woundmanagement

Wound management is the clinical approach to treating injuries to the body's tissues with the aim of promoting healing, reducing infection, preserving function, and minimizing scarring. It encompasses assessment, cleansing, debridement, dressing selection, infection control, analgesia, and when appropriate wound closure or staged healing.

Initial assessment should document wound type (abrasion, laceration, incision, puncture, burn), size and depth, tissue viability, contamination, vascular supply, and surrounding skin. Patient factors such as diabetes, immune status, nutrition, smoking, and medications influence healing. Tetanus status should be updated as needed. Pain and function goals should be established.

Cleansing and debridement are foundational. Irrigation with balanced normal saline or sterile water helps remove debris; avoid cytotoxic solutions. Debridement removes nonviable tissue and reduces infection risk. When necrotic tissue or devitalized tissue is present, selective or surgical debridement may be indicated.

Infection management relies on clinical judgment and, when indicated, cultures. Signs of infection include redness, warmth, swelling, purulent discharge, and systemic symptoms. Antibiotics are used for spreading infection or systemic signs, guided by local guidelines and wound type. Pain management is addressed with appropriate analgesia.

Dressing aims to maintain a moist wound environment appropriate to exudate level, protect from trauma, and permit observation. Common dressings include simple gauze, hydrogel, hydrocolloid, foam, alginate, and film. Some wounds require advanced therapies such as negative pressure wound therapy or enzymatic debridement; timing is individualized.

Wound closure decisions consider whether primary closure is appropriate or whether delayed closure or healing by secondary intention is preferred. Regular follow-up monitors progress, and referrals to wound care specialists are considered for chronic or complex wounds. Patient education on wound care and prevention is essential.