow-up after the wound is a special issue.

1-What should be considered in wound management?

Regardless of the cause of the wound, it is necessary to approach through five main themes. a) Management of wound nutrition: correction of arteriosclerosis or venous dilatation, b) Infection management: reduction of bacterial burden, c) Load recovery: reduction of pressure in bed sores with appropriate splint / wand etc. in diabetic patients, d) Dead tissue in wound cleaning: surgical or enzymatic cleaning, e) Stimulation of wound healing: providing an environment suitable for the release and functioning of tissue growth factors in addition to the moist environment.

2-Why is wound healing so late in some patients and is it possible to accelerate it? The wound healing process depends on many factors. However, the most common delaying reasons are; inflammation of the wound (bacteria), the presence of diabetes (vascular nutrition problem), the presence of varicose veins (circulatory disorders, skin edema, ulcer development), bed-dependent patients gravity and body pressure, as well as the wrong positions can be counted. All of these factors can be one or all of the listed factors. In order to speed up the healing process, it is important to control which factor is more dominant. The most effective method of this is active frequent wound care dressings.

3-Wound care and dressing where and how should be done? Since almost all wounds have bacterial load, the first strategy should be to remove them. To this end, sterile conditions should be provided as far as possible. The biggest challenge here is that these dressings sometimes have to be done on site (in the patient's home, in the bed). If possible, dressing should be performed in the outpatient clinics in the hospital, and if possible, at home, as much as possible in compliance with hygiene. It is necessary to decide the product and frequency used in wound care and dressing according to the condition of the wound. The main purpose is to close the wound as soon as possible. If the wound closes by size and location will take a long time, appropriate surgical procedures should be the first decision stage.

4-How can I get the wound care of my patient? Home health services across Turkey to the Ministry of Health that his team needed and deemed appropriate group of patients to provide this service. In addition, wound care is not defined by a specific area of expertise in the health field. For example, there are multiple units providing these services in 18 Mart University Research and Application Hospital.

5-Is there any SSI payment for wound care products? Unfortunately, there are very limited repayment products in Turkey. Most wound care products are not covered by reimbursement. Most patients are able to obtain these products at an additional cost.

6-What is the effectiveness of wound healing applications?

a-Hyperbaric oxygen therapy: increase the oxygenation of the wound by taking the patient to the pressure chamber. It is especially effective in patients with dead tissue. b-Negative pressure wound closure (VAC): in wounds with vacuum in the tissue under the wound with the effect of vacuum withdrawal, stimulates filling. It is an effective method as it reduces bacterial load in case of washing. c-Larva (worm) treatment: based on the principle of removing the dead tissue of the larvae placed on the wound. It is a recommended method for restricted and selected patient groups. d-Intermittent positive pressure: usually useful in varicose veins. It can be applied to any wound with edema. e-Electrical stimulation: It is the application made by applying electricity to the wound bed at the current. Rapidly stimulates healing tissue. f-Growth factor transfer: the person's own or external growth factor is obtained by the application. The results are quite successful. Epidermal growth factor, both gel form and the form of intravenous injection is one of the commonly used methods in recent years. g-Stem cell therapy: is the production of individual stem cells and subsequent transfer to the wound site. The effect of large wound surfaces has also been studied and is quite expensive.


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What is Bed Sores and Wound Care?

Bed sores are the result of impaired circulation in the soft tissues on the bone protrusions, which are usually subjected to pressure in the body. Although bed sores appear to be a result of chronic diseases, the onset of ulcers often coincides with the acute phase of the disease.

63% of ulcers develop while the patient is still in hospital. Bed wounds occur with a frequency of 41% during cardiovascular diseases, 27% during acute neurological disorders and 15% during orthopedic injuries. Pressure is the most important factor in the development of bed sores. Soft tissues, especially under the pressure of the bone protrusions due to the compression of the tissues can not be fed and continuous pressure is not prevented ulcers and tissue death develops. The general condition of the patient accelerates the development of pressure sores by decreasing the resistance of the tissue to pressure in patient-related factors such as nutrition problems, advanced age problems, diabetes and edema.

CLASSIFICATION OF BED WOUNDS

PHASE I

Skin redness and edema. If the pressure is removed and well maintained, the damage is reversible and recovery is the majority.

