Wound Healing (Nursing)

00:04 Alright guys, so now let's talk about wound assessment.

00:07 So this is important for you to know as a nurse and a nursing student.

00:12 So every wound is going to need a varying amount of time when we assess it, it's going to depend on the severity of the wound.

00:19 But this is really important because as the nurse, you're the one that monitors it.

00:23 Is it healing okay? Is there complications? Does it look like it's getting worse? We're the ones that are going to assess and report to the physician for any complications.

00:34 So now let's take a look at these wounds.

00:37 One thing I want you to know is a lot going on this slide, you just need to know that there's phases of wound healing.

00:44 And this is important for you to know when you're going to look at a wound at clinical.

00:48 So these are common stages that you're going to see.

00:51 Now, of course, if there's a severe wound, there could be interruption in that, that's why it's important you're a little bit familiar about what a wound that's healthy, and how it heals would look like.

01:03 So that first phase, just think about if a patient's got a wound, or maybe you cut your finger, for example, when you're chopping something up in the kitchen, you cut yourself with a knife.

01:13 Now, eventually, that wound should start bleeding, right? That's really important.

01:17 But in this phase, this is where we're going to have all of those healthy cells are going to rush to and help start healing that wound.

01:26 So next, we've got this epithelial phase.

01:29 And eventually, once the wound stops bleeding, for example, we see that redness, warmth edema phase, eventually, you should see that wound start to rebuild.

01:40 New growth is happening here.

01:42 And that's a normal, healthy stage.

01:45 And lastly, we call this the remodeling phase.

01:48 If a wound has all of the factors that we need for it to heal in a healthy way, you'll start seeing that to rebuild, that to close up potentially.

01:58 And this is what we want to see in our wound recovery.

02:03 Now a couple of things can cause that delay, we looked at those healthy wounds and what it should look like.

02:09 Here's a lot of the stuff that's going to come up with your patient though, that can delay that healing, or throw off some of those phases.

02:17 So a lot of its meds, a lot of the stuff that we give for the patients for their physical illness.

02:22 So one of those is a steroid, this can delay healing.

02:26 Blood thinners, a very common medication that your patient may be on, this can also delay healing and that clotting phase as well.

02:34 And you can imagine if a patient has a depressed immune system with like a chemotherapy drug, for example, it's going to delay that inflammatory process and that patient able to close up that wound.

02:47 And next with medications NSAIDs, those anti-inflammatories.

02:52 Here's a great example of that.

02:54 I work in a surgical hospital where we do a lot of back wounds.

02:58 So many times we do what we call a fusion, which is what we want for the goal of our patient for that particular surgery.

03:05 We actually tell our patients not to take any NSAIDs for at least like 3 months.

03:11 Reason being, because they can delay the fusion and delay healing.

03:15 Now let's look at these other causes.

03:18 Many of this has to do with the patient's disease process or their lifestyle choices.

03:23 But this first one in particular infections, and of course, lack of blood flow is definitely going to cause lack of, or delayed wound healing.

03:31 One thing I want to point out when you're talking about poor tissue perfusion, or lack of blood flow to that tissue, this is really common in our diabetic patients.

03:41 Therefore healing for them is very complicated.

03:44 I want you to take a minute and take a look at these last four points here on the slide.

03:50 These are all really common factors that you may run into with our patient and can cause delayed healing.

03:56 Now let's take a look.

03:57 We've talked a lot about wound assessment, what are our goals even for these patients? So we do want to believe it or not maintain a appropriate moisture balance in the wound itself.

04:09 We don't necessarily want that wound completely dry.

04:12 And again, this is going to be by your physician assessment and you reporting any abnormal signs to the physician as well.

04:19 And we've talked about this earlier as well about managing infection.

04:23 Infection is considered a complication of a wound.

04:27 And that's what we're trying to avoid.

04:29 Now, there's also surrounding skin around that wound.

04:32 It's important that we keep this skin integrity healthy, and if we can reduce the pain and minimize odor for the patient.

04:41 So let's take a moment and look at this question before we go into any more about wound assessment.

04:48 What is peri-wound? What it does that even mean? That may even sound like a word you've never heard of, but let's talk about that further.

04:55 So we're talking about wound assessment.

04:58 There's three important areas of wound assessment as a nurse.

05:02 You want to look at the wound bed itself.

05:04 So you see here on this image, we're talking about the inside of that wound.

05:09 It's important to also monitor the edge of that wound.

05:13 And next, the peri-wound skin.

05:16 So that peri-wound is actually the skin around the wound and that's important to keep healthy for patient.