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Definition
A wound is a disruption in the continuity of cellsanything that causes cells that
would normally be connected to become separated. Wound healing is the
restoration of that continuity. Several effects may result with the occurrence of a
wound: immediate loss of all or part of organ functioning, sympathetic stress
response, hemorrhage and blood clotting, bacterial contamination, and death of
cells. The most important factor in minimizing these effects and promoting
successful care is careful asepsis, which can be accomplished using aseptic
techniques when treating a wound.
Description
Wound healing is a biological process that begins with trauma and ends with scar
formation. There are two types of tissue injury: full and partial thickness. Partial
thickness injury is limited to the epidermis and superficial dermis, with no
damage to the dermal blood vessels. Healing occurs by regeneration of other
tissues. Full thickness injury involves loss of the dermis extends to deeper tissue
layers, and disrupts dermal blood vessels. Wound healing involves the synthesis
of several types of tissue and scar formation.
The three phases of repair are lag, proliferative, and remodeling. Directly after
injury, hemostasis is achieved with clot formation. The fibrin clot acts like a
highway for the migration of cells into the wound site. Within the first four hours
of injury, neutrophils begin to appear. These inflammatory cells kill microbes, and prevent the colonization of the wound.
Next the monocyte, or macrophage, appears. Functions of these cells include the killing of microbes, the breakdown of
wound debris, and the secretion of cytokines that initiate the proliferative phase of repair. Synthetic cells, or fibroblasts,
proliferate and synthesize new connective tissue, replacing the transitional fibrin matrix. At this time, an efficient nutrient
supply develops through the arborization (terminal branching) of adjacent blood vessels. This ingrowth of new blood vessels
is called angiogenesis. This new and very vascular connective tissue is referred to as granulation tissue.
The first phase of repair is called the lag or inflammatory phase. The inflammatory response is dependent on the depth and
volume of tissue loss from the injury. Characteristics of the lag phase include acute inflammation and the initial appearance
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Surgery St-Wr Wound Care
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und InIIILruLIon oI neuLropIIIs. NeuLropIIIs proLecL LIe IosL Irom mIcroorgunIsms und InIecLIon. I InIIummuLIon Is deIuyed or
sLopped, LIe wound becomes suscepLIbIe Lo InIecLIon und cIosure Is deIuyed.
TIe proIIIeruLIve pIuse Is LIe second pIuse oI repuIr und Is unuboIIc In nuLure. TIe Iug und remodeIIng pIuse ure boLI
cuLuboIIc processes. TIe proIIIeruLIve pIuse generuLes grunuIuLIon LIssue. n LIIs process, ucuLe InIIummuLIon reIeuses
cyLokInes, promoLIng IIbrobIusL InIIILruLIon oI LIe wound sILe, LIen creuLIng u IIgI densILy oI ceIIs. CoIIugen Is LIe mujor
connecLIve LIssue proLeIn produced und reIeused by IIbrobIusLs. TIe connecLIve LIssue pIysIcuIIy supporLs LIe new bIood
vesseIs LIuL Iorm und endoLIeIIuI ceIIs promoLe IngrowLI oI new vesseIs. TIese new bIood vesseIs ure necessury Lo meeL LIe
nuLrILIonuI needs oI LIe wound IeuIIng process. TIe murk oI wound cIosure Is wIen u new epIdermuI cover seuIs LIe deIecL.
TIe process oI wound IeuIIng conLInues beneuLI LIe new surIuce. TIIs Is LIe remodeIIng or muLuruLIon pIuse und Is LIe
LIIrd pIuse In IeuIIng.
TIe IIrsL prIncIpIe oI wound cure Is LIe removuI oI nonvIubIe LIssue, IncIudIng necroLIc (deud) LIssue, sIougI, IoreIgn debrIs,
und resIduuI muLerIuI Irom dressIngs. RemovuI oI nonvIubIe LIssue Is reIerred Lo us debridement ; removuI oI IoreIgn
muLLer Is reIerred Lo us cIeunsIng. CIronIc wounds ure coIonIzed wILI bucLerIu, buL noL necessurIIy InIecLed. A wound Is
coIonIzed wIen u IImILed number oI bucLerIu ure presenL In LIe wound und ure oI no consequence In LIe IeuIIng process. A
wound Is InIecLed wIen LIe bucLerIuI burden overwIeIms LIe Immune response oI LIe IosL und bucLerIu grow uncIecked.
