The Care of Wounds

Dr Carol Dealey is Senior Research Fellow at University Hospital Birmingham NHS Foundation Trust. She is a Council Member of the Tissue Viability Society and has served on the Boards of both the European Wound Management Society and the European Pressure Ulcer Society.

Preface vii

1 The physiology of wound healing 1

Introduction 1

Definitions associated with wounds 1

The structure of the skin 2

Wound healing 3

Impaired wound healing 9

Conclusion 12

2 The management of patients with wounds 15

Introduction 15

Physical care 15

Psychological care 39

Spiritual care 45

3 General principles of wound management 61

Introduction 61

Wound assessment 61

Managing wounds 77

Documentation 85

Evaluating the dressing 86

4 Wound management products 93

Introduction 93

The development of dressings through the ages 93

Traditional techniques 100

The use of lotions 102

Clinically effective wound management products 108

Modern wound management products 110

5 The management of patients with chronic wounds 127

Introduction 127

The prevention and management of pressure ulcers 127

The management of leg ulcers 149

Diabetic foot ulcers 165

The management of fungating wounds 170

6 The management of patients with acute wounds 185

Introduction 185

The care of surgical wounds 185

Traumatic wounds 199

The burn injury 205

Radiation reactions 216

7 The organisation of wound management 227

Introduction 227

Managing wounds in the community 227

Nurse specialists in wound care 228

Multiprofessional wound care 229

Wound healing centres 230

Conclusions 230

Index 233