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Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
The International Red Cross wound classification system is a system whereby certain features of a wound are scored: the size of the skin wound(s); whether there is a cavity, fracture or vital structure injured; the presence or absence of metallic foreign bodies. A numerical value is given to each feature (E, X, C, F, V, and M).
Wound bed, wound edge and periwound skin should be examined before the initial treatment plan is devised. It should also be re-assessed at each visit or each dressing change. For wound bed, the following parameters are assessed: Tissue type; presence and percentage of non-viable tissue covering the wound bed; Level of exudate; Presence of infection
The end goal of wound management is closure of the wound which can be achieved by primary closure, delayed primary closure, or healing by secondary intention, each of which is discussed below. Pain control is a mainstay of wound management, as wound evaluation, wound cleansing, and dressing changes can be a painful process.
The Abbreviated Injury Scale (AIS) is an anatomical-based coding system created by the Association for the Advancement of Automotive Medicine to classify and describe the severity of injuries. [ 1 ] [ 2 ] [ 3 ] It represents the threat to life associated with the injury rather than the comprehensive assessment of the severity of the injury. [ 4 ]
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The ISS is based (see below) upon the Abbreviated Injury Scale (AIS). To calculate an ISS for an injured person, the body is divided into six ISS body regions. These body regions are: Head or neck – including cervical spine; Face – including the facial skeleton, nose, mouth, eyes and ears; Chest – thoracic spine and diaphragm
Research into hormones and wound healing has shown estrogen to speed wound healing in elderly humans and in animals that have had their ovaries removed, possibly by preventing excess neutrophils from entering the wound and releasing elastase. [26] Thus the use of estrogen is a future possibility for treating chronic wounds.