⦁ Wound It is a break in the continuity of the
skin, mucous membranes, bone, or any body
organ
⦁ TYPES OF WOUNDS
⦁ INCISION
⦁ It is cause by sharp instrument. Ex knife or
scalpel.
⦁ CONTUSION
⦁ Cause by blowFrom a blunt Object.
⦁ Closed woundSkin appears ecchymotic
⦁ ABRASION
⦁ Surface scrape, either Unintentional or
Intentional It is an open wound Involving the
skin, Painful
⦁ PUNCTURE
⦁ Penetration of the Skin and often, the
Underlying tissues From a sharp Instrument.
⦁ LACERATION
⦁ Tissues torn apart Often from accidents
⦁ PENETRATING WOUND
⦁ Penetration of the Skin and the Underlying
tissues. (eg.gun short )
⦁ THE RYB COLOR CODE
⦁ This concept is based on the color of an open
wound - Red, Yellow, Black
⦁ Red wound - are usually in the late regeneration
phase of tissue repair and are clean and uniformly
pink in appearance
⦁this type of wound needs to be protected
Protect the Red wound
⦁ a. gentle cleansing
⦁ b. avoiding the use of dry gauze or wet to dry
saline dressings
⦁ c. applying a topical antimicrobial agent
⦁ d. changing the dressing as infrequent as possible.
⦁ YELLOW WOUNDS
⦁ Characterized by primarily by liquid to
semiliquid “slough” that is often accompanied
by purulent discharges.
⦁ CLEANSETHEYELLOWWOUNDS
⦁ Yellow wounds should be Cleanse to absorb
drainage and remove nonviable tissue.
⦁ Apply wet to wet dressing.
⦁ Hydrogel dressings
⦁ Exudate absorbent dressings
⦁ BLACK WOUNDS
⦁ This type of wound is covered with necrotic
tissue.
⦁BLACK WOUNDS requires debridement
( removal of infected and necrotic material)
⦁ GUIDELINES IN WOUND CLEANING
⦁ Use Isotonic saline or lactated ringers solution
to clean or irrigate the wound.
⦁ Warm the solution to body temperature before
use.
⦁ If wound is grossly contaminated by foreign
material, bacteria, or necrotic tissue, clean the
wound at every dressing change.
⦁ If wound is clean, has little exudate, and reveals
healthy tissue avoid repeated cleaning
⦁ Use gauze squares.Avoid using cotton balls and
other products that shed fibers onto the wound
surface. The fibers become embedded in the
granulation tissue and act as a foci for infection
⦁ Consider cleaning superficial noninfected wounds
by irrigating them rather than by mechanical
means
⦁ Purpose of wound Dressings
⦁ To protect the wound from mechanical injury
⦁ To protect the wound from microbial
contamination
⦁ To provide or maintain high humidity of the
wound
⦁ To provide thermal insulation
⦁ To absorb drainage or debride the wound
⦁ To prevent haemorrhage
⦁ To splint or immobilize the wound site and
prevent further injury