WOUND DRESSINGS

Wound Dressings

Wound Dressings

Clinical Practise Or Professional Issue

As I am out of practice from last few years so it's a challenging and rewarding area of clinical practice for the student nurse. This modern approach involves simple advances in practice. Firstly, I discuss it as the modern wound management uses moist wound healing processes that have been researched and determined to be significantly more effective than the dry healing of the past. Secondly, and more importantly, more holistically I describe as the approach looks at more than the wound itself, but addresses the whole patient in medical, environmental and social contexts. (Waldrop, Doughty, 2000: 4)

Gibbs model 1998

The Gibbs Reflection Model is one of several procedures that allow a professional nurse to assess professional competence through the analysis of a clinical encounter same as me. The Gibbs Reflection Model is a six element cycle through which a professional service deliverer can identify, reflect on, and assess professional competency. (Dealey 2004:45) As per the model the phases are known as the inflammatory phase, the proliferative phase, the maturation phase. I listed in the essay the series of the events that occur during the granulation, epithelisation and contraction stages of the proliferative phase.

Rationale

Most sources indicate that wound healing is made up of an orderly sequence of events. I characterised by specific movement of specialised cells into the wound, carrying out specific tasks. According to the movement of the cells and the orderly sequence of events in healing is regulated by cytokines or growth factors. Evidenced by its colour - bright red, moist and shiny appearance. As a student nurse I would always be well off to remember that healing is a continuum of complex connected processes that are divided into phases. (Cherry, Harding, Ryan 2000:21)

Firstly I describe Granulation which is also known as Angiogenesis, which is the growth of new blood vessel. It is an essential ingredient for regeneration of granulation tissue. Tissue hypoxia (low oxygen) sets in following disruption to the blood flow on injury, stimulating macrophages to secrete a substance known as angiogenesis factor. The process of angiogenesis is delayed if a thick layer of surface necrosis is present.

Changes Affect Patient

I studied as the undamaged capillaries beneath the wound produce buds, stimulated by growth factors, these buds form a network of loops, which fuse with other buds to form a new capillary bed. These new loops are fragile and can be easily damaged Dealey (Dealey 2004:45). Some types of dressing made of open weave cotton such as gauze become stuck to the granulating tissue and on removal could damage the new capillary loops for the patient. I will discuss more about gauze in the following paragraphs.

If the wound edges are close, the capillaries can bridge the wound. This new tissue is known as granulating tissue. However this process can be impaired by excess inflammation, dead surface tissue, wound exudates, decreased perfusion, and corticosteroids-A steroid hormone produced. (Cherry, Harding, Ryan 2000:21)

Now I describe the phase where the wound is covered epithelial ...