Wound care is a critical aspect of healthcare, particularly in aged care, chronic disease management, and postoperative recovery. Effective wound management focuses on promoting healing, preventing infection, and minimising complications.

Types of Wounds

• Pressure Ulcers – Common in immobile patients, particularly over bony prominences such as the heels and sacrum​.
• Diabetic Ulcers – Usually occur on the feet due to neuropathy and poor circulation​.
• Arterial and Venous Ulcers – Related to peripheral vascular disease, often found on the lower limbs​.
• Surgical Wounds – Result from medical procedures and require specific post-operative care.
• Traumatic Wounds – Caused by external injury and can vary in severity.

Principles of Wound Care

1. Assessment and Staging
   Wounds should be assessed for size, depth, exudate, surrounding tissue, and signs of infection. For pressure ulcers, staging helps guide treatment:
   • Stage 1: Red, intact skin with non-blanchable erythema.
   • Stage 2: Partial thickness skin loss, appearing as a blister or shallow ulcer.
   • Stage 3: Full-thickness skin loss involving subcutaneous tissue.
   • Stage 4: Deep ulceration with exposure of muscle, bone, or tendons​.
2. Wound Cleansing and Debridement
   • Use saline or appropriate wound cleansers to remove debris.
   • Debridement (removal of nonviable tissue) may be necessary for healing.
3. Dressing Selection
   The choice of dressing depends on the wound type:
   • Transparent films & barrier creams – For Stage 1 ulcers.
   • Hydrogels & foams – For Stage 2 wounds requiring moisture balance.
   • Calcium alginate & silver dressings – For deeper Stage 3 and 4 wounds with infection risk​.
4. Infection Control
   • Signs of infection include increased pain, erythema, and purulent discharge.
   • Systemic antibiotics may be needed for cellulitis or osteomyelitis.
5. Pressure Redistribution & Offloading
   • Essential for pressure ulcers and diabetic foot ulcers.
   • Use of cushions, mattresses, and repositioning techniques to prevent prolonged pressure.
6. Optimising Patient Health
   • Ensure adequate nutrition (especially protein and vitamins like C and zinc).
   • Manage underlying conditions like diabetes and vascular disease.
   • Address pain management and patient comfort.

Prevention Strategies

• Regular skin checks in at-risk patients.
• Maintaining skin hygiene and hydration to prevent breakdown.
• Educating patients and caregivers on early signs of skin damage.

Effective wound care involves a multidisciplinary approach, including general practitioners, nurses, wound care specialists, and allied health professionals​.

A2BC2D – Wound Care

• Assessment of the wound – TIME
  • Tissue
  • Infection
  • Maceration
  • Edge
• Assessment of the patient
• Best dressing
• Compression? – ABPI +/- Duplex
  • Graduated compression
• Concerns of the patient 
• Document