CIInIcuI sIgns oI InIecLIon ure redness oI LIe skIn uround LIe wound, puruIenL (pus-conLuInIng) druInuge, IouI odor, und
edemu.
TIe second prIncIpIe oI wound cure Is Lo provIde u moIsL envIronmenL. TIIs Ius been sIown Lo promoLe reepILIeIIuIIzuLIon
und IeuIIng. ExposIng wounds Lo uIr drIes LIe surIuce und muy Impede LIe IeuIIng process. Guuze dressIngs provIde u moIsL
envIronmenL provIded LIey ure kepL moIsL In LIe wound. TIese ure reIerred Lo us weL-Lo-dry dressIngs. GeneruIIy, u suIIne-
souked guuze dressIng Is IooseIy pIuced InLo LIe wound und covered wILI u dry guuze dressIng Lo prevenL dryIng und
conLumInuLIon. L uIso supporLs uuLoIyLIc debrIdemenL (LIe body's own cupucILy Lo Iyse und dIssoIve necroLIc LIssue), ubsorbs
exuduLe, und Lrups bucLerIu In LIe guuze, wIIcI ure removed wIen LIe dressIng Is cIunged.
PrevenLIng IurLIer Injury Is LIe LIIrd prIncIpIe oI wound cure. TIIs InvoIves eIImInuLIon or reducLIon oI LIe condILIon LIuL
uIIowed LIe wound Lo deveIop. ucLors LIuL conLrIbuLe Lo LIe deveIopmenL oI cIronIc wounds IncIude Iosses In mobIIILy,
menLuI sLuLus cIunges, deIIcILs oI sensuLIon, und cIrcuIuLory deIIcILs. PuLIenLs musL be properIy posILIoned Lo eIImInuLe
conLInued pressure Lo LIe cIronIc wound. Pressure reducIng devIces, sucI us muLLresses, cusIIons, supporLIve booLs, Ioum
wedges, und IILLed sIoes cun be used Lo keep pressure oII wounds.
ProvIdIng nuLrILIon, specIIIcuIIy proLeIn Ior IeuIIng, Is LIe IourLI prIncIpIe oI IeuIIng. ProLeIn Is essenLIuI Ior wound repuIr und
regeneruLIon. WILIouL essenLIuI umIno ucIds, ungIogenesIs, IIbrobIusL proIIIeruLIon, coIIugen synLIesIs, und scur remodeIIng
wIII noL occur. AmIno ucIds uIso supporL LIe Immune response. AdequuLe umounLs oI curboIydruLes und IuLs ure needed Lo
prevenL LIe umIno ucIds Irom beIng oxIdIzed Ior cuIorIc needs. GIucose Is uIso needed Lo meeL LIe energy requIremenLs oI
LIe ceIIs InvoIved In wound repuIr. AIbumIn Is LIe mosL ImporLunL IndIcuLor oI muInuLrILIon becuuse IL Is sucrIIIced Lo provIde
essenLIuI umIno ucIds II LIere Is InudequuLe proLeIn InLuke.
Diagnosis/Preparation
EIIecLIve wound cure begIns wILI un ussessmenL oI LIe enLIre puLIenL. TIIs IncIudes obLuInIng u compIeLe health histor
und u pIysIcuI ussessmenL. AssessIng LIe puLIenL ussIsLs In IdenLIIyIng cuuses und conLrIbuLIng IucLors oI LIe wound. WIen
exumInIng LIe wound, IL Is ImporLunL Lo documenL ILs sIze, IocuLIon, uppeurunce, und LIe surroundIng skIn. TIe IeuILI cure
proIessIonuI uIso exumInes LIe wound Ior exuduLe, necroLIc LIssue, sIgns oI InIecLIon, und druInuge, und documenLs Iow Iong
LIe puLIenL Ius Iud LIe wound. L Is uIso ImporLunL Lo know wIuL LreuLmenL, II uny, LIe puLIenL Ius prevIousIy receIved Ior
LIe wound.
AcLuuI componenLs oI wound cure IncIude cIeunIng, dressIng, deLermInIng Irequency oI dressIng cIunges, und reevuIuuLIon.
