The Steps of Wound Care

As a plastic surgeon, my success rate is high for closing wounds. Early in my practice I reviewed my success in wound care and found out that nearly 70% of the wound referred to me were closed without the need of major surgical procedures. If I performed a simple surgical procedure, it was often simple debridement or surgical cleansing of the wound. Most of the time however, all I did to close the wound was to improve the way the wounds were cleansed and dressings were applied to the wound. To understand what is happening in wounds, you must understand the following facts:

  • Infections are the major reason why wounds do not close or close slowly
  • Antibacterial soaps kill germs that can get into the wound
  • The dressings prevent germs from entering the wound and provide comfort

The skin is covered with germs that we need to prevent from getting into the wound. This includes the skin not only around the patients wound, but also the skin of the caregiver and the doctor as well. Like a doctor preparing for surgery, using antibacterial soap kills the germs on the skin and prevents the germs adjacent to the wounds from getting inside the wound. Gentle cleansing with a wound cleansing agent disrupts the contact between the wound surface and the germs on the open wound.

The steps of basic wound care are:

  1. A 10 minute antibacterial lather and wash
  2. Rinse and remove the antibacterial lather
  3. Dry the wound
  4. Apply prescribed medicines
  5. Apply a professional looking dressing

During the 10 minute antibacterial wash, the the soap emulsifies the bacterial film on the skin while the antibacterial agent kills the bacteria. The 10 minute period is important for the process to be successful. It is important to build up a lather as well as it has the antibacterial action needed to kill the bacteria. The rinse contains the soap lather that contains the dead bacteria in skin cells. Do not leave the lather to dry on the skin.

Drying is a preparation step before dressing the wound. Distal applications are typically applied to fight infections or accelerate the wound healing process. Pressing the wound protects it from the environment and secondary infection from outside the wound. It also absorbs any drainage from the wound and provides comfort for the patient.

It is important to dress the wound properly so that the dressing can provide the necessary protection to keep the contamination away from the wound and provide comfort. If the doctor has provided additional instructions to fight infections and/or improve the condition of the patient, they are followed at this time. In wound care one training, these steps are the absolute core of what is done for every wound every day.