PHASE II

There is advanced superficial tissue death into subcutaneous tissue. Non-surgical treatments provide improvement.

PHASE III

There is full-thickness tissue death on the skin. The damage was reduced to subcutaneous tissue. If secondary infection is added, the wound becomes challenging. Surgical intervention is required for large lesions.

PHASE IV

The damage also took the bone tissue down to the protrusion. The treatment is surgical.

STAGE V

The lesion spread to the joint and body cavities. Bone infection may include pathological fractures, joint dislocations, and internal organs. The transfer of bacteria to the circulation may occur. There are always serious cases where the treatment is surgery.

PREVENTION OF BED WOUNDS

The most effective method to prevent pressure sores is to change position frequently and to provide movement to the patient as quickly as possible. Patients should be repositioned at intervals of at least 1-2 hours. Skin and bed care is very important. The skin should be wiped with soapy water every day and dried to avoid moisture. Massage should be applied in order to increase the blood circulation and endurance of the skin. Bed linen should be clean and dry. The bed sheet under the patient should not be folded. Anemia, protein deficiency, vitamin deficiencies, improper dressings and muscles that may cause pressure sores to be opened should be eliminated.

TREATMENT OF BED WOUNDS

The ideal solution for wound cleaning is saline which will not harm the tissue. Newly produced anti-septics are used today because Batikon damages living tissue. Systemic antibiotics should be used depending on the condition of the wound. Accelerates wound healing;

hydrotheraphy
Hyperbaric oxygen
Ultrasound
Electric Currents
Some tropical ointments are used for superficial wounds where skin patches are not lost.
3. Surgical method is used in the treatment of pressure sores in stages 4 and 5. In order to be successful in the treatment of pressure sores, the dead tissue must be cleaned (surgical debridement of the wound).


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NON-HEALING WOUND CARE Wound Treatment Specialist

Non - healing wound treatment, non - healing wound care. Wound care and wound treatment specialist.

A wound is any kind of damage caused by a physical or chemical factor that disrupts the integrity of the body.

Skin or mucous membrane integrity due to biological, physical and chemical reasons, destruction, destruction of tissues as a result of the cut, the physical or temporary loss of tissue is called a wound.

It does not only mean deterioration of skin integrity; For example, a blunt stroke may not cause skin disruption, but bone fracture or internal organ rupture may occur.

How is wound care done and what kinds of wounds?

Acute wounds

If the anatomical and functional integrity of the wound is restored in a timely and regular manner, these wounds are acute wounds. for example; surgical incision wounds.

Chronic wounds

Such wounds are chronic wounds that do not heal on time, ie if the wound is worn during inflammation and / or proliferation.

Chronic wounds

Pressure sores (such as bed sores),
Diabetic foot wounds.
Venous and arterial ulcers (such as leg sores)
Pressure Sores (Bed Sores)

Pressure ulcer; and localized skin and / or subcutaneous tissue damage, usually on bone protrusions, caused alone or in combination with rupture pressure. (NPUAP EPUAP)

Stages of Pressure Sores
Professional Wound Care
Wound Healing Stages

Diabetic foot

Diabetic foot, disruption of nerves and vessels extending to the feet due to diabetes; It is caused by open wounds, gangrene and severe microbial infections that do not heal in the feet as a result of weakening of the immune system.

Venous ulcer

Venous ulcers are usually wound around the ankle and leg due to insufficiency in the veins of the leg veins. It is also known as varicose vein wounds. These wounds usually heal very hard and can recur.

What is Bed Sores?

For any reason, people with limited mobility (such as depression, excess weight, etc.) and patients (comatose, paralyzed patients, end-stage cancer patients) for long periods of bed-related sores that occur due to bed sores called pressure sores. Bed wounds can be prevented with good patient care and skin care.

If it is formed it can heal with professional wound care. It is much easier to avoid bed breaks. Positioning (placing the patient on the right, left side if he can lie down) is very important.

Adequate and balanced nutrition with plenty of protein is very important both for preventing the formation of wounds and for the fast closure of opened wounds.

Skin cleaning and care should be done with care.

The skin should not be too dry and should not remain wet. The bed-dependent patient should be evaluated once a day for skin integrity and the risk of bed sores. As soon as redness starts, precautions should be taken. If no intervention is required during the redness phase, further wounds may occur.

Please contact us for further information, training and maintenance.