Deud LIssue und debrIs cun Impede IeuIIng: LIe gouI oI cIeunIng LIe wound Is ILs removuI. WIen cIeunIng LIe wound,
proLecLIve goggIes sIouId be worn und sLerIIe suIIne soIuLIon sIouId be used. ProvIdone IodIne, sodIum IypocIIorILe, und
Iydrogen peroxIde sIouId never be used, us LIey ure LoxIc Lo ceIIs.
GenLIe pressure sIouId be used Lo cIeun LIe wound II LIere Is no necroLIc LIssue. TIIs cun be uccompIIsIed by uLIIIzIng u 6o cc
cuLIeLer LIp syrInge Lo uppIy LIe cIeunIng soIuLIon. I LIe wound Ius necroLIc LIssue, more pressure muy be needed.
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WIIrIpooIs cun uIso be used Ior wounds IuvIng u LIIck Iuyer oI exuduLe. AL LImes, cIemIcuI or surgIcuI debrIdemenL muy be
needed Lo remove debrIs.
DressIngs ure uppIIed Lo wounds Ior LIe IoIIowIng reusons: Lo provIde LIe proper envIronmenL Ior IeuIIng, Lo ubsorb
druInuge, Lo ImmobIIIze LIe wound, Lo proLecL LIe wound und new LIssue growLI Irom mecIunIcuI Injury und bucLerIuI
conLumInuLIon, Lo promoLe IemosLusIs, und Lo provIde menLuI und pIysIcuI puLIenL comIorL. TIere ure severuI Lypes oI
dressIngs und mosL ure desIgned Lo muInLuIn u moIsL wound bed:
AIgInuLe: Mude oI non-woven IIbers derIved Irom seuweed, uIgInuLe Iorms u geI us IL ubsorbs exuduLe. L Is used Ior
wounds wILI moderuLe-Lo-Ieuvy exuduLe or druInuge, und Is cIunged every 1z Iours Lo LIree duys, dependIng on
wIen LIe exuduLe peneLruLes LIe secondury dressIng.
ComposILe dressIngs: CombInIng pIysIcuIIy dIsLIncL componenLs InLo u sIngIe dressIng, composILe dressIngs provIde
bucLerIuI proLecLIon, ubsorpLIon, und udIesIon. TIe Irequency oI dressIng cIunges vury.
oum: Mude Irom poIyureLIune, Ioum comes In vurIous LIIcknesses IuvIng dIIIerenL ubsorpLIon ruLes. L Is used Ior
wounds wILI moderuLe-Lo-Ieuvy exuduLe or druInuge. DressIng cIunge Is every LIree Lo seven duys.
Guuze: AvuIIubIe In u number oI Iorms IncIudIng sponges, puds, ropes, sLrIps, und roIIs, guuze cun be ImpregnuLed wILI
peLroIeum, unLImIcrobIuIs, und suIIne. requenL cIunges ure needed becuuse guuze Ius IImILed moIsLure reLenLIon und
properLIes, und LIere Is IILLIe proLecLIon Irom conLumInuLIon. WILI removuI oI u drIed dressIng, LIere Is u rIsk oI wound
dumuge Lo LIe IeuIIng skIn surroundIng LIe wound. Guuze dressIngs ure cIunged Lwo Lo LIree LImes u duy.
HydrocoIIoId: Mude oI geIuLIn or pecLIn, IydrocoIIoId Is uvuIIubIe us u wuIer, pusLe, or powder. WIIIe ubsorbIng exuduLe,
LIe dressIng Iorms u geI. HydrocoIIoId dressIngs ure used Ior IIgIL-Lo-moderuLe exuduLe or druInuge. TIIs Lype oI
dressIng Is noL used Ior wounds wILI exposed Lendon or bone, LIIrd-degree burns, or In LIe presence oI bucLerIuI,
IunguI, or vIruI InIecLIon or ucLIve ceIIuIILIs or vuscuIILIs becuuse IL Is uImosL LoLuIIy occIusIve. DressIngs ure cIunged
every LIree Lo seven duys.
HydrogeI: Composed prImurIIy oI wuLer, IydrogeI dressIngs ure used Ior wounds wILI mInImuI exuduLe. Some ure
ImpregnuLed In guuze or non-woven sponge. DressIngs ure cIunged one or Lwo LImes u duy.
