Wound Management .

The article discusses wound management, wound bed status, wound measurements, wound exudate, and wound healing process. It evaluates the wound management plan and pain management. The patient's medical condition and history are also discussed.

Running head: WOUND MANAGEMENT
WOUND MANAGEMENT
Name of the Student:
Name of the University:
Author Note:

1WOUND MANAGEMENT
Principle diagnosis of patient
The case study presented depicts the condition of Mr. David Perason who is a
57 year make hailing from England. He is a retired merchant navy man by
profession. He along with this wife and his four sons migrated to Australia in the year
1987. The past medical history of the patient shows that he has been suffering from
osteoarthritis for the last 10 years which kept on increasing because of his job as an
Engineer. Additionally Mr. Pearson had developed hypertension which had occurred
about six years ago. Recent problems with him constitute his problem of weight gain,
which has resulted in the risk of diabetes. The current health condition of the patient
shows that his orientation is proper and that he is oriented to time and to place. The
reason of the admission of the patient to the hospital is the total knee replacement of
the patient of the right knee.
The medical condition of the patient reports that he is suffering from
hypertension. He also mentions that his right hip and knee are in pain while it is in
rest and it also rises when I the mobile condition. The pain scale shows 6-7 when in
rest and 8 when in motion. The patient also reports that while he is trying to cover
long distances, most of the time he runs out of breath in addition to having difficulties
to breathe at night which makes him sit up at night. Inspite of the fact that he love
food, the patient is trying to follow a diet plan however there has been no such effect
because of it. He also mentioned that he has an alcohol problem. Elimination for him
occurs about 12 times a day while he gets up twice at might. He also suffers from
constipation problems and therefore requires to use laxative about once a week. He
also has problems in sleeping at night as he has to get up several times for going to
the toilet and also he had bouts of breathlessness along with the occurrence of
osteoarthritis pain.

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Evaluation of the wound management plan
Wound bed status (include colour/s) – The wound bed status shows bruising
of the leg that is ecchymosis, which is followed by the surgery. The color of the
wound bed shows blue to deep red. There is inflammation in the first stage of the
wound bed, this is followed by proliferation and the final one is the maturation of the
wound (Matatov et al., 2013).
Wound measurements – The wound measurement shows that the incision is
about 10 inches.
Condition of surrounding skin (ie intact, breaking down) –The condition
around the wound shows that the skin is intact since the wound have been stitched
after the surgery. However there is necrosis of the soft tissues in some places
(Rosenberg et al., 2014).
Wound exudate (colour, consistency, odour) –The wound exudate is
clearless to pale in color with a thick consistency, which a pungent odour.
Frequency of dressing change- The dressing change is done twice a day,
once in the morning and once in the night.
Wound management
The primary aim of wound care or wound management is to prevent the
contamination from happening in the area of wound and to properly clean the
infected wound for any kind of surgical closure or the healing of the second
intension. In order to obtain the objective of assessment of the wound, it is required

3WOUND MANAGEMENT
to provide a complete sedation or anaesthesia which might be indicated (Pastar et
al., 2014). It is possible for the wounds to be lavaged and to be debrided
immediately. There is also a scope of biopsy that needs to be considered for most of
the chronic as well as the non-healing wounds (Gause, Wynn & Allen, 2013). For the
treatment of the wounds, an aseptic technique is required for the treatment of the
wounds which uses the things like sterile gloves, instruments, and bandage
materials. It must also be kept in mind that the process of wound healing occurs in a
moister and wet condition.
For pain management, pain education has been defined as any planned
activities which are designed in order to improve the health behaviour of the patient
along with the improvement of the health status of the patient (Stevens et al., 2014).
This activity of pain management helps the patient to facilitate the knowledge of the
patient in order to help them to interpret their pain and help them get directed
towards an effective along with the ongoing self-management. In order to bring about
the understanding of the complexities of pain and understand the importance of self-
determination as well as sustainable self –management, it is important to develop
skills that are facilitatory in nature (Itatsu et al., 2014). The expectation of the healing
process is long as it takes a long time to heal after an incision has been made for the
surgery of total knee replacement. There are also persistent wound leakage which
increases the risk of the periprosthethic infection of the joint (Rosenberg et al.,
2014).
The expectation of the healing process depends on the location of the wound,
as well as the age and chronic health condition of the given patient. According to the
given situation, the patient has a condition of chronic health conditions like diabetes.
Presence of this makes the process of wound healing much slower (Webster et al.,

4WOUND MANAGEMENT
2014). Diabetes makes the wound less susceptible to healing and the wound takes a
long time to dry up. Additionally the patient presented here is an older adult,
therefore the age of the person also becomes an inhibiting factor for wound healing.
With the increase of age, the immunity of the person declines so does the secretion
of the coagulating factors therefore the healing process becomes long enough
(Kosins et al., 2013).
The process of wound healing mainly occurs through two distinguished
processes. These are the primary intension healing and the second intension
healing. According to the primary intension healing, this process occurs only when
the tissue surface has been closed. This might be because of the stiches, or skin
glue or staples and tapes. When there is a closure of this kind, there is very little
tissue lost. This process is also often called the primary union or the first intension
healing. In case of surgical incision, the process is primary intension. Another
method is the secondary intension healing which occurs when the wound is
extensive and also involves a considerable amount of tissue loss (Yu-Wai-Man &
Khaw, 2015). It is in such cases that the edges of the tissues cannot be brought
together to heal. Through this process the pressure ulcers heals. In terms that the
secondary intension is different from the primary is intension is that the repair time
required is longer, the scarring is greater and there are higher chances of infection.
Most of the surgical wounds are accounted as acute wounds, however there
might be complications due to the intrinsic and the extrinsic factors. The
complications might be dehiscence and infection. There are a number of factors that
are associated with the complications like smoking, rheumatoid arthritis and
diabetes. Factors like malnutrition affects the process of healing along with obesity

5WOUND MANAGEMENT
which influences breakdown of the reduced tissue oxygenation (Pierpont et al.,
2014).
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