Proper wound treatment can be a very complex, time-consuming and costly task. Effective wound management is needed to avoid anything going wrong and prevent complications. Typing the wound is the starting point. That’s because comprehensive knowledge of the specific wound is essential for establishing a clear and personalised treatment regimen for wound management.
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Wound typing can start with the origin of the wound, but it is not always easy to determine this. If this is not possible, a number of other criteria can be used for typing: The depth and extent of the wound, as well as the area of the body, can act as distinguishing features that are crucial for modern wound treatment. The most common typing classification involves a division into acute and chronic wounds.
Acute wounds can be caused by trauma or be thermal, chemical and radiation-induced and require urgent medical treatment above a certain level of severity. The quality of care of acute wounds is of crucial importance for the functional and aesthetic outcome. The goal of medical wound treatment for acute wounds is to support the body's regeneration and speed up the healing process. There are as yet no guidelines in Germany on wound management for the treatment of acute wounds. Medical wound treatment is based on the type of injury.
Traumatic wounds are caused by various, mostly external, sharp or blunt forces and trauma (pressure, tension or shear forces) on the tissue. They include accidental or occasional wounds as well as planned surgical wounds.
Thermal wounds are produced by exposure of tissue to heat or cold (burns/scalds/frostbite/injuries caused by electricity).
Chemical wounds occur when the skin or mucous membranes are burned by acids or alkalis.
Radiation-induced wounds can be caused by radioactive isotopes or ionising radiation. Sunburn caused by UV radiation also falls into this category.
Wounds are defined as chronic if they show no signs of healing within eight weeks under professional treatment. In most cases, chronic wounds develop from an acute wound, frequently in patients with existing underlying diseases such as venous insufficiency or diabetes. Chronic wounds can take a long time to heal and may be associated with complications.
“Wounds that do not heal within eight weeks are considered chronic. Some wounds should be considered chronic from the outset since they require treatment of the original cause. They include, for example, diabetic foot ulcer, lower leg ulcer, wounds caused by peripheral arterial occlusive disease (PAOD) or pressure sores. 1
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Medical treatment of chronic wounds can take a long time and may involve complications. Wound management also involves treating the causes of the wound healing disorder. Microbial growth must be at a non-critical level before the wound can heal. Cleaning and debridement are therefore crucial for healing of chronic wounds. If healing is not possible, the goal of modern wound treatment is to optimally support the body's self-healing powers and achieve good quality of life in spite of the impairment.
The German S3 guidelines on wound management2 for chronic wounds by topical therapy in patients with peripheral arterial occlusive disease (PAOD), diabetes and chronic venous insufficiency have not been updated since 2017. The authors recommend the use of antiseptic wound treatment in combination with mechanical wound cleansing in cases of suspected pathogen-related inflammation. Modern wound management uses this measure to remove local inflammation caused by microorganisms and prevent the spread of pathogens within the body through antiseptics.
Professional wound treatment requires materials that are precisely calibrated to the wound. The S3 guidelines on wound management2 contain an algorithm on “wound dressings”. This also looks at how to successfully select adequate materials for wound management. The wound management guidelines contain important information on both outpatient and inpatient wound management. This is because modern wound management is very complex and is generally based on an interdisciplinary approach that prioritises the individual requirements of the patient.
Post-operative wound infections are a common complication of surgical interventions. There are not only associated with increased mortality and extended periods of hospitalisation but also enormous costs to the healthcare system.
Find out more about preventive measures to stop post-operative infections.
octenisept® Active substances: octenidine dihydrochloride, phenoxyethanol (Ph.Eur.). Composition: 100 g solution contain: 0.1 g octenidine dihydrochloride, 2.0 g phenoxyethanol (Ph.Eur.). Other ingredients: cocamidopropylbetaine, sodium D gluconate, glycerol 85%, sodium chloride, sodium hydroxide, purified water. Indications: For repeated, short-term antiseptic treatment of mucous membranes and adjacent tissues prior to diagnostic and surgical procedures - in the ano-genital region including the vagina, vulva and glans penis as well as prior to bladder catheterization - in the oral cavity. For short-term supporting therapy of interdigital mycotic infections and adjuvant antiseptic wound treatment. Contraindications: octenisept® may not be used in cases of hypersensitivity to any of the components of the preparation. octenisept® should not be used for rinsing the abdominal cavity (e.g. intra-operatively) or the bladder, nor the tympanic membrane. Undesirable effects: rare: burning, redness, itching and warmth at the application site, very rare: allergic contact reaction, e.g. temporary redness at the application site; frequency unknown: after lavage of deep wounds with a syringe, persistent edema, erythema and also tissue necrosis have been reported, in some cases requiring surgical revision. Rinsing of the oral cavity may cause a transitory bitter sensation. Revision 11/22
To prevent possible tissue injury, the product must not be injected into the deep tissue using a syringe. The product is intended for superficial use only (application by swab or spray pump).
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1 Dissemond J et al., Initiative Chronische Wunde 2020
2 Deutsche Gesellschaft für Wundheilung und Wundbehandlung e. V. (DGfW). Kurzfassung S3-Leitlinie „Lokaltherapie chronischer Wunden bei Patienten mit den Risiken periphere arterielle Verschlusskrankheit, Diabetes mellitus, chronische venöse Insuffizienz“, 2014, Entwurfsfassung 2