Wound care

We’ve all experienced a wound at some point—a grazed knee on the playground, an accidental nick with the vegetable knife, or something more serious like a surgical incision. Some wounds may require more care than others, but whether they’re big or small, there are some things you should keep in mind when treating a wound that may help the healing process.

Generally, wounds can be classified as either acute or chronic.

Although acute wounds are not always short-lived—they can still take several weeks to heal!—they generally heal following predictable phases of wound healing (read more in 'The healing' process below).[1] They may still require stitches or tape to hold them together as they heal, and they still require care to ensure optimal healing. Examples of acute wounds include accidental or surgical cuts, minor burns, blisters, and grazes.[2]

In contrast, chronic wounds are wounds that don’t progress through expected phases of wound healing, and as such take longer than expected to heal.[3] There are several factors that may delay wound healing, and may mean that an acute wound becomes chronic (read more inFactors that may slow wound healing below). Examples of chronic wounds include pressure injuries (or bed sores) and diabetic foot ulcers.[4]

Both acute and chronic wounds may leave a scar.

The healing process[5]

1.  Rapid initial response

The body usually mounts a quick response to a sustained physical injury to control bleeding—blood vessels near the wound constrict to limit blood loss, and platelet cells gather to form a blood clot or scab.

2.  Inflammatory stage

Once a blood clot has formed, blood vessels expand again to increase blood flow to the wound, bringing blood cells, nutrients, and other factors to the site to fight infection and support healing. During this stage, the wound might be warm, red, and/or swollen due to the increased blood flow.

3.  Fibroblastic stage

Protein fibres called collagen start to grow in the wound which helps close it and give the skin strength.

4.  Maturation stage

The body will continue to add more collagen to strengthen the area over a period of months or even years.


Factors that may slow wound healing

Some factors that may cause slower wound healing, or may increase the likelihood of wounds becoming chronic wounds, include:[6]

  • Infection (see 'Signs of infection') below
  • Older age
  • Certain medicines

Ask your pharmacist if any medication you regularly take may impact wound healing.

  • Pressure or friction on the wound
    This may include consistent pressure, like bedsores, or frequent accidental knocking of the wound during day-to-day activity. Ask your pharmacist about the best ways to protect your wound.
  • Lack of balanced diet
    Wounds need nutrients to heal. In particular, ensure you’re eating enough foods rich in vitamin C, protein, and zinc.
  • Certain medical conditions
    If you’re living with a medical condition, ask your pharmacist whether it may impact wound healing.
  • Smoking
    Smoking can slow healing. For help quitting smoking, just ask your Amcal pharmacist.
  • Dryness
    Wounds need a warm, moist environment to heal. Ask your pharmacist about the best ways to dress your wound.


Signs of infection

Infection of a wound can occur if microbes from the environment contaminate and grow within the wound. Healing wounds usually don’t look pretty or feel comfortable, but how can you tell if what you are experiencing is normal or a sign of infection?

Some common signs of infection include:[7]

  • Increased pain
  • Increased redness
  • Spreading redness
  • Increased swelling
  • Foul odour
  • Fever

Always speak to a health professional if you suspect your wound is infected.

Tips for optimal wound care

  • Ensure wounds are clean but don’t overuse antiseptic
    Cleaning a wound initially is important to minimise the likelihood of infection. Rinsing with clean running water is advised. Don’t use antiseptic solutions or creams on chronic wounds, as they may delay healing for these types of wounds.[8]
  • Keep wounds moist and warm
    Wounds heal best in a moist environment. Choose a wound dressing that appropriately seals in moisture, protects your wound from air, and keeps it close to body temperature.
  • Protect wounds from trauma
    Wounds on hands can often get knocked around as you go about your daily activities. Similarly, wounds on knees or elbows may get disrupted when you bend the joint. Frequent dressing changes can also disrupt the skin around a wound. Choose a wound dressing that provides padding and protection, and avoid changing it too often.
  • Don’t change your dressing too often!
    50% of dressing changes in the community are clinically unnecessary![9] [JB1] In many cases, inspecting your dressing from the outside can help you determine if it is time to change.

See your doctor if:

  • Your wound is taking longer than expected to heal
  • You have increasing pain, swelling, or redness around a wound
  • You have a fever
  • There is puss coming from the wound
  • You are unable to clean dirt out of the wound
  • You have loss of function or feeling in the wounded area

References

  1. https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Wound_assessment_and_management/
  2. Smith and Nephew Woundwise 2021
  3. https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Wound_assessment_and_management/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4528992/
  5. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/wounds-how-to-care-for-them
  6. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/wounds-how-to-care-for-them
  7. https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Wound_assessment_and_management/, Smith & Nephew Woundwise 2021
  8. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/wounds-how-to-care-for-them#see-your-doctor
  9. Joy H, Bielby A, Searle R. A collaborative project to enhance efficiency through dressing change practice. Journal of wound care. 2015;24(7):312, 314-317.