A wound is a breakdown of, or injury to, your skin. There are things you can do to help your wound heal well.
Key points about wound care
- A wound can be caused in lots of different ways, such as from cuts and grazes, puncture or stab wounds, burns, poor blood supply or bites.
- There are 3 stages of wound healing. Healing can slow down or stop at any stage if something gets in the way of your body's healing process.
- Factors that can slow down or stop wound healing include poor blood supply, infection, further damage to the wound, poor diet, smoking and wound dryness.
- Treatment of a wound aims to control or remove anything that slows the wound healing process.
- There are things you can do to take care of your wound and help it to heal.
See your doctor or GP immediately if you have any signs of infection, such as fever and chills, a wound that drains pus, smell from your wound and increased redness, temperature or swelling around your wound.
What are the different types of wounds?
The different types of wounds include:
- a surgical wound – a cut made on your skin for the purpose of an operation
- leg ulcers such as arterial or venous leg ulcers and diabetic foot ulcers
- pressure ulcers or pressure sores – an area of damaged skin and tissue caused by spending long periods of time in bed or in a wheelchair
- cuts and grazes
- bites and stings
- trauma or injury wounds, such as punctures, stab wounds, lacerations (deep cuts) or part of your body being crushed.
What are the stages of wound healing?
There are 3 stages of wound healing:
- Inflammatory stage – when your skin is broken down or injured, the blood vessels around it narrow to stop more bleeding and allow a blood clot to form. Once a clot is formed, the blood vessels expand to increase blood flow to the area. This brings white blood cells to remove dead tissue and bacteria, as well as nutrients to help the wound heal.
- Fibroblastic or proliferation stage – collagen starts to grow in the wound to increase the strength of the skin. This makes the edges of the wound shrink and close. More skin cells form new skin growth under the dried scab. Small blood vessels (capillaries) start to form around the area to increase blood flow to the new skin.
- Maturation stage – your body refines the area by adding more collagen over time. With a large wound, this can take months or years.
If any of these processes are interrupted, the wound may not heal.
What are the barriers to wound healing?
Factors that can slow or stop the wound healing process include:
- poor blood supply – any medical condition that affects blood supply can slow the wound healing process, eg, diabetes
- dead skin or tissue
- bleeding or haemorrhage (a large bleed) from the wound
- further injury or damage to the wound
- poor diet, such as lack of vitamin C, zinc and protein, which are needed for wound healing
- being elderly
- medicines such as non-steroidal anti-inflammatories
- wound dryness
- poor immune system functioning.
How is a wound treated?
Treatment of a wound aims to control or remove the underlying factors that slow the wound healing process. It depends on factors such as your general health, age and the type of wound you have.
For example, if you smoke, your doctor will advise you to quit smoking, as smoking can affect wound healing. If you have diabetes, good blood sugar control is important, as diabetes can restrict blood flow to the wound, which can delay wound healing.
Some of the steps your doctor or nurse may take or advise include the following:
- Regular cleaning of the wound using water that is safe to drink or sterile saline solution. This helps to remove dirt and dead skin or tissue from a fresh wound. It is important to clean not just the wound but the surrounding skin too.
- If you have a surgical wound, it needs to be kept dry for 2 days and only gentle cleaning is required. Read more about caring for a surgical wound.
- Removing dead skin or tissue by a surgical procedure called debridement if needed.
- Providing tetanus vaccination, especially in cases of traumatic injury.
- Dressing the wound using a suitable dressing based on your wound type.
- Treating or controlling any underlying medical conditions or factors that can affect wound healing, such as diabetes or peripheral vascular disease.
- Recommending that you make lifestyle changes to support wound healing, such as stopping smoking, being active, eating healthy food, reviewing medicines that can slow wound healing, and getting rest and sleep.
- Treating any wound infection with topical dressings or antibiotics.
- Regular monitoring of the wound.
How do I care for my wound?
Your doctor will tell you some things you can do to look after your wound and allow it to heal normally. The following steps are general self-care measures. There may be other steps you need to follow that are specific to your type of wound. Talk to your doctor or nurse about these.
- Wash your hands before and after cleaning your wound.
- Don't take medications that can affect wound healing, eg, non-steroidal anti-inflammatories.
- Only take medications prescribed by your doctor for pain.
- Ask your doctor or nurse about what medications to avoid.
- Don't use an antiseptic cream for too long as it can harm the new skin cells.
- Keep your wounds clean and dressed to avoid infection and keep it moist. The wound needs moisture to heal faster.
- Eat a healthy diet. Eat plenty of fresh fruits and vegetables as they have lots of vitamin C, which helps to make collagen. Protein and zinc are important too. Read more about good food for wound healing. Your doctor can refer you to a dietitian if you need advice on your diet.
- If you have diabetes, you need to control your blood sugar, as high blood sugar can reduce blood flow to the wound.
- Don't smoke or get support to stop smoking if you are a smoker. Smoking can reduce blood flow to your skin especially the wound. If you need help to quit smoking, ask your doctor or read more about how and why to quit smoking.
- Exercise regularly. This can help increase blood flow and speed up wound healing. Your doctor can suggest suitable exercise for you based on your general health and to minimise any strain on the wound, depending on its location.
- If you have pressure sores or pressure ulcers, avoid sitting or lying for prolonged periods. Read more about pressure sores.
The following links provide further information about caring for your wound. Be aware that websites from other countries may have information that differs from New Zealand recommendations.
- General wound care 3D Regional HealthPathways, NZ
- Wounds DermNet, NZ
- Wounds – how to care for them Better Health Channel, Australia
|Dr Arna Letica has worked as a GP for over 13 years, with particular interests in women's and children's health. She is currently focusing on non-clinical roles, including working as a medical assessor.|