Name: Franchie M.
Hsu Group #: 2
I. Describe each type of wound and provide the appropriate management for each.
Types of Wounds Description
Black necrotic (eschar) Eschar is characterized by dark,
crusty tissue at either the
bottom or the top of a wound.
The tissue closely resembles a
piece of steel wool that has
been placed over the wound.
The wound may have a crusted
or leathery appearance and will
be tan, brown, or black. Eschar
may be either softer or firmer
than the skin around it. Eschar
is often part of a larger wound.
The area around the eschar may
appear red or tender to the
touch. The area may also be
swollen or fluid filled.
Yellow, sloughy Non-viable fibrous yellow
tissues which may be pale,
greenish in color or have a
washed out appearance. It is
formed as a result of infection
or damaged tissue in the
wound. Slough is usually a
combination of leucocytes,
bacteria, devitalized tissue or
debris and usually has a moist,
shiny stringy appearance or may
be firmly attached to the wound
bed.
Green infected  Exudate that becomes a thick,
milky liquid or thick liquid that
turns yellow, tan, grey, green,
or brown which is almost
always a sign that infection is
present. This drainage contains
white blood cells, dead bacteria,
wound debris and inflammatory
Wound Care
 autolytic debridement
 enxymatic debridement
 mechanical
debridement
 surgical debridement
 Rinse the wound with
sterile saline before
each dressing
application.
 Choose the correct size
of Enluxtra dressing.
 Change Enluxtra every
1-2 days for the first 1-2
weeks, or until slough
and odor are removed.
 Then gradually increase
wear time to 5-7 days,
until the wound is
healed.
 Before beginning
wound care, ensure
that all necessary
equipment is clean.
 Thoroughly wash the
hands with soap and
warm water, then rinse
and dry them.
cells.  Clean the cut or scrape
by running warm water
over it for several
minutes. Use warm,
soapy water to clean
the surrounding skin,
but avoid getting soap
in the wound.
 Make sure that there is
no dirt or debris. To
remove debris, either
use tweezers or
carefully and gently rub
the wound with a soft,
damp cloth.
 If desired, apply a thin
layer of antiseptic
ointment or petroleum
jelly to the cut or
scrape.
 Allow the skin to air-dry
before covering it with
gauze or a bandage.
There is usually no need
to cover minor cuts and
scrapes.

 Change the wound

dressing at least once a
day. Replace it
immediately if it gets
damp or dirty.

 Gently wash the wound

each day.

 Avoid using hydrogen

peroxide or iodine on
the wound as these may
cause skin irritation in
some people. Stop using
other antiseptic
ointments if they cause
skin irritation.
  Do not pick at the skin
or the scab as this can
lead to scarring, slow
down healing, and
increase the risk of
infection.

Red granulating Red, bumpy tissue  Wound cleansing and

Pink epithelialising
maintaining a moist
in the wound bed as the wound
environment.
heals due to the budding or
 Protect newly formed
growth of new blood vessels
tissue and of
into the tissue. This tissue is
surrounding skin.
firm to touch and has a shiny
appearance.
Light pink in color, usually  Maintain a moist, warm
migrates inwards from the and clean healing
wound margins or may appear environment.
as small islands of tissue over  Protect newly formed
the surface of the wound. epithelium tissue.
 Effectively manage the
presence of foreign
material, desiccation,
temperature, Ph
changes and infection
within the wound.

II. Below are a list of factors that may affect wound healing. Describe how each factor can interfere with
the healing process.

Factors affecting wound healing Describe how the factor affects wound healing

Local Factors
Oxygenation Oxygenation is very important for wound healing. It is
needed for cellular function, can kill bacteria, and cause
resistance to infection. Oxygen stimulates the creation
of new blood vessels and also aids growth factors to
form new skin.

Infection Infection of the wound triggers the body’s immune

response, causing inflammation and tissue damage, as
 well as slowing the healing process.

Venous sufficiency Venous insufficiency leads to the high pressure in the

lower leg veins. The increase in pressure and buildup of
fluid prevents nutrients and oxygen from getting to
tissues. The lack of nutrients causes cells to die,
damaging the tissue, and a wound can form.
Systemic Factors

Age and gender Wound healing slows down during the aging process.
Skin gets thinner and the body shows a decreased
inflammatory response. Moreover, increased
testosterone levels are associated with delayed wound
healing in elderly men. Elderly men heal more slowly
than elderly women.
Sex hormones Sex hormones can influence healing by modulating
inflammation, which may explain the observed reversal
in the gender advantage for healing between dermal
and mucosal tissues.

Stress Stress-induced glucocorticoid hormones reduce the

recruitment of inflammatory cells to the wound margin,
impair antibacterial function, and slow healing.
Ischemia Poor blood flow or supply to any part of the body
deprives the affected tissue of essential nutrients,
causing damage at the cellular level where processes
require oxygen to progress.

Diseases: diabetes, keloids, fibrosis,
hereditary healing disorders, jaundice,
uremia
Obesity
Chronic diseases have a direct impact on the body's
natural ability to heal. Prescription medications can have
a negative effect on healing.
Poor perfusion and oxygenation of subcutaneous
adipose tissue can predispose obese individuals to
infection since there is insufficient oxygen, leukocytes
are able to ingest bacteria but are unable to kill them,
leading to infection which significantly impacts wound
healing.

Medications: glucocorticoid steroids, Non-steroidal anti-inflammatory drugs (NSAIDs) have

non-steroidal anti-inflammatory drugs,
chemotherapy
been shown to have a depressant effect on wound
healing while simultaneously decreasing the granulocytic
inflammatory reaction. Glucocorticoids (corticosteroids)
cause dehiscence of surgical incisions, increases risk of
wound infection, and delay healing of open wounds.
Chemotherapy affects wound healing by inhibiting cell

Alcoholism and smoking
Immunocompromised conditions: cancer,
radiation therapy, AIDS
Nutrition
division and protein synthesis. Many chemotherapy
drugs can also cause immunosuppression. This can
inhibit the inflammatory response in the early stages of
wound healing.
Excessive alcohol consumption is detrimental to wound
healing. It increases the risk of wound infection by
diminishing the body’s resistance to bacteria and other
harmful elements. Smoking lowers the level of oxygen in
the blood which slows the healing process as less oxygen
is delivered to the wound.
People who are immunocompromised have an increased
risk for hypothermia, which can affect post operative
wound healing process and increase the risk of wound
infection.
Eating well during wound healing helps an individual
heal faster and fight infection. During healing the body
needs more nutrients and the best source of these is
food.