Week 2 | Principles of Wound Management (16180-SP)

Photo of healthcare professional assessing the lower limb of a patient.

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  • Initial focus 
    • Patient history and presentation 
    • Identify factors that impact wound healing. 
    • Thorough wound assessment 
    • Confirm wound etiology  
    • Set realistic goals: maintenance vs. comfort vs. healing 
  • Control or Eliminate the Causative Factors (i.e.) 
    • Pressure ulcers: eliminate mechanical forces 
      • Pressure redistribution 
      • Measures to reduce friction and shear 
    • Arterial ulcers: enhance perfusion 
    • Venous ulcers: promote venous return with compression.
    • Neuropathic ulcers: off-load pressure 
  • Provide Systemic Support to Reduce Existing or Potential Co-factors. 
    • Optimize nutrition 
    • Provide adequate hydration 
    • Reduce edema 
    • Control blood glucose levels 
    • Promote blood flow 
  • Identify and manage critical colonization/infection. 
    • Appropriate and accurate wound culturing/biopsy 
    • Use of topical antimicrobials 
    • Systemic antibiotics 
    • Rule out osteomyelitis  
  • Maintain a Physiologic Local Wound Environment: Wound bed preparation 
    • Cleanse the wound: select appropriate solution and delivery method. 
    • Debridement 
      • Objectives for debridement 
        • Removal of non-viable tissue.
        • ​Reduce Bioburden 
        • Facilitate visualization of the wound base
        • Interrupts the cycle of the chronic wound 
      • Indications for debridement 
      • Contraindications for debridement
      • Classification of debridement 
        • Selective 
        • Non-selective 
      • Types of debridement  
        • Autolytic 
        • Chemical-Enzymatic 
        • Biologic
        • Mechanical  
        • Sharp 
      • Selection of debridement method. 
    • Maintain an appropriate level of moisture 
    • Eliminate dead space 
    • Control odor 
    • Eliminate or minimize pain 
    • Protect the surrounding skin 

Objectives for Learning Outcomes

After completing this session, you will be able to:

  1. Discuss the key principles of wound management. 
  2. Describe the objectives to maintain a physiologic local wound environment.
Course summary

Renee Anderson, MSN, RN, CWON
Certified Wound Ostomy Nurse; Co-Director, Wound Management Education Program (WMEP) and Wound Management Fundamentals Course (WMFC), Continuing Nursing Education, University of Washington School of Nursing, Seattle; President, Rainier Clinical Consultants, Inc, Seattle, WA


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