LEARNING OUTCOME AND OBJECTIVES:  Upon completion of this continuing education course, you will demonstrate an understanding of wound assessment and management for patients with acute and chronic wounds in various clinical settings. Specific learning objectives to address potential knowledge gaps include:

• Describe the role of the skin.
• Discuss the types of wounds and the wound healing process.
• List the steps in treating acute wounds.
• Explain what is included in a detailed wound assessment.
• Summarize the various wound cleansing techniques and dressing options.
• Recognize the signs and symptoms of wound infection.
• Identify impediments to wound healing.
• Discuss wound care for specific types of wounds and special populations.
• Describe advanced wound care treatment modalities.
• Review patient and caregiver wound care education.

INTRODUCTION

The skin is the largest organ in the human body, comprising approximately 15% of total adult body weight. The skin maintains our internal environment while protecting us from the external environment. It allows us to experience a wide range of stimuli, from pleasure to pain.

A break in the continuity of the skin surface is the first step in the formation of a wound and provides a potential portal of entry for infection. A wound can be as simple as a surface abrasion, or it can be an extensive, life-threatening destruction of tissue that reaches down to and includes the internal organs of the body.

While the healing process is basically the same for all wounds, there are many extenuating factors that will either expedite or impede healing.

Wound care is not exclusive to any one healthcare profession. Successful outcomes are achieved when an interdisciplinary team approach is used, calling on the expertise of many different clinicians and employing many different treatment modalities—from simple dressings to advanced treatments such as negative-pressure wound therapy and hyperbaric oxygen therapy.

Clinicians encounter wounds in every healthcare setting, from the penetrating gunshot wound that is rushed to the emergency department, to acute and chronic wounds that need to be treated in the acute-care hospital setting, outpatient clinics, skilled nursing facilities, hospice care, and in-home care.

Overall, chronic wound care is estimated to cost around $20 billion annually, and healthcare clinicians are called upon to provide cost-effective, state-of-the-art care of increasingly complex wounds.

• Approximately 2% of the American population are affected by nonhealing chronic wounds (Sen, 2021).
• 6.7 million people have nonhealing chronic wounds of a lower extremity (UT Health East Texas, 2022).
• An estimated 2 million new cases of venous ulcers occur annually in the United States (WOCN, 2022).
• Chronic venous disease is the seventh most frequently occurring chronic condition, and it is the determinative cause in 95% of lower extremity ulcers (Baranoski & Ayello, 2020).