1. Keep the patient and yourself from being infected!!
Basic Wound Care
Keep the patient and yourself from being infected!!

2. What is a Wound?
A wound is the disruption of the Stratum Corneum skin barrier

3. Layers of the Skin Epidermis – the top layer of the skin
Dermis – the next layer
Subcutaneous – fat layer

4. Signs of Infection Tenderness Red Streaks leading from wound Redness
Swollen Glands
Swelling around Wound
Throbbing
Increase discharge
from the wound
Red Streaks leading from wound
Fever
Pus
Continued or increasing redness beyond
day four of wound healing

5. Universal Precautions for the Athletic Environment
Take care against possible transmission of AIDS, HIV, & HBV
ALWAYS take precautionary measures
Glove Up!
All open wounds or lesions MUST be covered with a fixed dressing
before practice or competition.
Athletes with active bleeding MUST be removed ASAP & return
only when OK’d by medical staff.

6. Universal Precautions for the Athletic Environment
Clothing saturated with blood MUST be changed before returning to room(game).
Protective equipment MUST be used when there is potential for contact with blood borne pathogens.
Infectious waste/Biohazard materials (gauze, dressings, tissues, towels, gloves, sharps, etc.) MUST be disposed of properly.

7. Components of a Safety for Blood Borne Pathogens
Gloves
Bandages
Face shields
Disposable towels
Biohazard bags
Antiseptics
Disposable bags
Hand towels
Resuscitation mask
Absorbency material
Disinfectant spray/liquid
Sharps container
Others

8. Wound Care Products Antiseptics Antibiotics Cleansers Bandages Tapes
Wraps
Other covers including Hydrogels, Films, Liquid Bandages, and Foams
Tissue Growth Promoters

9. Selection of Wound Care Products
Do NOT put in your wound anything you would not put in your eye.
Do not select products that stick to your wound, or if bandages stick, moisten with saline or water before removal.
Do not select products that harm growing tissues.
Select dressings that can be changed easily and do not cause irritation.
Clean the wound in a very gentle manner in-between dressings.
Wounds are not sterile and strict sterility is not a necessity, but CLEAN IS A MUST!
Select dressings that will protect the wound.

10. Wound Dressing Evolution
Cotton Linters
Linters
Non-woven swab
Paper
Fibers
Sleeve dressing
Feathers
Cotton Gauze
Adhesive Pads
Dust
Knitted Fibers
Plaster/Strips
1960’s
1980’s
2000’s
Non-wovens
Urethane Films
Active Agents
Plastic Films
Hydrocolloids
Growth Factors
Foams
Cell/Gene Therapy
Hydrogels/Alginates
Smart Dressings

11. Care of a Wound Glove Up! Remove anything covering the wound.
Manage open and closed wounds by applying direct or indirect pressure to control bleed.
Elevate the wound area if there is excessive bleeding.
Clean the wound from the inner portion to the outer portion.
Use sterile equipment.

12. Care of a Wound Clean, debride, & protect the open wound.
Soap & water or saline may be used along with a sterile gauze pad to clean the wound.
Various cleansers
Note: Hydrogen Peroxide (H2O2) is being phased out. Bubbles away blood clots & related debris. Flush the wound with lots of water, then dry with sterile gauze.

13. Wound Wash Saline & Topical Antibiotics

14. Various Bandages

15. Care of a Wound
Use isopropyl rubbing alcohol to clean the skin adjacent to the wound site. DO NOT APPLY DIRECTLY OVER THE WOUND!
Apply superficial closures. Apply antibiotic ointment if necessary. Note: Do not apply ointment directly on the wound from the ointment tube. You will cause contamination to the tube.
Types of ointments: Neosporin, Bactroban, Garamycin, bacitracin, gentamicin, mupirocin, neomycin, silver sulfasalazine, chloramphenicol, and clindamycin

16. Care of a Wound
Apply appropriate dressings. If dressing becomes soaked with blood. Add more. DO NOT REMOVE BLOOD-SOAKED DRESSINGS UNTIL BLEEDING HAS BEEN CONTROLLED!
Properly remove gloves & other personal protective equipment. Properly dispose of biohazardous waste.

17. Care of a Wound
Apply ice, compression & elevation of an acute sprain, strain, or contusion, if associated with wound.
A tetanus shot may be required depending on the cause of the wound.
Change dressing daily & look for signs of infection.

18. Hydrocolloid
Wound Care
You want to keep the wound moist so it can heal for the inside out.
The “crust” that forms impedes the rapid re- epithelialization.
3 types of Occlusive Dressings
Hydocolloids
Semipermeable films
Hydrogels
Semipermeable film
Hydrogel

19. Moist Wound Healing – How & Why
Maintaining moisture allows the body to move cells into the entire area of injury.
This reduces the scarring.
The chance of infection is reduced
Excessive drainage is absorbed by the bandages if present, but does not dry out the wound bed.
Protection from bacteria and protection of the newly formed cell growth is maintained.

20. Biological Activity of Moist Wound Healing
Re-epithelialization – Coverage with new skin is enhanced.
Granulation – Growth of new collagen and blood vessels occurs more rapidly.
Debridement – The wound is cleaned by the body more rapidly.
Pain relief – The nerves are soothed.
Angiogenesis – New blood vessels grow more rapidly in a low oxygen environment, oxygen comes from below the skin, not from the environment.

21. Occlusive Dressings Hydrocolloids:
Made up of gelatin, pectin, &/or carboxymethylcellulose in a polyisobutylene adhesive base.
Impermeable to H2O, O2, & bacteria
Effective in absorbing minimal to moderate amount of exudate.
Suitable for high friction areas.
Not recommended for wounds with anaerobic infections.

22. Occlusive Dressings Semi-permeable Films:
Made from transparent polyurethane membranes with H2O adhesives.
Highly elastic, conforms well, provides visual site of wound.
Semi-permeable to moisture vapor & O2, but occlusive to bacterial invasion.
Can be used for superficial wounds, burns, post-op wounds, donor sites.
Minimally absorbent, so they trap moisture & facilitate autolytic debridement.

23. Occlusive Dressings Hydrogels (semi-permeable)
Contains approximately 96% H2O or glycerin
Transparent, comfortable, moisture-retentive, & permeable to O2.
Available in sheet or gel form.
Used with acute & chronic, partial & full-thickness wounds with minimal to moderate amounts of exudate.

24. Hepatitis B Shots Series of 3 shots
1st shot
2nd shot given approx. 4 weeks after 1st shot
3rd shot given 6 months later
Hepatitis B: Virus that affects the liver
Occurs when blood or body fluids from an infected person enters the body of a person who is not immune.

25. And Finally… Always take precautionary measures! Glove up!
Hepatitis B Shots
Proper placement of contaminated material
Education of various blood borne pathogens

26. The
End