Wound

A wound is not just a hole in the skin. It is a visible record of perfusion, pressure, inflammation, infection risk, tissue damage, and the patient's ability to heal. Healing normally moves from haemostasis and inflammation into granulation, contraction, epithelialization, and remodelling. A wound that is gradually becoming smaller, has a healthy granulating bed, produces less exudate, and causes less pain is generally moving in the expected direction. Persistent pressure, poor arterial or venous circulation, hyperglycaemia, malnutrition, smoking, immunosuppression, infection, or repeated trauma can interrupt that progression. This is why trends matter more than a single attractive-looking photograph. A wound may appear clean but fail to contract. Conversely, a healing wound may contain some slough without having a spreading infection. The nurse compares today's findings with the previous assessment and asks, “What has changed, and what could explain the change?” The wound's location and pattern also suggest its cause: - A pressure injury is usually over a bony prominence and reflects sustained pressure, shear, or both. - A venous wound is commonly shallow, irregular, and located in the gaiter area...