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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 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).
In the presence of comorbidities, such as diabetes or edema, a higher value is likely needed. Patients with oxygen tensions less than 20 mmHg are likely to need revascularization to promote adequate wound healing. [3] The required TCOM level for adequate wound healing, however, remains controversial. [citation needed]
This parameter measures a patient's ability to detect and respond to discomfort or pain that is related to pressure on parts of their body. The ability to sense pain itself plays into this category, as does the level of consciousness of a patient and therefore their ability to cognitively react to pressure-related discomfort.
The goal of wound care is to promote an environment that allows a wound to heal as quickly as possible, with emphasis on restoring both form and function of the wounded area. Although optimal treatment strategies vary greatly depending on the specific cause, size, and age of a particular wound, there are universal principles of wound management ...
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.
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The Lund and Browder chart is a tool useful in the management of burns for estimating the total body surface area affected. It was created by Dr. Charles Lund, Senior Surgeon at Boston City Hospital , and Dr. Newton Browder, based on their experiences in treating over 300 burn victims injured at the Cocoanut Grove fire in Boston in 1942.