Summary of a Wound Assessment Article

Summary of a Wound Assessment Article

Grey, J., Enoch, S., & Harding, K. (2008). Wound Assessment. BMG, (332), 285-288. http://dx.doi.org/10.1136/bmj.332.7536.285

The article by Grey, Enoch, and Harding (2008) explains the ABC of wound healing through assessment of wounds. According to the article, majority of wounds regardless of their aetiology heal without difficulty. However, some of the wounds are subjected to factors that impede healing although they do not prevent the healing process of a wound if appropriately managed. Only a section of the wounds becomes non-healing or chronic. In such cases, the critical goal is preventing complications and controlling the symptoms rather than healing the wound. This article explains different causes of ulcerations which includes; factitious, latrogenic, traumatic, pannuculitis, infectious, neoplastic, immunodeficiency, dysproteinaemias, haematological disease, pyoderma gangrenosum, connective tissue disease, metabolic, neuropathic and vascular.

It is important before treating a wound to follow the normal process in developing a diagnostic hypothesis. This is undertaken through a detailed clinical history which should include characteristic of the ulcer, family history of ulceration, trauma history, previous ulceration, duration of the ulcer, allergies to drugs and dressing, under medical conditions, limb temperature, and smoking medications. Chronic wounds causes various complications like; fistula, septicaemia, heterotopic, osteomyelitis, Marjolin’s ulcer, sinus formation, systemic amyloidosis and others. While assessing wounds, the wound size should be assessed during first presentation and thereafter regularly. The wound margin outline should be traced to provide a means of the progress of wound closure identification. The edge of the wound should also be examined to assist in identification of the wound aetiology in the context of its history.

It is important to assess the site of the wound as it aids in diagnosis like venous ulcerations which mostly occurs in the leg’s gaiter area. Wound bed is also important as it assists in differentiating health and unhealthy granulation giving idea on the type of treatment to use. Other aspects that require to be assessed include surrounding skin, depth, infection, presence of necrotic tissue and pain. The article winds up in explaining about non-healing wounds which are the ones that fails to progress in an orderly repair sequence. These wounds according to the article are caused by misdiagnosis, incompetence, neglect or inappropriate treatment strategies.

Pressure Ulcer Prevention

One preventive measure of pressure ulcer is frequent and regular changes of a client’s position. If a patient has a pressure ulcer, changing their position regularly will eliminate exerting more pressure on the ulcer. Families and relatives should assist the patient in changing position (NHS, 2014). Another prevention measure according to Haesler (2014) is nutrition as healthy eating contains adequate amount of vitamins, proteins and minerals that are essential in speeding up healing process and preventing skin damage. Smokers with pressure ulcers should quit smoking as it reduces oxygen levels in blood. Individuals who are at known risks of pressure ulcers should check their skins on regular basis such as discolored skin areas.

References

Grey, J., Enoch, S., & Harding, K. (2008). Wound Assessment. BMG, (332), 285-288. http://dx.doi.org/10.1136/bmj.332.7536.285

Haesler, E. (2014). PAN PACIFIC Pressure Injury Alliance Prevention and Treatment of Pressure Ulcers: Quick Reference Guide (2nd ed.). Perth, Australia: Cambridge Media. Retrieved from http://www.npuap.org/wp-content/uploads/2014/08/Updated-10-16-14-Quick-Reference-Guide-DIGITAL-NPUAP-EPUAP-PPPIA-16Oct2014.pdf

NHS,. (2014). Pressure ulcers – Prevention. NHS. Retrieved from http://www.nhs.uk/conditions/pressure-ulcers/pages/prevention.aspx