Definition of a wound: it is an abnormal cut or tear in the tissues of the body.

Risks of wounds: bleeding, contamination and shock

Steps of Wound Care 

1.    Stop bleeding: minor wounds and abrasions usually stop bleeding on their own, if this does not happen, gently press with a clean cloth or bandage, continue to press continuously for 20 to 30 minutes, and if possible lift the wound up to help stop the bleeding, do not open to examine the wound to see if the bleeding has stopped or not, and Because this may delay the clotting process, and this is what causes the bleeding to continue. And if the blood continues to flow after constant pressure.

2.    Clean the wound: rinse the wound with clear water, soap can irritate the wound, so stay away from using soap directly on the wound, if you find dust or fragments still in the wound after washing, use forceps after disinfecting it with alcohol to remove any foreign particles in the skin, if some fragments remain inside, see a doctor, thorough cleaning reduces Risk of infection and tetanus, to clean the area around the wound, use only soap and a towel, no need to use hydrogen peroxide, iodine or iodine-containing disinfectants.

3.    Antibiotic mode: after cleaning the wound, apply a thin layer of antibiotic cream or ointment to help keep the wound surface moist, antibiotic does not accelerate healing, but it can inhibit infection and help the body's natural healing process, some ingredients in some ointments can cause skin rash in some people, if it appears Rash, stop using the ointment immediately.

4.    Covering the wound: bandages can help keep the wound clean and keep harmful bacteria away from the wound, after the wound has healed enough that infection is unlikely, leave it exposed to the air for faster healing.

5.    Change on the wound: spare on the wound at least daily or whenever it becomes wet or dirty, if you become allergic to the adhesive that n8is used in most bandages, change to adhesive-free bandages or sterile gauze, which is held in place by a paper strip, or a gauze roll fixed with a adhesive, these supplies are generally available in pharmacies.

Getting stitches for deep wounds: if the depth of the wound is more than 6 millimeters, or if it is gummy it usually requires stitches, strips

1.    Bandages or bandages are suitable for minor wounds, but if they are difficult to close easily, you should see a doctor as soon as possible, proper closure within a few hours reduces the risk of infection.

2.    Follow up on signs of wound contamination and infection: check with your doctor if the wound is not healing or you notice any redness, increased pain, discharge of pus, warmth or swelling.

3.    Getting tetanus vaccination: doctors recommend getting tetanus vaccination every 10 years, if your wound is deep or dirty and your last vaccination you had more than five years ago, your doctor may recommend taking a tetanus booster dose.

Wounds are divided into :

(1) closed wounds or bruises :where the skin remains intact, and the cut occurs in the subcutaneous tissue, the subcutaneous tissue may be severely injured.

Causes: collision with a blunt hard machinehemorrhage occurs in the blood vessels under the skin

Symptoms: pain, swelling and discoloration of soft tissues .

Closed wound ambulances:

* Lifting the injured arm or leg.

* Apply ice packs or cold water to the injury area.

* Examine the injured thoroughly for fractures and injuries.

If an internal organ injury is suspected, the injured person is immediately sent to the doctor

(1) open wounds : these are wounds where a cut appears in the skin, and open wounds are usually accompanied by external bleeding .

Types of open wounds and their causes:

1.  Abrasions:they are just scraping the skin like minor scratches or friction with objects such as the ground and occur in children often from falling on the ground .

The possible bleeding in these cases is no more than a simple leakage of blood from the capillaries , but the possibility of contamination exists, as dust and bacteria may find their way into the open tissues

First aid for abrasions:

* Wash the wound thoroughly with soap and water and can be disinfected with antiseptic solutions such as Betadine .

• It can be left without a lid, and if necessary, it can be covered with an adhesive plaster after applying a small piece of gauze.

* Looking for an8y other injuries in other places

2.  Segmental wounds are wounds in which tissue is cut, usually with regular edges, caused by sharp objects such as knives and pieces of glass, and bleeding is frequent from these wounds .

         

First aid for segmental wounds:

* A medical glove should be worn to prevent transmission of infection.

* Bleeding should be stopped immediately before cleaning and treating wounds.

* Press the wound site with sterile medical gauze or clean cloth with the tip lifting the injured part up.

* After the bleeding stops, clean the wound by gently washing it with clean water only (keep soap away from reaching directly to the wound opening because soap irritates the frayed tissues in the wound).

* If there are obvious objects inside the wound even after washing it with water, use alcohol-sterilized forceps to remove those objects.

* Wrap the wound taking care not to press too hard so as not to affect the flow of blood and always make sure that the fingers and toes are warm and the injured can move them.

* If the fingertips are found to be cold, loosen the ligament to allow blood to flow in the limbs and take the injured person to the hospital immediately.

* Deal with bleeding as mentioned above.

* It is better to change the dressing of the wound cover every day if amounts of fluid and pus come out of it, but if the wound is clean, the bandage or patch is changed whenever it gets dirty externally.

* After the start of wound healing, the lid is opened because wounds heal faster when exposed to air.