TrunspurenL IIIm: An udIesIve, wuLerprooI membrune LIuL keeps conLumInunLs ouL wIIIe uIIowIng oxygen und wuLer
vupor Lo cross LIrougI, IL Is used prImurIIy Ior wounds wILI mInImuI exuduLe. L Is uIso used us u secondury muLerIuI Lo
secure non-udIesIve guuzes. DressIngs ure cIunged every LIree Lo IIve duys II LIe IIIm Is used us u prImury dressIng.
n cuses wIere u wound Is purLIcuIurIy severe, Iurge, or II IL Is u LIIrd degree burn, ceIIuIur wound IeuIIng producLs muy be
used Lo cIose LIe wound und speed recovery. n some cuses (I.e., u LIIrd-degree burn), u skIn gruIL wIII oILen be used.
AILIougI mosL surgeons preIer Lo use skIn donuLed Irom unoLIer person (known us cuduver skIn, or Iumun uIIogruIL), skIn
donuLIons ure noL uIwuys uvuIIubIe. TIey musL reIy on more recenL producLs uvuIIubIe, sucI us ceIIuIur wound dressIngs, Ior
LIe LreuLmenL oI burns. or kin gafing oI IuII-LIIckness burn wounds, surgeons use IeuILIy skIn Irom unoLIer purL oI
LIe person's own body (uuLogruILIng) us u permunenL LreuLmenL. Surgeons muy use ceIIuIur wound dressIngs us u Lemporury
coverIng wIen LIe skIn dumuge Is so exLensIve LIuL LIere Is noL enougI IeuILIy skIn uvuIIubIe Lo gruIL InILIuIIy. TIIs IeIps
prevenL InIecLIon und IIuId Ioss unLII uuLogruILIng cun be perIormed.
TIe survIvuI ruLe Ior burn puLIenLs Ius Increused consIderubIy LIrougI LIe process oI quIckIy removIng deud LIssue und
ImmedIuLeIy coverIng LIe wound. Burns coverIng IuII LIe body were rouLIneIy IuLuI zo yeurs ugo buL Loduy, even peopIe
wILI exLensIve und severe burns Iuve u good cIunce oI survIvuI, uccordIng Lo LIe AmerIcun Burn AssocIuLIon.
Cellular ound dressings
n recenL yeurs, LIe LecInoIogy oI burn und wound cure usIng ceIIuIur wound dressIngs und gruILs ure IeIpIng Lo LrunsIorm
LIe LreuLmenL oI burns und cIronIc wounds by decreusIng LIe rIsk oI InIecLIon, proLecLIng uguInsL IIuId Ioss, requIrIng Iewer
skIn gruILs, und promoLIng und speedIng LIe IeuIIng process. TIese dressIngs provIde u cover LIuL keeps IIuIds Irom
evuporuLIng und prevenLs bIood Irom oozIng ouL once LIe deud skIn Ius been removed. Some oI LIese producLs grow In pIuce
und expund nuLuruI skIn wIen IL IeuIs.
CeIIuIur wound dressIngs muy Iook und IeeI IIke skIn, buL LIey do noL IuncLIon LoLuIIy IIke skIn becuuse LIey ure mIssIng IuIr
IoIIIcIes, sweuL gIunds, meIunocyLes, und ungerIuns' ceIIs. Some ceIIuIur wound dressIngs Iuve u synLIeLIc Lop Iuyer
sLrucLured IIke un epIdermIs. L peeIs uwuy over LIme, or Is repIuced wILI IeuILIy skIn LIrougI skIn gruILIng. How LIese
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products are involved in wound repair is a subject of great scientific interest; it is known that they promote a higher rate of
healing than does standard wound care.
People with severe wounds, chronic wounds, burns, and ulcers can benefit from cellular wound dressings. Several artificial
skin products are available for nonhealing wounds or burns such as: Apligraft (Norvartis), Demagraft, Biobrane,
Transcyte (Advance Tissue Science), Integra Dermal Regeneration Template (from Integra Life Sciences
Technology), and OrCel.
Apligraf is a two-layer wound dressing that contains live human skin cells combined with cow collagen. It delivers live
cells from a different donor (circumcised infant foreskin). Thousands of pieces of Apligraf are produced in the
laboratory from one small patch of cells from a single donor.
Dermagraft is made from human cells placed on a dissolvable mesh material. The mesh material is gradually absorbed
and the human cells grow and replace the damaged skin after being placed on the wound or ulcer.
Biobrane is used as a temporary dressing for a variety of wounds, including ulcers, lacerations, and full-thickness
burns. It may also be used on wounds that develop on areas from which healthy skin is transplanted to cover damaged
skin. It consists of an ultrathin silicone film and nylon fabric. As the wound heals, or until autografting becomes
possible, the Biobrane is trimmed away.
