Wound Healing and Wound Dressing by Dr. Sudarshan Kale SignUp
Boloji.com
Boloji
Home Kabir Poetry Blogs BoloKids Writers Contribute Search Contact Site Map Advertise RSS Login Register
Boloji
Channels

In Focus

Analysis
Cartoons
Education
Environment
Going Inner
Opinion
Photo Essays

Columns

A Bystander's Diary
Business
My Word
PlainSpeak
Random Thoughts

Our Heritage

Architecture
Astrology
Ayurveda
Buddhism
Cinema
Culture
Dances
Festivals
Hinduism
History
People
Places
Sikhism
Spirituality
Vastu
Vithika

Society & Lifestyle

Family Matters
Health
Parenting
Perspective
Recipes
Society
Teens
Women

Creative Writings

Book Reviews
Ghalib's Corner
Humor
Individuality
Literary Shelf
Love Letters
Memoirs
Musings
Quotes
Ramblings
Stories
Travelogues
Workshop

Computing

CC++
Computing Articles
Flash
Internet Security
Java
Linux
Networking
Health Share This Page
Wound Healing and Wound Dressing
by Dr. Sudarshan Kale Bookmark and Share
 

Wound Healing can be explained as:

Dynamic process involving tissue response to insults
Continuous sequence of signals and responses
Platelets, fibroblasts, epithelial, endothelial, and immune cells come together outside their usual domains
Orchestration of very complex event leading to

Tissue Repair

1) COAGULATION:- it is summarized as following events

a) Vessel Rupture - Platelet aggregation and coagulation
b) Platelet degranulation - Release of cytokines and growth factors like PDGF, TGF-1IGF-1, PDEGF, Fibronectin, Serotonin
c) Fibrin clot formation

2) INFLAMMATION: Attraction & Activation of Infiltrating cells

a) Neutrophils
- Bacteria and matrix phagocytosis
- Not essential unless wound contaminated

b) Macrophages
- Debridement / matrix turnover
- Major source of stimulatory signals
- Important for wound healing

3) MIGRATION / PROLIFERATION

a) Angiogenesis
- Formation of vessels
- Begin as endothelial cell buds
- Progress toward wound space, following oxygen gradient
- Immature vessels differentiate into capillaries, arterioles, and venules
- Macrophages and keratinocytes provide angiogenic stimuli

b) Epithelization
- Epidermal covering (keratinocytes) reconstituted from wound margin and hair follicle remnants
- Keratinocytes migrate across wound
- During and after migration, differentiation and stratification of neodermis occur
- Epithelization aided by moist environment

c) Fibroplasia
Fibroblasts
- Migrate into wound site and replicate
- Dominant cell type at wound edge
- Synthesize and deposit collagen and proteoglycans
- Matrix deposition dependent on oxygen and substrate availability as well as growth factors

Wound Dressing

1) Components
- Wound cleaning.
- Topical agent.
- Wound cover.
- Holding method.
- Splinting / Immobilization.
- Future plan.

2) Considerations
- Type of wound.
- Location of wound.
- Wound status.
- Patient status.
- Co-morbid conditions.
-
a) Type of Wound
- Clean –but depth of tissue loss should be assesed
- Superficial – Spray, Seal, Film, Collagenase effective for dressing
- Deep – Early wound closure, Graft / Flap,
- Delayed wound closure
- Contaminated – Expectant – Short term temporary wound cover.
- Infected – Discharge Necrotic tissue- proper discontamination.

b) Location of Wound
- Face, Hands, Feet, Ears, Perineum,Joints
 
c) Wound Status
- Depth, Infection, Arterial supply, Venous drainage, Lymphatic drainage, Edema, Exudation etc. should be considered.

4) Wound Cleaning
- Irrigation with normal saline.
- Potable water.
- Antibacterial solutions .
- Chlorhexidine, Povidone Iodine
- Cetavlon / Savlon, Hydrogen peroxide.

5) Topical Agent – Purpose
- Infection prevention – SSD, SSD + Chlor. Povidone iodine, Framycetin.
- Infection control – Povidone iodine, SSD. Mupirocin, Chlorhexidine, Nadifloxacin, Miconizole.
- Indigenous – Honey, Jaggery, Herbal, Camphor containing creams.
- Edema reduction – Glycerine + Acriflavin
- Epithelisation promotion – Collagen+ SSD, P.D.G.F, E.G.F creams.
- Debridement – Collagenase – Proteases. Hydrogen Peroxide, Eusol solution,
- For examples Pappain + Urea, Benzoic acid, Bromelain.

6) Wound Debridement
- Mechanical – Scrubbing , Sepsis, Tissue damage. Waterjet .
- Surgical – Sharp – Daily Analgesia required!
- Enzymatic – Proteolytic enzymes.
- Biological – Maggot therapy.
- Autolytic – Wound bed, bacteria.

7) Wound Cover
- Non-adherent – Impregnated tulle gras ,Wide variety
- Indigenous – Banana leaf dressing.
- Boiled potato peel bandage.
- Long term adherence – Films, Collagen, Amnion.
- Non-adherent – Alginates, Hydrocolloids, Hydrogels – Unsuitable for exuding wounds, Expensive, 
- Drug eluting – Silver nano particles, Drug releasing hydrogels – Effective,R educed dressing frequency. Availability and Cost should be considered.
- Biosynthetic Dressings

Secondary Dressing
- If needed – Support, Protection.
- Absorbent as Gamgee.
- No discharge – Gauze alone.
- Holding – Bandage, Net – Bandafix.
- Adhesive tapes - With discharge.
- Consider splinting, Immobilization.

Wound Dressing
- Reassurance.
- Gentle cleaning.
- Use of Spray , Shower, Syringe – asepto.
- Clean surrounding normal skin. Wipe dry.
- Surgical debridement
- Topical agent.
- Non adherent dressing, secondary dressing.
- Bandaging , Adhesive tapes .

5-Mar-2016
More by :  Dr. Sudarshan Kale
 
Views: 115
 
Top | Health







A Bystander's Diary Analysis Architecture Astrology Ayurveda Book Reviews
Buddhism Business Cartoons CC++ Cinema Computing Articles
Culture Dances Education Environment Family Matters Festivals
Flash Ghalib's Corner Going Inner Health Hinduism History
Humor Individuality Internet Security Java Linux Literary Shelf
Love Letters Memoirs Musings My Word Networking Opinion
Parenting People Perspective Photo Essays Places PlainSpeak
Quotes Ramblings Random Thoughts Recipes Sikhism Society
Spirituality Stories Teens Travelogues Vastu Vithika
Women Workshop
RSS Feed RSS Feed Home | Privacy Policy | Disclaimer | Site Map
No part of this Internet site may be reproduced without prior written permission of the copyright holder.
Developed and Programmed by ekant solutions