• In some wounds, it may require stitches to sew the two ends of the wound and bring them closer together to facilitate wound healing, in the case of:

     - If the wound is more than 6 centimeters.

     - There is a clear spacing between the two ends of the wound.

     - The cut in the wound has reached such an extent that tissues from the adipose or muscular layer have begun to appear through it.

1.  Tendinous wounds are wounds in which a part of the injured person's body tissue is separated or torn, such as a finger, ear tip, or one of the limbs of the body .. They usually occur as a result of animal bites or injuries from accidents, machinery, crackers, and are usually followed by severe bleeding.

First aid for traumatic wounds:

• Wearing a jacket to prevent transmission of infection.

* Press the wound with a clean cloth or sterile dressing, if any, to stop the bleeding.

* The affected part is raised above the level of the heart.

                

* If the frayed tissues (skin or muscles) have not separated, they are returned to their place and the wound is pressed with bandages.

As for whether the removed part has broken off:

* Place the removed object (if possible)in a salt solution bag or put it in any clean bag

• This bag is placed in another bag filled with ice.

* The injured and the removed part are transferred to the nearest (large)hospital immediately because it is possible for some surgeons to return the removed part to its place in the body.

In case the bleeding is not stopped by pressing and lifting up:

* The feeder artery is pressed to the place of injury

* Do not resort to tourniquet unless there is a possibility of severe bleeding and delayed ambulance.

1.  Puncture wounds or window wounds: these wounds are caused by pointed objects such as nails and shrapnel, these wounds reach a deep distance inside the tissues, and there is no apparent external bleeding from them. But the pointed object can penetrate the tissues to a great depth, infect the viscera and organs, causing internal bleeding

These wounds are among the most likely to be contaminated for their depth and lack of external bleeding, and there is a high probability of tetanus microbe activity.

First aid for puncture or window wounds:

* Fix the implanted part (knife or succession) inside the body in order to prevent air ingress, contamination of the wound, increased bleeding and tissue laceration.

* The implanted object is lifted only if cardiopulmonary resuscitation is needed and the implanted object is in the chest or if this object penetrates the respiratory tract.

• In case of need to transfer the injured person, pressure is applied around the implanted object and it is fixed by ligaments

• If the implanted thing is long, it is shortened if possible to reduce its movement and thus reduce the wear of surrounding tissues, reduce bleeding, and transfer the injured person as soon as possible to the hospital

Telltale signs of serious bleeding:

◾ Bleeding continues in a large amount despite pressure on the bleeding site for at least 15 minutes .

◾ The occurrence of severe pain .

◾ Bleeding from the vagina of a pregnant or postpartum lady.

◾ Blood coming out of holes in the human body .

◾ A shock occurred.

         

                      

Tools used to spare on the wound:

A spare car containing:

(The upper surface contains: solutions[alcohol 7.% - Betadine 10% - salt solution - and other disinfectants according to the doctor's instructions) sterile spare bags with them (2 dried spare + 2 pieces of threshing + 5 pieces of gauze + Basin-the lower surface contains: a large renal basin for storing the machines after use-linoleum plastic bags for placing the machines used in them-clean gaskets-gauze bands sizes Different-clean scissors).

Steps:

1.    Hand washing (hygienic ).

2.    Preparation of tools 

3.    Explain the procedure that will be done to the patient.

4.    Make sure that the spare vehicle is clean and dry and that the calf is healthy.

5.    Make sure that the vehicle is ready and complete (top and bottom surface).

6.    Maintaining patient privacy.

7.    Lift the lid and the patient lies in a comfortable position for the spare.

8.    Uncover the wound site and put linoleum under the patient next to the wound.

9.    Put a clean renal pelvis on linoleum.

10.   Wear a clean sleeve and remove the adhesive plaster gently and quickly so that the patient does not suffer.

11.   Place the spare inside the bag, which is located inside the renal pelvis.

12.   Assess the condition of the wound in order to determine its type.

13.   The collar is removed and another collar is put on.

14.   Open the sterile bag on the top surface of the trolley.

15.   Picking up the peat tip from the bag, in case there is a doctor to make a spare or nursing assistant, he picks up another peat with this peat and hands it to the second party, then the contents of the bag are covered.

16.   Determine the type of solution that will be used for the replacement according to your assessment of the wound or according to the doctor's instructions.

17.   Placing the solution in a sterile renal pelvis.

18.   Pick up a piece of gauze from the bag with peat and then put it in the tub or dry.

19.   Starting to clean the wound starting from the inside out, more than one piece can be used.

20.   Make sure to clean the wound and then dry it by following the previous step.

21.   Note the wound during the work of the spare, the surface around it and any topical symptoms.

22.   Put the sterile spare part and fix it using adhesive tape or gauze bands.

23.    Clean the place of all used refills and then put them in the red bag.

24.   Pull the linoleum out from under the patient, then apply it inward and put it on the bottom surface of the trolley.

25.   Assemble the used machines and put them in a renal basin with soapy water.

26.   Cover the patient and arrange bedding.

27.   Hand washing ( routine).