Essential Wound Care Guide for Family Caregivers

Learn to identify, treat, and care for wounds at home, and know when to seek medical attention to ensure your loved one’s health and safety.
Published on
May 31, 2024
Presented by Givers
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Do you remember falling off your bike when you were a kid? You probably scraped your knee or bruised your elbow. As a family caregiver, you will probably treat many minor wounds at home. But sometimes, an injury requires a medical professional or even a trip to the emergency room. So, what are the basics of identifying and treating a wound? And when do you need to worry about infection?

Understanding wounds and healing

A wound is a disruption in the integrity of the skin, which serves as the body's primary barrier against the external environment. When this barrier is compromised, it can range from minor abrasions to deep lacerations. Wounds can be categorized based on their severity and the mechanism of injury.

Types of wounds

Scrapes (abrasions)

Scrapes occur when the skin rubs against a rough surface, causing the outer layer to wear away. These wounds are usually superficial but can be painful and prone to infection if not properly cleaned and protected.

Cuts (lacerations)

Cuts are injuries caused by sharp objects like knives, glass, or metal. Proper care involves stopping the bleeding, cleaning the wound, and sometimes suturing to promote healing.

Punctures

Puncture wounds are caused by objects like nails, needles, or animal bites that penetrate the skin and underlying tissues. These wounds are often narrow and deep, making them susceptible to infections, including tetanus. Immediate and thorough cleaning is essential, and medical evaluation is often necessary.

Burns

Burns result from exposure to heat, chemicals, electricity, or radiation. They are classified by their depth and severity:

  • First-degree burns: Affect only the outer layer of the skin (epidermis), causing redness and pain.
  • Second-degree burns: Involve the epidermis and part of the dermis, leading to blistering and more intense pain.
  • Third-degree burns: Extend through the dermis and affect deeper tissues, potentially causing white or blackened, charred skin that may be numb due to nerve damage.

Bites

Bite wounds can be inflicted by insects, animals, or humans. These injuries can vary in severity, from minor punctures to extensive tissue damage. Bites are particularly concerning due to the risk of infection from bacteria present in the saliva of the biting organism. Rabies and other zoonotic diseases are additional risks associated with animal bites.

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Phases of wound healing

When someone hurts themselves, the body immediately begins fixing the problem. Wound healing has four main stages.

  1. Stage 1: Clot forms — Blood vessel walls tighten to slow blood flow. Special cells called platelets rush into the wound. Proteins in your blood act like glue, making platelets clump and seal the wound. Platelets form a clot to plug up the leak.
  2. Stage 2: Inflammation — The clot forms a scab, protecting the wound. White blood cells, the body's warriors, fight invasive germs. The area grows red, swollen, and warm – that's the body working hard. This stage lasts a few days.
  3. Stage 3: Rebuilding starts — Now that the fight is under control, rebuilding begins. Fresh blood cells bring oxygen and nutrients to heal the wound. Special messengers tell your loved one's body to make collagen, a protein that builds a strong foundation for new skin cells. You might see a scar form, but it should fade over time. This stage can take weeks.
  4. Stage 4: Brand new skin — The final stage focuses on making the new skin stronger and more flexible. Your loved one might feel tightness or itching as the new tissue takes hold. Depending on the wound size, healing can take days, months, or even years.

Factors that affect wound healing

Wound healing in aging adults is influenced by several critical factors. Understanding these factors can help caregivers provide better care for their loved ones. Here are the main factors that affect wound healing in aging individuals:

Infection

Infection is a concern for any open wound, but older adults are especially vulnerable due to a generally weaker immune system. Signs of infection include redness, pus, and fever. Infections can complicate and delay the healing process significantly. According to research, the immune response becomes less efficient with age, making it crucial to maintain strict hygiene and monitor wounds closely for any signs of infection.

Nutrition

Proper nutrition is vital for wound healing. Aging adults often face challenges with their diet, such as reduced appetite, difficulty chewing or swallowing, and certain dietary restrictions. Ensuring they have a balanced diet rich in proteins, vitamins (especially A and C), and minerals like zinc is essential. Protein is necessary for tissue repair, while vitamins and minerals support various aspects of the healing process.

Chronic diseases

Chronic conditions such as diabetes, cardiovascular diseases, and peripheral artery disease can significantly impair wound healing. Diabetes, for instance, affects blood circulation and can lead to neuropathy, reducing sensation in the affected area and making wounds less likely to heal properly. Effectively managing these conditions with the help of healthcare providers is crucial to improving wound healing outcomes.

Medications

Certain medications can impede the wound healing process. For instance, corticosteroids, often prescribed for inflammatory conditions, can suppress the immune response and delay healing. Statins, used to manage cholesterol, might cause increased bruising and slow tissue repair. Reviewing medications with healthcare providers to understand their potential impact on wound healing and adjust treatments if necessary is important.

