Frequently Asked Questions on Wound Management

Wound Management

Should I be concerned if an area on my skin shows change in color?

In many cases, the change is usually harmless and can be ignored. If you see redness on your skin, you should be concerned. You must monitor the skin daily. If your skin is red, you should consult your doctor immediately.

Is there any problem if my wound gets wet in the shower?

Wetting your wound is a matter of concern when you have exposed staples, bones, or stitches. And if you have been told to keep it dry by your doctor in that case, it is advisable to cover your wound when taking a shower. You can use a plastic bag to keep it dry while you shower.

How does diabetes affect wound healing?

When a wound is in the healing process blood sugar must be kept at a minimum. High levels of blood sugar can slow down or prevent the wounds healing process. Your doctor can help you in keeping it under control.

What is recommended - keeping the wound exposed or covered?

Keeping the wound covered helps in its healing faster. That is why a doctor covers the wound with a dressing. The dressing provides the right balance of moisture required for healing and enables the good bacteria to function and thus, disallow infection. The healing cells are also able to cover the wound with new smooth tissue faster. Covering a wound also reduces the chance of scarring. This is because it helps prevent scabbing. The earlier belief was to let a wound be exposed to the air and allow a scab to form. But this scab actually slows the healing process. And on falling off, it leaves a visible mark.

What is the significance of the terms 'antimicrobial' and 'antibacterial’ with regard to wound care?

Antimicrobial refers to properties of an agent that has antibacterial, antifungal and antiviral properties. Antibacterial refers to properties of an agent that destroys bacteria or suppresses their growth or ability to reproduce. Both these properties are important when caring for a wound.

What is the difference between antiseptic and antibiotic?

An antiseptic solution helps clean wounds, getting rid of germs and dirt. And an antibiotic is what provides protection to a wound from developing infections. It offers an optimal healing environment.

What are the chances of a burn injury leaving behind a scar?

All burn injuries, except first degree burns, leave behind some kind of a scar.

How are scars caused?

Changes in the skin lead to scars. For example, after a burn the skin loses part of its structure and this loss is replaced by scar tissue. All this - the thinness, the irregularity and the scar tissue - form the scar.

What kind of wound dressing should I use?

If the wound is superficial, meaning only the outer layer of skin is affected, a dry gauze bandage such as a 3M Nexcare Waterproof Bandage is a good choice. If the wound is deeper, a dressing that keeps the wound moist, such as McKesson Hydrocolloid Thin Dressing is a better choice. If the wound is not healing, seek evaluation from your doctor.

How to clean a wound?

Superficial wounds should be cleaned with soap and warm water (showering daily) or a no rinse cleanser like Hollister''s Restore Wound Cleanser. Just pat the area dry before applying the bandage. Larger or deeper wounds can be cleaned with a wound cleanser such as Medline''s Skintegrity Wound Cleanser. Showering is acceptable as well, allowing soap and water to run down the wound. Pat the area dry prior to applying the dressing.

How long will it take my wound to heal?

Wound healing varies depending on many factors. A superficial wound can heal within 1-2 weeks for a healthy person. With deeper wounds, heal time is increased because the wound needs new tissue to grow from the bottom up to the skin level. Proper nutrition is vital for healing. Consider increasing protein in your diet along with a multivitamin. If your appetite is not great, nutritional supplement may help. Consider Abbott Juven Therapuetic Nutrition Powder for the adequate nutrients needed for wound healing.

Why does my wound keep draining?

The body sends a plasma fluid to the area of injury to start the healing process. This fluid brings nutrients for healing and takes away waste. Some of the fluid will take the path of least resistance and drain out of the opening in the skin. Drainage that is yellow, pink, orange or brown are acceptable colors. It ususally does not have an odor. If you note an odor, be sure you are cleaning the wound regularly. If the color changes to green or is very bloody, call your doctor for evaluation. Also monitor for redness and warmth that spreads outward from the wound at the skin margins. Again, contact your doctor.

What do you do when you have a scar?

Superficial wounds often close with minimal scaring. Deeper wounds will leave a scar. Scar minimizing products are available for use once the skin closes.
What is the difference between an acute wound and a chronic wound?
An acute wound is usually surgically created wound or caused by trauma to the skin tissue. Wound healing follows a pattern for repairing the tissue. The end result is strong, healed and durable skin. In a chronic wound, the normal healing process is interrupted, causing a delay. Chronic wounds often occur due to decreased vascular flow, persistent inflammation or repeated trauma to the wound. A wound is considered chronic if healing does not occur in 3 months.
What does it mean to heal by primary intention?
Surgically created wounds are generally sutured at the lower portion of the skin (dermis) and subcutaneous tissue layers. The epidermis (outer layer of the skin) may be closed with sutures, staples or liquid band-aid. With this process, wound healing begins at the surface of the skin and continues downward to the subcutaneous layer. These wounds heal quickly with minimal scar formation.
How does a wound heal by secondary intention?
Some wounds cannot be closed at the skin level. One reason is infection in the wound. These wounds are left open to heal from the bottom (subcutaneous tissue) up to the skin level. They take significantly longer to heal because they require rebuilding of tissue to fill the defect. When dressing open wounds, the defect should be filled with a Gauze Pad. Scarring is much more noticeable on wounds that heal by secondary intention.
What is tertiary wound healing?
Wounds may need to have a delay in wound closure due to infection or debris in the wound bed. Initially, the wound is left open for infection to drain. Once debris is the wound is cleared, the wound can then be closed by primary intention. In tertiary wound healing intention scarring is less than wounds closed by secondary intention but not as fine as those closed by primary intention initially.
Should I leave my wound open to air to dry out?
This is not recommended. Wounds need a moist environment to heal properly, but not too much moisture. Covering the wound with the appropriate dressing helps manage the moist environment by wicking away excess moisture and protecting the wound from exposure to environmental microbes.
Can I use hydrogen peroxide (H2O2) to clean the wound?
This is not recommended. H2O2 can damage healthy skin. It is best to use a wound cleanser such as Coloplast’s Sea-Clens Wound Cleanser. Its base is normal saline (salt-water) and is available in spray form to loosen debris from the wound bed.
How do I know if my wound is infected?
  • Monitor the wound daily, including the surrounding skin.
  • Signs of infection include:
    - Increased drainage
    - Redness of the skin surrounding the wound
    - Warmth of the skin surrounding the wound
    - Increased pain at the wound site
    - Elevated body temperature (fever)
    - If diabetic, increased blood sugars
    - If any of these signs occur, call you doctor for evaluation.
Will the sun help heal my wound?
No. Exposure to the sun’s rays will dry the wound out. It will also tattoo the area causing a scar that will look darker than the skin. Normal scarring usually turns light but with sun exposure during the first year, it will remain more noticeable.
What are the most common wounds?
Pressure injuries (pressure ulcers)
Venous ulcers
Arterial ulcers
Diabetic Ulcers
What causes a chronic wound?
Risk factors include diabetes, age, vascular insufficiency (poor blood flow), and immobility. Traumatic injuries can develop into chronic wounds as well as non-healing or delayed surgical wounds.
What defines a chronic wound?
If a wound does not improve significantly in 4 weeks or has not completely healed in 8 weeks, it is considered a chronic, non-healing wound.
When should I see a doctor about a wound?

If you are concerned about a wound that may not be healing, seek out a wound care specialist as early as possible to maximize the chance of complete healing. Some things to look out for include:

• Wounds that have not made progress in one week (commonly experienced by people with diabetes)

• Sores accompanied by increasing pain, redness, swelling, foul odor, or change in color

• Surgical wounds that have become infected