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A discussion and analysis of wound care

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Paul B.
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  1. Introduction
  2. The concept of care
  3. Stages of wound healing
  4. Pain assessment
  5. Indications for wound cleansing
  6. The importance communication in nursing
  7. The importance of body image
  8. Effects of improper sleeping habits
  9. The use of dressing regime
  10. Conclusion
  11. References

The aim of this essay is to explore the underlying theory of wound care. This will be broken down and looked at in terms of comfort, safety, and status and assessment of the nursing model - activities of daily living concerning wound care. Under examination will be definitions of care and comfort, and biological theories of wound care. In addition, I will examine holistic care (looking at the whole person, not just the wound) and the skills required by the nurse in order to fulfill this. Reflection from practice experience will be included.

The concept of care has wide-ranging definitions and theoretical perspectives, and can sometimes be taken for granted (McKenna, 1993). McFarlane (1976, cited in McKenna, 1993) points out that nursing is the same as caring and Leininger (1986, cited in McKenna, 1993) defines caring as ?the essence of nursing?. McFarlane and Leininger share a consensus here, however, there is a lack of agreement between nurses and patients on the concept of care. Nurses tend to consider trusting and comforting types of behavior essential to care whereas patients prefer behaviors associated with competency and physical care (McKenna, 1993).

[...] Produced during this phase is wound exudate, which contains proteins and a variety of nutrients, growth factors, and enzymes, which cleanse the wound surface and assist healing. Wound exudate also has anti-microbial properties (Hutchinson cited in Miller and Glover, 1999). This phase can last from the moment damage to the skin has occurred and can last for two to five days (Wound Expert, 2001). The next stage of wound healing is the proliferative phase when the formation of new connective tissue occurs. [...]


[...] A good blood supply to the wound and a sufficient supply of oxygen, are essential to the healing of the wound. Factors that can affect this include age and cardiovascular disease. The activities of daily living, ?eating and drinking', are necessary for health, well-being and wound healing. There is significant research that shows impaired wound healing in malnourished patients (Haydock and Hill and 1987, Delmi et al Paterson et al Tkatch et al cited in Dealey, 1994). An assessment should identify those at risk, the inclusion of a dietary history, observation of obvious signs of obesity, emaciation, or muscle wasting, and the patient weighed for comparison with ?usual weight' (Dealey, 1994). [...]


[...] (1993) Caring is the Essence of Nursing Practice. British Journal of Nursing. Vol No pp 76. Miller, M. and Glover, D. (1999) Wound Management. Theory and Practice. London: Nursing Times Books. Morison, M. et al, (1999) Nursing Management of Chronic Wounds. London: Harcourt Publishers Limited. Morse, J.M., Bottorff, J.L., and Hutchinson, S. (1994) The Phenomenology of Comfort. Journal of Advanced Nursing. Vol pp. 189-195. Tortora, G.J., and Grabowski, S.R. (1996) Principles of Anatomy and Physiology. (Eighth Edition) New York: Harper Collins Publishers [...]

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