Wound Care Mobile
Wound care often begins with topical dressing changes with saline (saltwater) or Dakin’s solution (bleach-like) 2 to 3 times daily to gently remove nonviable or contaminated tissue and promote healing by the body. Topically applied agents with active enzymatic components can help debride the devitalized (dead) tissue. Pulsavac treatment (pressurized salt water irrigation) can additionally prepare wounds for healing. Finally, when topical and local management fail, surgical debridement is sometimes necessary.
Difficult wounds often require reconstructive surgery, either skin grafts, skin flaps, muscle flaps, tissue expansion, VAC®, or microvascular reconstructive techniques to bring new tissue into the area.
When a wound is open but otherwise ready for coverage with skin, a skin graft may be used. There are artificial skins and skin substitutes, but typically a patients own skin is used. If small enough, a full thickness skin graft may be used that borrows skin from an area that can be sutured closed and moves the skin to the needed area. If too large to close the area where the skin was taken off, it is necessary to use a split thickness skin graft where the deep components of the donor site remain and can heal the shaved off skin wound fairly quickly. Skin grafts need a healthy wound to take, as blood vessels must grow into the skin graft for it to become alive.
Flaps involve moving living tissue over a wound. This is important in wounds with vital structures exposed or with a wound with a less prone to healing base such as exposed bone, tendon, etc. Flaps also can be used to bring in extra tissue to correct a shortage of tissue. For example, a flap may help with tight burn scar or radiated site or to provide enough tissue for breast reconstruction.