How to Prevent Bed Sores (Pressure Sores)?

Bed dependent patients should be evaluated for daily skin appearance.
Particularly in areas of bone protrusions and areas under pressure should be observed for redness.
If redness is not taken into account, bed sores may develop which are very difficult to care for.
First of all, nutrition of the patient is very important. It should be fed with high protein and high color foods.
Drink at least 2-2.5 liters of water per day.
The structure of the bed is important, pipe-type air beds and visco mattresses can prevent wound opening according to studies. However, regular position change and patient care are also very important.
A position should be given every 2 hours. After 2 hours of pressure, the tissue begins to die and the wound is formed.
The skin should be kept clean;
The skin should not be too dry or wet, a moisturizer can be used to protect the skin's natural moisture.
Treatment and Wound Care Services.

Diabetic foot care
Pressure ulcer wounds
Venous ulcer wounds
Wounds after radiotherapy
Postoperative wounds
Traumatic wounds cause rheumatologic diseases
Induced wounds-ischemic wounds due to circulatory disorders
Lymph edema
Burn wounds
Wound Care Treatment Methods Non-Healing Wound Care

Negative pressure vacuum therapy
Hyperbaric oxygen
Topical oxygen
Medical ozone treatment
Maggot (larva) treatment
Amniotic membrane treatment
Prp application
Compression Bandage
Mesenchymal stem cell application
Modern wound care products and methods


Skin Control

Temperature control (hot and cold control) Color control (pale, purple, red) Edema control Finger fungus control Sweat loss, dryness Check for standing ulcers

What is Diabetes?

It is a chronic disease that occurs when the pancreas cannot produce enough insulin or the body cannot use the produced insulin effectively.

Effects of Diabetes on Feet

Damage to the nerves (heat, cold and no pain) Damage to blood vessels
delay in recovery

Why does a foot wound occur?

Inability to feel the sinking objects and to be understood that the shoes are squeezed,
Insufficient circulation
Deformations, calluses and hardening,
Unsuitable shoe selection,
Toenails and ingrown toenails,
cracks due to dryness of minds.
What is diabetic foot?

Wounds and deformities seen in the feet of diabetic patients are called diabetic feet.

Foot Wound and Types

Neuropathic foot (due to numbness)
Ischemic foot (due to insufficient blood circulation)
Neuro-ischemic foot (for both reasons)
Symptoms of diabetic neuropathy

Tingling Combustion Hot, cold sensory loss Touch sense loss Difficulty in walking

Symptoms of diabetic ischemia

Pain shedding thinning in the skin shine bristles

Symptoms of diabetic ischemia

The toenails should be cut straight while softening after bathing.
Even at home, you should never walk around barefoot.
No hot water bag should be placed on the feet.
Clean socks should be worn every day.
Standing warts, calluses, water collection and so on. should not be played with.
Suitable shoes should be worn (shoes should not be large or small).
In case of any wound formation in the foot, consult a doctor.
Long walks should not be done. Smoking should be avoided.
Self-examination of the feet should not be neglected.
Skin should be kept moist to avoid calluses and cracks.

Diabetic Foot Wound Protection

The toenails should be cut straight while softening after bathing.
Even at home, you should never walk around barefoot.
No hot water bag should be placed on the feet.
Clean socks should be worn every day.
Standing warts, calluses, water collection and so on. should not be played with.
Suitable shoes should be worn (shoes should not be large or small).
In case of any wound formation in the foot, consult a doctor.
Long walks should not be done. Smoking should be avoided.
Self-examination of the feet should not be neglected.
Skin should be kept moist to avoid calluses and cracks
The patient should be positioned in such a way that it does not overlap the bone protrusions per hour. network, left (30 degrees), supine, and if prone, prone, if necessary, the patient should be turned over every hour. 15 min if necessary. pressure-relieving movements should be carried out.

The waist and head should not be idle and should be supported. A small towel-cushion should be placed between the knees and a wooden board should be used to prevent foot fall. Ring or bagel-shaped tools should not be used under the hip of the patient.

The risk areas are evaluated for redness, abrasions, bullae, fracture and lesion at each position change.

The patient should not be pulled from the armpit while being pulled up or sideways in the bed and moved through an intermediate sheet.

While the patient is in bed, care should be taken not to fall under the materials such as urinary catheter and feeding catheter which may be attached. Otherwise, their pressure may cause a scar on the skin.

