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Wound, ostomy, and continence nursing is a nursing specialty involved with the treatment of patients with acute and chronic wounds, patients with an ostomy (those who have had some kind of bowel or bladder diversion), and patients with incontinence conditions (those with issues of bladder control, bowel control, and associated skin care).
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 wound is initially cleaned, debrided and observed, typically 4 or 5 days before closure. The wound is purposely left open. Examples: healing of wounds by use of tissue grafts. If the wound edges are not reapproximated immediately, delayed primary wound healing transpires. This type of healing may be desired in the case of contaminated wounds.
Adhesive glue and sutures have comparable cosmetic outcomes for minor lacerations <5 cm in adults and children. [37] The use of adhesive glue involves considerably less time for the doctor and less pain for the person. The wound opens at a slightly higher rate but there is less redness. [38] The risk for infections (1.1%) is the same for both.
An example of a vacuum bandage Negative pressure system used in a surgical wound in the right knee and thigh. The little vacuum pump is shown on the left of the photo, as is a subcutaneous drain. The dressing type used depends on the type of wound, clinical objectives and patient.
Emotional stress can also negatively affect the healing of a wound, possibly by raising blood pressure and levels of cortisol, which lowers immunity. [7] What appears to be a chronic wound may also be a malignancy; for example, cancerous tissue can grow until blood cannot reach the cells and the tissue becomes an ulcer. [13]
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Wound closure strips are porous surgical tape strips which can be used to close small wounds. They are applied across the laceration in a manner which pulls the skin on either side of the wound together. Wound closure strips may be used instead of sutures (stitches) in some injuries, because they lessen scarring and are easier to care for.