TransCyte is used as a temporary covering over full thickness and some partial thickness burns until autografting is
possible, as well as a temporary covering for some burn wounds that heal without autografting. It consists of human
cells from circumcised infant foreskin, and grown on nylon mesh, combined with a synthetic epidermal layer.
TransCyte starts with living cells, but these cells die when it is shipped in a frozen state to burn treatment facilities.
The product is then thawed and stretched over a burn site. In one to two weeks, the TransCyte starts peeling off, and
the surgeon trims it away as it peels.
Integra Dermal Regeneration Template is used to treat full thickness and some partial thickness burns. Integra
consists of two layers; the bottom layer, made of shark cartilage and collagen from cow tendons, acts as a matrix onto
which a person's own cells migrate over two to three weeks. A new dermis is created as the cells gradually absorb the
cartilage and collagen. The top layer is a protective silicone sheet that is peeled off after several weeks, while the
bottom layer is a permanent cover. A very thin layer of the person's own skin is then grafted onto the neo-dermis.
OrCel is also made from circumcised infant foreskin, grown on a cow collagen matrix, and used to treat donor sites in
burn patients. It is also used to help treat epidermolysis bullosa, a rare skin condition in children.
To ensure the safety and quality of products such as cellular wound dressings, the Food and Drug Administration (FDA) has
initiated a new regulatory system.
Rik
Hematoma: dressings should be inspected for hemorrhage at intervals during the first 24 hours after surgery. A large
amount of bleeding is to be reported to a health care professional immediately. Concealed bleeding sometimes occurs in
the wound, beneath the skin. If the clot formed is small, it will be absorbed by the body, but if large, the wound bulges
and the clot must be removed for healing to continue.
Infection: The second most frequent nosocomial (hospital-acquired) infection in hospitals is surgical wound infections
with Staphlococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Prevention is accomplished with
meticulous wound management. Cellulitis is a bacterial infection that spreads into tissue planes; systemic anibioic
are usually prescribed to treat it. If the infection is in an arm or leg, elevation of the limb reduces dependent edema
and heat application promotes blood circulation. Abscess is a bacterial infection that is localized and characterized by
pus. Treatment consists of surgical drainage or excision with the concurrent administration of antibiotics.
Dehiscence (disruption of the surgical wound) and evisceration (protrusion of wound contents): This condition results
from sutures giving way, infection, distention, or cough. Dehiscence results in pain; the surgeon is called immediately.
Prophylactically, an abdominal binder may be utilized.
Keloid: refers to excessive growth of scar tissue. Careful wound closure, hemostasis, and pressure support are used to
ward off this complication.
Nomal el
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The goals of wound care include reducing risks that inhibit wound healing, enhancing the healing process, and lowering the
incidence of wound infections.
Resources
BOOKS
Dipietro, Luisa A. and Aime L. Burns, eds. Wond Healing: Mehod and Poocol (Mehod in Molecla Medicine Se). Totowa, NJ:
Humana Press, 2003.
Herndon, David, ed. Toal Bn Cae, 2nd ed. London: W. B. Saunders Co., 2001.
Hess, Cathy Thomas. Clinical Gide o Wond Cae, 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2002.
Hess, Cathy Thomas and Richard Salcido. Wond Cae, 3rd ed. Springhouse, PA: Springhouse Pub Co., 2000.
PERIODICALS
Collins, Nancy. "Obesity and Wound Healing." Adance in Wond Cae 16, no 1. (January/February 2003): 45.
Collins, Nancy. "Vegetarian Diets and Wound Healing." Adance in Wond Cae 16, no. 2 (March/April 2003): 65.
McGuckin, Maryanne, Robert Goldman, Laura Bolton, and Richard Salcido. "The Clinical Relevance of Microbiology in Acute and Chronic
Wounds." Adance in Wond Cae 16, no 1. (January/February 2003): 12.
Trent, Jennifer T., and Robert S. Kirsner. "Wounds and Malignancy." Adance in Wond Cae 16, no 1. (January/February 2003): 31.
ORGANIZATIONS
American Burn Association. 625 N. Michigan Ave., Suite 1530, Chicago, IL 60611. (800) 548-287 6. Fax: (312) 642.9130. E-mail:
info@ameriburn.org. http://www.ameriburn.org .
