Treatment of Wounds

Abstract

There can be no standard treatment for wounds. The treatment of each wound must be individualized, taking into account such factors as destruction of tissue, amount of contamination, and lapse of time since the wound was received. The final decision as to the treatment of a wound must be based on sound knowledge of the physiology and pathology of the healing process.

The chief factors that promote sound and rapid wound healing are as follows:

1. Absence of infection

2. Absence of foreign material

3. Good blood supply

4. Complete immobilization

5. Pressure dressing

6. Normal serum proteins

7. Normal supply of vitamin C

8. Absence of nerve injuries, debilitating disease, and unrecognized factors that may retard healing

BACTERIOLOGY

The staphylococcus is one of the most common contaminants of wounds. This organism is widely distributed in the skin, in the nose and throat, and often even in the air.

Staphylococcic infections are characterized by suppuration. Thick creamy pus forms early, and in the average case the infection remains more or less localized. When the organisms are of high virulence (usually hemolytic Staphylococcus aureus) or when the patient’s resistance is low, the staphylococcus may become more invasive and is likely to cause spreading cellulitis, lymphangitis, or septicemia. But most staphylococcic infections of wounds are low grade and often cause protracted suppuration and drainage.

Before the advent of the sulfonamides, hemolytic streptococcus was the most dreaded cause of fulminating infection. Infections from this organism have been known to produce septicemia and death. . .