Powder is not used in skin care. Massage on sensitive and dry skin.

When giving the bolt, the skin is not irritated. The patient should not be kept on the bolt for longer than necessary. Patient nutrition and diet should be done, high-calorie and protein foods should be given.

Non-Healing Wound Care; If the patient has pain, a physician should be consulted. If pressure sores are observed, PROFESSIONAL ASSISTANCE MUST BE TAKEN.

More:

Wound Care and Wound Treatment

Who is Halime Aydın?

Wound Care Certificates

Wound Healing Processes

What is Pressure Sores (Bed Sores)?
Pressure (bed sores) is usually localized tissue damage caused by the effect of friction and tear associated with pressure or pressure in the skin and subcutaneous tissues above the bone protrusions.

PRESSURE WOUNDS is a preventable maintenance problem without simple precautions and good radiation.

HOW DO WE PREVENT PRESSURE WOUND (BED WOUND)? CAUTIONS
Non-Healing Wound Care
Wash hands before and after patient care. Non-healing wound care The mattress is very important if your patient is bed-bound and cannot stand up at all. Use visco-elastic foam mattresses that delay bed wound opening.

Your patient's bed linen should be changed daily, always dry, clean and wrinkle-free. Make sure that there are no foreign objects in the bearing. Sweat-absorbing cotton sheets should be preferred.

Urine and fecal incontinence patients should be checked at frequent intervals (30 minutes), six wet and dirty should not be left.

It is ensured that the patient's clothing is always clean, dry, non-perspiring and absorbent. Garments should not be too stitched, adhesive tapes should be preferred instead of buttons.

In cases where the head of the patient's bed is raised more than 30 degrees, the bed wound may develop as a result of sliding downwards and applying pressure to the sacrum and opaque of the patient while positioning the patient.

For this reason, the head of the patient should not be raised more than 30 degrees, the heels should be supported with a foot support board and protective edges should be used against the friction points (heel, elbow).


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Chronic Wound Treatment

These patients should be treated with a multidisciplinary approach when a wound occurs. The treatment of progressive chronic wound patients is done in hospital.

In these chronic wound patients, first of all sugar is corrected and wound treatment is performed. Antibiotic is started according to the culture result. In wound care, in addition to daily dressing and debridement, additional treatments such as vacuum treatment and hyperbaric O2 treatment are applied. The vascular structure of the patients should be investigated and investigated with the necessary tests such as USG, CT, angiography. The interventional radiologist performs this procedure. If necessary, the vascular surgeon will intervene. The wound, which is under control, is then closed with grafts if necessary.

There is a 75% risk of recurrent wounds within 5 years. Therefore, it should be followed very closely.

In our clinic, inpatient treatment is applied with a multidisciplinary approach in order to protect the living tissues, eredicate the infection, and solve the problem with healing accelerating interventions.

The priority in chronic wound debridement is the removal of dead tissue. If necessary, amputations (dead tissue-blackened tissues) are applied. Debridement is performed until blood supply is seen in muscle tissue.

Since infection is one of the main reasons delaying wound healing, antibiotic treatment is started according to the culture results.

The patient is provided with diabetes treatment (by internal medicine specialists).

Psychological support (Psychiatrist, psychologist)

Vacuum treatment can be applied. It is a dressing method in which localized negative pressure is applied. Dressing is changed every 2-3 days. In addition to these treatments, hyperbaric oxygen and ozone are provided to these patients when necessary.

Hyperbaric O2 treatment is performed in special centers by breathing 0 O2. Hypoxigenization in blood and tissues is the main mechanism of action. While it is very beneficial in the early period, it decreases in the later periods.

Oxygen administration is controversial.

Medical ozone application is the regional or systematic application of 0.5-5% ozone / O2 gas mixture. The regionally ozonated material is applied for 15-20 minutes. Some growth factor increases the production of infection that has the effect of helping the treatment. It is the systematic removal of the patient's blood and ozonizing. It can also be applied rectally.

Some treatment methods are currently being followed.

Growth factor has a strong effect on wounds. Research is ongoing.

Gene therapy, stem cell applications are still in the early phase. The efficacy and safety of these treatments will be determined by long-term studies.

Pressure water, ultrasound and radiofrequency methods are also tried in various centers.


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