Chronic wound care

• Wound healing is a complex and dynamic process of restoring cellular structures and tissue layers. There are two types of wounds: acute and chronic. Acute wounds are either traumatic or surgical and move through the healing process at a predictable rate from insult to closure. Chronic wounds do not progress through the predictable stages of wound healing.

• The type of wound repair is classified as either primary, secondary, or tertiary intention. In primary intention, the wound edges are approximated and held together with staples, sutures, or some form of adhesive tape. Healing occurs with epithelialization and connective tissue attachments, usually without complications.

•  A chronic wound is a wound that has not resolved over a reasonable period of time no matter the cause.Changes occur within the molecular environment of a chronic wound that are not conducive to healing, such as high levels of inflammatory cytokines, proteases, and low levels of growth factors. These changes terminate the healing process and increase the potential for septic infections. Addressing the issues that might be responsible for the physiological wound changes may restart healing

The skin is the largest organ of the body and is continually adapting to meet the needs of an ever-changing external environment. 

 WOUND HEALING PHASES:-

nBegins within 24 hours of the initial injury and may continue for up to 21 days

nIt is characterized by three events:

• nInflamation

• Proliferation

exudate
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• nMaturation

Inflamation

•  Characterized by redness, heat, pain and swelling
  nLast approximately 4 to 5 days
  nInitiates the healing process by stabilizing the wound through platelet activity that stops bleeding & triggers the immune response

 PROLIFERATION:-

 

• Epithelization:- 

 

nFormation of an epithelial layer that seals and protects the wound from bacteria and fluid loss

nIt is essential to have a moist environment to foster growth of this layer

nIt is a very fragile layer that can be easily destroyed with aggressive wound irrigation or cleansing of the involved area .

 

 

Granulation:-

 

nFormation of new capillaries that generate and feed new tissue

nGranulation tissue is the beefy red tissue that bleeds easily.

 

Maturation:-

 

nFinal stage of wound healing

nBegins around day 21 and may continue for up to 2 years

nCollagen synthesis continues with eventual closure of the wound and increase in tensile strength

nTensile strength reaches only about 80% of pre-injury strength

nCreates a support matrix for the new tissue that provides it with its’ strength

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nOxygen, iron, vitamin C, zinc, magnesium & protein are vital for collagen synthesis

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nThis stage is the actual rebuilding and is influenced by the overall patient condition of the wound bed.

 

 

Red light therapy

 

 

  Red Light Therapy for Healing
Aside from its cosmetic and anti-aging benefits, RED light therapy can provide relief from chronic and acute pain including muscle pain, joint pain, arthritis, high blood pressure, tissue and nerve damage, and can decrease injury healing time. Originally discovered by NASA for this purpose, RED light therapy is now used by professional athletes to promote healing with powerful results.

Collagen:-

collagen

• Collagen produces through its porous structure a capillary suction effect and absorbs the discharge from the wound. The discharge from the wound dissolves the porous structure and releases the native collagen. This accelerates the building of new granulation tissue in the granulation phase.

• Collagen has an indirect influencing control on the epithelization and regeneration phases by stimulating the body`s own collagen synthesis, accelerating the epithelization process considereably.

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