Diagnosing and Treating Skin Wounds Paper
Diagnosing and Treating Skin Wounds Paper
Skin wounds are sometimes challenging for health care providers to diagnose and treat as many have similar presentations. For advanced practice nurses, being able to identify various types of skin wounds, including whether a wound is a colonization or an infection, is critical because it impacts recommended patient care. In your role, you must be able to evaluate skin wounds, determine the diagnosis, and develop an appropriate treatment and management plan according to current evidence-based guidelines Diagnosing and Treating Skin Wounds Paper.
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To prepare:
Review Chapter 46 of the Resnick text, as well as the Burr article in this week’s Learning Resources.
Consider how to properly diagnose skin wounds in frail elders, including how to distinguish between a colonization and infection.
Select a type of skin wound, such as bumps, bruises, shingles, herpes, bullous pemphigoid, Stevens-Johnson syndrome, etc. Research the guidelines for treatment of the skin wound you selected. Reflect on how you would treat and/or dress this wound.
Think about factors that might contribute to the development of the skin wound you selected. Consider strategies for the prevention and improvement of this type of wound.
To complete:
Write a 2- to 3-page paper that addresses the following:
Explain how to properly diagnose skin wounds in frail elders, including how to distinguish between a colonization and infection.
Describe the type of skin wound you selected.
Explain how you would treat and/or dress this wound based on guidelines for treatment.
Explain factors that might contribute to the development of the skin wound you selected. Include strategies for the prevention and improvement of this type of wound.
Diagnosis
A skin wound refers to any injury to the skin that results in the skin breaking and exposing the inner tissue. It can be resultant from contusion, blunt force trauma, puncture, cut, or tear. All skins wounds contain microorganisms (bacteria) although there is a distinction whether a particular would is merely colonized, or it is infected with bacterial overgrowth. Colonization is preferred since infection can result in impaired healing of the wound. Some symptoms would indicate whether the wound is colonized or infected. For infected wounds, symptoms would include unpleasant odor and purulent appearance of wound exudate. In addition, the bacterial infection is likely to stimulate vascular endothelial growth factor resulting in the faster formation of new blood vessels that would then bleed. Also, an infection would be accompanied by erythema and cutaneous increasing in the area surrounding the wound (Bryant & Nix, 2016)Diagnosing and Treating Skin Wounds Paper.
Describe the type of skin wound you selected.
The selected skin wound is pressure ulcers. These are resultant from pressure going unrelieved, typically over bony prominence such as heel or sacrum although it can occur on any part of the body. The wound formation may be hastened by friction and shear forces over the affected areas. The medical profession describes pressure wounds based on its stage of formation. Stage one wounds see the development darkened erythema that occurs over unbroken skin and is not resolved within half an hour. The second stage would see both the epidermis and dermis broken to form a lesion. The third stage entails the wound going deeper into the tissue but falling short of exposing the bone or tendon. The fourth stage entails the wound extending into the muscles and supporting structure, while eroding the ligaments, tendons and bone. There is a fourth stage considered unstageable since the wound is covered by necrotic debris, eschar and slough that make it difficult to see the specific tissue that has been breached by the ulcer (Hamric, Hanson & Tracy, 2014).
How to treat and/or dress
Treatment of a pressure ulcer is dependent on its particular stage of development. Superficial wounds with minimal colonization are treated using topical agents (such as normal saline, bacitracin, scarlet red dye, hydrogen peroxide, acetic acid, betadine, and chlorhexidine) that would keep the wound clean and clear bacterial colonization even as the wound heals naturally. For deep wounds that entail bacterial infection (such as osteomyelitis and cellulitis), regular debridement and systemic antibiotics would be necessary. Additional, oral antibiotics would be prescribed with less severe bacterial infections with intravenous antibiotics earmarked for the more severe infections (Haesler, 2014). It is important to note that the specific antibiotic to be prescribed is dependent on results from antibiotic sensitivity and gram staining tests. This is in consideration of the fact that wound microbial fauna will change over time. An ulcerated wound determined to not have a possibility of healing should be treated with topical agents to eliminate microorganisms and keep the wound clean. Wound dressing should be done using broad-spectrum antimicrobial agents that include polyacrylates and silver products since they reduce the wound’s bioburden (Dziedzic, 2014)Diagnosing and Treating Skin Wounds Paper.
Skin wound development
Pressure ulcer development can be prevented through a range of strategies. These include using special support surfaces, preventing damp skin by targeting urinary and fecal incontinence, moisturizing dry skin, and reposition. Urinary and fecal incontinence are a particular concern since their chemical properties irritate the skin, and they expose the skin to excessive moisture that makes it easier to breach the skin. Using special support surfaces redistributes the pressure so that no single area is exposed to an excessive unrelieved pressure that results in ulcer development. Repositioning helps to maintain equal pressure and reduces the risk of skin breakdown. Moisturizing dry skin reduces the risk of skin breakdown (Dziedzic, 2014; Haesler, 2014).
References
Bryant, R. & Nix, D. (2016). Acute & chronic wounds: current management concepts (5th ed.). New York, NY: Elsevier.
Dziedzic, M. E. (2014). Fast facts about pressure ulcer care for nurses: how to prevent, detect, and resolve them in a nutshell. New York, NY: Springer Publishing Company, LLC.
Haesler, E. (2014). Prevention and treatment of pressure ulcers: clinical practice guideline. Cambridge: Cambridge University Press.
Hamric, A., Hanson, C. & Tracy, M. (2014). Advanced practice nursing: an integrative approach (5th ed.). New York, NY: Elsevier Diagnosing and Treating Skin Wounds Paper.
