Definition of wound nursing

From the point of view of clinical practice, wound care is a whole-cycle intervention process aimed at the damage of skin and mucosa caused by external forces, inflammation, abnormal metabolism and other factors. The core is to eliminate the unfavorable factors that hinder healing, help the wound restore its original function and appearance as much as possible, and reduce the risk of long-term complications.

To tell the truth, many people's understanding of this matter is still at the stage of "rubbing iodophor with gauze". I thought so when I first entered the business, until I met the high school student who fell on his knee riding an electric car, and I applied purple liquid medicine and put two layers of gauze at home. When I came to change my medicine for three days, pus accumulated under the scab, and the whole person cried with pain. When I was debridement, I grabbed my arm and pinched out the marks. At that time, I realized that wound care is really not something that can be done casually.

Speaking of this, I have to mention the debate on dry-wet healing that has been arguing in the industry for many years. The older generation always said that "the wound should be aired, and it will get scabbed quickly when it is dry", which is actually the core of the traditional concept of dry healing: the wound can get scabbed quickly by dry environment, and the scab shell is used as a natural barrier to isolate external pollution. There is nothing wrong with this idea. For those small bruises that are only very superficial and have little oozing, such as the arm being marked by a branch, if it doesn't bleed, it will scrape some skin and dry for a long time, and form a thin scab.

However, the concept of wet healing, which Copley often talks about now, was confirmed by the British zoologist Winter in an experiment in 1962: in a moist environment with constant temperature and airtight, the crawling speed of epithelial cells is about 30% faster than that in a dry environment, which can obviously shorten the healing time and reduce the probability of scar hyperplasia. Now it is also the mainstream nursing idea in clinic. However, it doesn't mean that wetness is all right. For example, if you suffocate a wound with a lot of exudation, it will easily breed bacteria and heal more slowly. To put it bluntly, there is no absolute right or wrong between the two ideas. It depends on the specific situation of the wound and there is no universal "standard answer".

When I usually do popular science for the community, I sorted out several common wound care points that everyone asked the most, and made a list. According to this, the probability of stepping on the pit can be reduced by more than half:

By the way, there are still many patients chasing me and asking, is the more expensive dressing the better? Really not. Last month, there was a programmer who made a small cut less than a centimeter on his hand, which had stopped bleeding and scabbed. He also put on more than 300 pieces of imported hydrocolloid dressing every day, and after covering it for three days, the wound was white and swollen. I just took off the dressing and dried it for two days, which was a pure waste of money. Dressing is the best thing, and there is no need to blindly pursue expensive ones.

What many people don't know is that the care of chronic wounds is the most important test, such as diabetic foot, pressure ulcers in bed for a long time, and venous ulcers. It is useless to treat the wounds locally, but it is necessary to cooperate with the whole body conditioning such as sugar control, turning over regularly and improving circulation. Before, there was an 80-year-old grandmother who had not recovered from the sacral and caudal pressure sore after three months of medication. Later, she told her family that she had to turn over every two hours and not always lie down. After half a month, the wound obviously grew fat. This is the role of systemic intervention and an important part of wound care, which many people ignored.

To put it bluntly, wound care has never been a standardized operation according to the process. It depends on the wound condition, the patient's physical condition and even the usual living habits. It can make patients suffer less crimes, leave less scars and get better quickly, which is a good nursing method. If you can't handle it at home, don't push it hard. Find a professional to deal with it as soon as possible, which is more effective than any remedy.