Wound Management Introduction

Introduction to Wound Management

Chapter 1 Wound Introduction Enable fullscreen INTRODUCTION The skin is the largest organ in the human body, comprising approximately 15% of total adult body weight. The skin maintains our internal environment while protecting us from the external environment. It allows us to experience a wide range of stimuli, from pleasure to pain. A break in the continuity of the skin surface is the first step in the formation of a wound and provides a potential portal of entry for infection. A wound can be as simple as a surface abrasion, or it can be an extensive, life-threatening destruction of tissue that reaches down to and includes the internal organs of the body. While the healing process is basically the same for all wounds, there are many extenuating factors that will either expedite or impede healing. Wound care does not belong to anyone healthcare profession. Successful outcomes are achieved when an interdisciplinary team approach is used, calling on the expertise of many different clinicians and employing many different treatment modalities—from simple dressings to advanced treatments such as negative-pressure wound therapy and hyperbaric oxygen therapy. Clinicians encounter wounds in every healthcare setting, from the penetrating gunshot wound that is rushed to the ER, to acute and chronic wounds that need to be treated in the acute care hospital setting, outpatient clinics, nursing homes, hospice care, and in-home care. Over 7.5 million people in the United States currently have a chronic wound, and as the population ages with a concurrent increase in chronic health conditions, this number is set to increase (Krasner, 2014). For instance, in the United States diabetes is the number one cause of nontraumatic lower-extremity amputations, accounting for approximately 80,000 cases each year, and nearly 85% of all lower extremity amputations in patients with diabetes are preceded by a foot ulcer. Aggressive wound care is a critical part of limb salvage programs (Armstrong & Lavery, 2010). Overall, it is estimated that chronic wound care costs run at around $20 billion annually, and healthcare clinicians are called upon to provide cost-effective, state-of-the-art care to increasingly complex wounds.