American Diabetes Association. 17 01 North Beauregard Street, Alexandria, VA 22311. (800) 342-2383. E-Mail: AskADA@diabetes.org.
http://www.diabetes.org .
American Professional Wound Care Association (APWCA). Suite #A1-853 Second Street Pike, Richboro, PA 18954. (215) 364-4100. Fax:
(215) 364-1146. E-mail: wounds@erols.com. http://www.apwca.org .
National Institutes of Health. 9000 Rockville Pike, Bethesda, MD 20892. (301) 496-4000. Email: NIHInfo@OD.NIH.GOV.
http://www.nih.gov .
OTHER
Lippincott Williams & Wilkins. Adance in Skin & Wond Cae 2003. [cited April 9, 2003]. http://www.aswcjournal.com/ .
Ren A. Jackson, RN Crystal H. Kaczkowski, M. Sc.
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Ue Conibion:
alfonso
Ma 16, 2009 @ 11:11 am
WeII my quesLIon, Is wIuL II or cun u person uILer IosIng u Iurge umounL oI weIgIL cun donuLe excess skIn LIssue Ior burn
puLIenLs? And II so couId you poInL me In LIe rIgIL dIrecLIon wILI InIormuLIon us wIo or wIere Lo cuII? My moLIer know's
oI u womun wIo Iud surgery Lo donuLe excess skIn LIssue Irom IosIng uIoL oI weIgIL Lo LIe sun unLonIo burn unIL . und II
ubIe wIuL wouId be LIe cosL buII purk IIgure prIce runge ? I wouId IIke Lo IeIp u persons IIIe In need II I cun. AIIonso
Kim AKinremi
Sep 2, 2009 @ 11:11 am
Iuve Ieurd LIe sumeLIIng ubouL, peopIe geLLIng LIeIr excess skIn removed und IL beIng uL no cousL Lo LIe donor. Iud
GusLrIc bypuss und Iuve u IoL oI skIn LIuL need Lo be removed und wouId uIso IIke someJuny InIormuLIon ubouL LIIs
procedure!!
athish
Aug 30, 2010 @ 10:10 am
pIs LeI more InIormuLIon ubouL wond IeuIIng, und pIs LeI ubouL pIunLs used In LIe wound IeuIIng uL presenL. drugs used In
LIe wound IeuIIng. LIIs urLIcIe Is so good.
MArk
Oct 16, 2010 @ 4:16 pm
TIere Is noL u currenL process Ior u burn unIL Lo remove excess skIn Irom u person und process IL under cosmeLIc
condILIons. Excess skIn Is Ior LIe mosL purL consIdered no LIreuLenIng und LIe procedures ure cIussIIIed us cosmeLIc. A
burned person or u cosmeLIc surgIcuI puLIenL do oIIer LIeIr own skIn (donor) Ior repIucemenL oI LIe uIIecLed ureu.
Cuduver skIn Is used buL, IL Is IosIng popuIurILy due Lo LIe cosL oI sLoruge und LIe IImILed IIIe spun In sLoruge. TIere ure
muny more suIe und Iess expensIve muLerIuIs Ior use In LreuLIng burn vIcLIms us weII us cosmeLIc uppIIcuLIons.
um deveIopIng LIe nexL generuLIon oI synLIeLIc skIn Ior jusL LIIs use und oLIer LreuLmenLs In skIn und Iumun muLerIuI
uppIIcuLIons due Lo Injury und dIseuse.
Amber Koehn
Feb 6, 2011 @ 5:17 pm
um u coIIege sLudenL LukIng prerequIsILes Ior pIysIcuI LIerupy. wouId uILImuLeIy IIke Lo work wILI burn puLIenLs. BuL
LIe more Iook InLo IL, LIe more IuscInuLed um by wound cure. n order Lo LreuL burn wounds sIouId be IookIng InLo
nursIng InsLeud?
Ed Earl
Sep 12, 2011 @ 2:14 pm
Iuve u quesLIon. Iud mImuIIy IvusIse IeurL surgery on Muy 1sL zo11. souId oI IeuIed In u monLI und IL Ius been
monLIs. My IeurL Is LIckIng IIne buL IL Is uound LIe ureu LIey go InLo
on LIe rIgIL sIde oI your body nsIon nexL Lo my rIgIL breusL IeuIed IIne. TIe severe puIn Is jusL under my rIgIL breusL und
wIere LIe Lwo druIn Lubes LIey puL jusL under your rIgIL urm pIL ure uIso IeuIed. BuL LIe wIoIe ureu sweeIs und goes
down und LIen sweIIs und goes down. My CL scun sIows LIuL Iuve ceIIuIILIs oI my cIesL wuII. AII my bIood work Is
normuI. wus LreuLed Irom nIecLous Deuses wILI .V. DrIp oI DupLImycn Ior Lwo weeks.
