For a day in our primary healthcare setting, we received more than ten patients or clients for wound care. They’re either with post surgery wound or minor laceration or abrasions due to minor home accidents. They came alone or with significant others, who at times annoy your neurons because of fear.
As a nurse, your priority is to manage the impaired skin integrity promptly. It will be followed by pain management, and emotional needs of patient/ client and his significant other. The nurse’s goal is to ease the healing process and prevent wound complications such as infection. So the following is the step by step process on how to execute wound care according to two different cases.
Care for Post Surgery Wound
There are two types of surgical wound – healing by primary intention and healing by secondary intention. I’d focus on the secondary because most patient who come to us have this case and the facility I’m working with is classified under primary healthcare setting.
Surgical wounds healing by secondary intention requires dressing for 5 to 7 days, or depending on the size, depth of the wound, level and position of exudates. Nurses are tasked to assess the wound area, and other factors (pain felt and vital signs) before wound care. A nurse cleans the wound with gauze soaked in Normal Saline and Betadine Solution, in a inward to outward motion. Antibactaerial cream is sometimes prescribed by the surgeons or doctors to prevent infection. The cream is placed last before closing the wound with a sterile waterproof dressing pads and crepe bandage. Dressing pads and bandages are selected according to the size and location of the wound. There are some post surgery wounds that require special dressing pads. Some patients we handled brought their own dressing pad because it’s what their doctor prescribed.
Most post op wounds should be cleaned thereafter, but exemptions are done depending on the nature and reason for surgical intervetion.
Care for Minor Laceration and Abrasion
Most of the accidents we experience in our homes are lacerations while cutting vegies or fruits or opening canned goods; and abrasions when we got tangled with our doormat (it happens you know *wink*). These two classification of wounds are popular in our facility. School children and young adults are our most frequent visitors.
Care for lacerations and abrasions also depends on its size, depth, location, and other factors. Cleaning the wound area with Normal Saline is a priority. This procedure allows the wound area to be free from dirt and other exudates; and to make it more visible. Inward to outward motion is to be done when cleansing the wound. Betadine and antibiotic cream are placed on the wound. Sterile waterproof dressing pads and crepe bandage are placed to cover the wound. If it’s in the extremeties, we put net bandage to prevent the dressing from falling off.
At times, our general practitioner perform minor suturing of the laceration. Then wound care is to be done thereafter.
Nursing Care Plan for Wound Care