Wound Care at a Glance

Ian Peate, Melanie Stephens

• Publisher: Wiley-Blackwell
• Year: 2019
• Print ISBN: 9781119590507
• eBook ISBN: 9781119590590
• Edition: 2
• Topic: Medicine
• Subtopic: Nursing

The second edition of Wound Care at a Glance is the ideal study and revision companion for undergraduate nursing and healthcare students, newly qualified practitioners, and for all involved with the provision of high quality, evidence-based wound care. This concise and user-friendly guide enables readers to expand their knowledge and understanding of wound care and skin integrity, and render safe and effective patient-centred care.

The guide's highly illustrated, visual approach to the subject of wound care and skin integrity explores the anatomy and physiology of the skin, acute and chronic wounds, pain management, legal and ethical issues, the various complexities of practical wound care, and more.

• Contains all the information you need to provide safe and effective patient care
• Presents a clear and concise account of appropriate wound care
• Incorporates both images and text to appeal to visual and non-visual learners alike
• Features a companion website containing interactive self-testing features

Part 1
Anatomy and physiology

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Chapters

• 1 The history of wound care
• 2 Anatomy and physiology of the skin
• 3 Psychological and social aspects of the skin
• 4 Body image
• 5 The skin and ageing

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Visit the companion website at www.ataglanceseries.com/nursing/woundcare to test yourself on these topics.

1
The history of wound care

Table 1.1 Historical references and wound care.

Age	Occasion
Hippocrates (c. 460–c. 377 BC) Cornelius Celsus (c. 25 BC–c. 50 AD) Claudius Galen (c. 130–c. 210 AD)	Early Greek and Roman physicians Wine or vinegar was used to cleanse wounds, and the follow‐up treatment included the application of honey, oil and wine
Ambrose Pare (1510–1590)	Encouraged wounds to suppurate
Ignaz Semmelweiss (1818–1865) Louis Pasteur (1822–1895) Joseph Lister (1827–1912)	Accepted the germ theory and the introduction of antiseptics
Florence Nightingale (1894)	‘Not in bacteriology, but looking into drains (for smells) is the thing needed’. Nightingale was a firm believer in the benefits of sanitation, hand‐washing and application of strict hygiene practices
George D. Winter (1962)	Discovered the importance of moist wound‐healing in experimental animals
Mary Ayton (1985)	Defined the terminology that is currently used for wound infection – wound contamination and wound colonisation
Vincent Falanga (1994)	Identified the concept of ‘critical colonisation’ with fresh insights into chronic wound‐healing and non‐healing wounds

Table 1.2 Wound care timeline.

A brief history of wound care

Wound care and infection is not a modern phenomenon; it spans from pre‐history to modern medicine. The healing of wounds is a complex process, influenced by a number of factors:

• The host (the patient)
• The environment
• The multidisciplinary team
• Available therapies.

Those providing wound care can no longer stick to a single approach in the progressive care of a wound. Wound care practitioners must critically select such wound‐healing therapies that can respond to the healing phase of any wound using the best available evidence. For thousands of years, dressing materials have been continually developing so as to provide protection, absorption and act as a base for wound bed preparation. Over the last 30 years, the advances in would care have been more prolific as compared to the previous 2000 years.

Early civilisation

Since the era of cave dwellers, humans have been tending to their wounds in one form or another. Wound care continues to evolve from casting magical spells and applying potions and ointments to a more systematic approach (see Table 1.1). See Table 1.2 for the wound care timeline.

Romans, greeks and egyptians

As early as 14–37 AD, Cornelius Celsus (a Roman physician) described the four principal signs of inflammation using some form of ‘antiseptic’ solutions. Claudius Galen (130–200 AD), another Roman physician, had such expertise on the management of healing wounds that he is still considered the ‘father of surgery’ by many. Galen and some of his followers must be remembered for instigating the ‘laudable pus’ theory, whereby they incorrectly considered the development of pus in a wound as an encouraging aspect of the healing process.

The lint provided a fibrous base promoting the covering of a wound site, the animal grease offered a protective barrier to the environmental pathogens, and the honey helped with its antimicrobial actions. The Egyptians and Greeks observed the significance of covering a wound. The Greeks were the first to identify the difference between acute and chronic wounds, correspondingly calling them ‘fresh’ and ‘non‐healing’. Around 120–201 AD, a Greek surgeon, who served the Roman gladiators, made a number of contributions to wound care by successfully covering a moist wound site and recognising its importance.

After the fall of the Roman Empire, many of these advances were lost. In the Middle Ages in Europe, there was a regression in the field of wound care, returning to the use of potions and charms.

The use of honey as a wound care treatment has recently seen a revival. Ancient Egyptians used honey as a wound treatment as early as 3000 BC, and its traces have been found in Egyptian tombs. Honey is said to have been an essential part of the ‘Three Healing Gestures’ used by the Egyptians.

19th century

Pasteur’s theories were associated with the impact of microbes on diseases, and the use of phenol by Lister introduced the modern ‘germ theory’ when he demonstrated the beneficial effects of carbolic acid (phenol) in the dressings of infected wounds at the turn of the century. Halstead introduced the wearing of gloves, gowns and masks, and silver was revived as an antiseptic used in dressings, enhancing the healing of wounds.

All of these events make the 19th century a significant and eventful era with regard to advances within the field of sterility and sterile surgical procedures. Skin cleaning, the use of antiseptics and debridement became common practices thereafter.

20th century

The 20th century brought some key advances, when there was a resurgence and rediscovery of the significance of a moist wound site with the invention and development of polymer synthetics used for wound dressings.

Fleming’s discovery and the subsequent development of antibiotics provided us with potent antimicrobial therapies with high specificity, transf...

Table of contents

• Cover
• Table of Contents
• Preface to the second edition
• Acknowledgements
• How to use your textbook
• About the companion website
• Part 1: Anatomy and physiology
• Part 2: The normal healing process: acute wounds
• Part 3: The abnormal healing process: chronic wound healing
• Part 4: Wound management in practice
• Part 5: Dressing selection
• Part 6: Complexities of wound care
• Glossary
• References and further reading
• Index
• End User License Agreement