L dId noLIIng Ior my CeIIuIILIs und LIe seveve puIn wus kIIIIng me uround my rIgIL breusL.
wenL buck Lo my surgeon und compIuIned. He dId unoLIer CT Scun wIIcI sLIII sIows LIe ceIIuIILIs. BuL Ie suys IL's noL u
InIecLIon under LIe skIn. He Iound IL Lo be more ImmIIummuLIon oI my cIesL wuII rIbs und puL my on u qomg per duy oI
PredIzone. I LIIs PredIzone doesn'L cIeur LIIs up wIere do Lurn. Muyo J CIeuveIund CIInIc? PIeuse HeIp
Nnnie Davis
Nov 26, 2011 @ 11:23 pm
Huve you ever Ieurd oI u soIuLIon Ior LreuLmenL oI un InIecLed wound on LIe Iower Ieg uILer surgIcuI removuI oI u cysL oI 1
purL cIorox(bIeucI) und purLs wuLer? My duugILer wus LoId Lo use LIIs soIuLIon Ior u weL Lo dry dressIng. L burned Ier so
budIy we ure usIng suIIne wuLer unLI sIe reLurns Lo IIm.
andrea
Dec 3, 2011 @ 11:11 am
II, LIIs messuge Is Lo nznnIe duvIs, LIe onIy LIme I've Ieurd oI LIIs LreuLmenL wus wIen my 16 yr oId duugILer Iud u cysL
In Ier urmpIL.. I Look Ier Lo un urgenL cure und LIey LoId me Lo do LIIs Lo LIe cysL, buL oI course LIe cysL wusn'L removed!
no one sIouId ever use uny kInd oI bIeucI mIxed wILI unyLIIng on un ruw, open wound!!! nor sIouId LIey use proxIde uL
unyLIme, LIe proxIde kIIIs LIe new growIng ceIIs und couId cuuse someone Lo geL u cIoL Irom LIe bubbIIng bubbIes und IL
mukes LIe wound spreud us weII! ( prIor exp wILI LIe peroxIde ) I Iuve cume ucross LIIs geI cuIIed ZM'S WOUND CARE,
IL's uIILLIe expensIve ($z.oo) Ior u 1Jz ounce und you cun IInd IL kroger's und uround. I Iuve u Iusbund wIo Ius suIIered
u beIow LIe knee umpuLuLIon on ocL 1z, zo11 und we couIdn'L geL IIs surgIcuI wounds Lo IeuI! so uILer cIeunIng, uppIyIng
bucLrIn oInL, und wruppIng IL In guuze sLIII no cIunge, muybe uIILLIe worse.. so jusL IusL week I cume ucross zIm's uL LIe
sLore, I purcIused IL und cume Iome und cIeuned IIs wound und uppIIed LIe zIm's geI Lo LIe wound und covered IL und
wrupped IL, LIen zqIrs IuLer I repeuLed, buL us I wus LukIng LIe guuze oII I wus uImosL sIocked Lo see LIuL LIe wound wus
IeuIIng rIgIL beIore our eye's!! ( I Iuve pIcs Lo prove ).. LIe onIy LIIng bud ubouL LIe zIm's geI Is LIuL IL STNKS!! you cun
uIso Iook IL up on LIe InLerneL und reud ubouL IL, IL works wonderIuI mugIc, IusL!! GOOD UCK, ANDREA
Joanne
Jan 26, 2012 @ 8:20 pm
Iound LIIs urLIcIe on LIe InLerneL und LIougIL IL wouId be oI InLeresL Lo you.
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3/13/12 Wound Care - recovery, blood, removal, pain, time, infection, graft, cells, t
7/7 www.surgeryencyclopedia.com/St-Wr/Wound-Care.html#b
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jeorgee alaro
Feb 17, 2012 @ 11:23 m
what injuries can semi broad bandages be used..???/
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White Blood Cell Count and Differential Wound Culture
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