Age

Wound healing naturally slows down with age due to several factors, including decreased skin elasticity, reduced collagen production, and slower cell regeneration. Aging skin is also more prone to tears and injuries, further complicating healing. Creating a safe environment, minimizing injury risks, and being patient and attentive to wound care can help manage these challenges.

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Treating a wound at home

Caregivers can treat minor wounds at home. However, seeing a doctor for deep wounds, heavy bleeding, or wounds from accidents improves outcomes and may save a loved one's life. If you're treating a wound at home, always wash your hands well before touching it. Then, gently clean the wound with clean water to remove dirt or debris. 

To stop bleeding, apply gentle pressure with a clean cloth for a few minutes. Finally, use a sterile bandage or dressing to keep the wound clean and moist. Call a doctor for professional advice if you don't know how to care for a wound.

Role of a family caregiver in wound care

Family caregivers play a crucial role in wound care by managing practical tasks and providing emotional support. They assess the wound's severity, clean and dress it, monitor for signs of infection, and ensure the patient receives proper nutrition and hydration.

Regular wound inspections, pain management, and maintaining communication with healthcare providers are essential duties. Caregivers must also recognize when professional medical help is needed, such as in cases of severe infection or non-healing wounds.

Caregivers also provide significant emotional support, offering reassurance and encouraging compliance with care routines. They maintain a clean and safe environment, educate the patient on proper wound care techniques, and document the care provided. By fulfilling these responsibilities, family caregivers significantly contribute to the healing process and overall well-being of their loved ones.

When to see a doctor

Sometimes, an injury doesn't heal with home treatment or shows signs of infection. It's crucial to recognize when to seek medical attention for your loved one. If any of the following signs are present, it’s time to visit the doctor or emergency room:

  • Redness spreads: If the redness around the wound is spreading, it could indicate an infection that requires medical treatment.
  • Pus or bad smell: The presence of pus or a foul odor from the wound is a clear sign of infection.
  • Increased pain: If the pain around the wound intensifies rather than decreases over time, it might indicate an underlying problem.
  • Swelling gets worse: Worsening swelling can be a sign of infection or other complications.
  • Fever: A fever may suggest that the body is fighting an infection.
  • Won't stop bleeding: If the wound continues to bleed despite applying pressure, it needs professional attention.
  • Deep or gaping wound: Deep cuts or wounds that are gaping open often require stitches or other medical interventions.
  • Numbness around wound: Numbness can indicate nerve damage, which needs to be evaluated by a healthcare professional.
  • Diabetes: If the individual has diabetes, they are at higher risk for complications, and wounds should be monitored closely.
  • Wound over a week old: Wounds that do not show signs of healing within a week need to be checked by a doctor.

Emergency situations

If your loved one exhibits any of the following severe symptoms, call 911 immediately:

  • Unconsciousness: If they are unconscious, seek emergency help without delay.
  • Severe pain or bleeding: Severe pain or uncontrolled bleeding requires immediate medical attention.
  • Visible broken bones: If there are visible signs of broken bones, urgent care is necessary.
  • Difficulty breathing: Inability to breathe properly is a medical emergency.

Additional considerations

  • Signs of shock: Pale, clammy skin, rapid breathing, or weakness can be signs of shock, requiring immediate medical intervention.
  • Underlying health conditions: Individuals with compromised immune systems or other chronic health conditions should seek medical advice sooner, as they may be more susceptible to complications.

Professional wound care

The doctor or hospital will provide your loved one with extensive medical care. Some types of treatment include: 

  • Hyperbaric oxygen therapy: Uses pure oxygen in a pressurized chamber to heal wounds faster.
  • Negative pressure wound therapy: Creates a gentle suction to help remove fluids and promote healing.
  • Autolytic debridement: Uses special dressings to moisten wounds and help remove dead tissue naturally.
  • Enzymatic debridement: Applies enzymes to break down dead tissue and clean wounds.
  • Compression therapy: Uses wraps or garments to reduce swelling and improve circulation.
  • Skin grafts: Transplants healthy skin from another body area to cover the wound.
  • Laser therapy: Uses concentrated light to stimulate healing and kill bacteria.

If you have questions about your loved one's care, talk to hospital staff about your concerns. Once your loved one is discharged from the hospital, you will need to follow a regime of wound care at home. Their physician will give you detailed instructions to help your loved one heal faster. 

A Note From Givers

We understand the dedication required for caregiving. You might be eligible to get paid for the care you provide through a Medicaid waiver with participant-direction. These programs allow Medicaid recipients to choose their caregivers, including family members, ensuring that those who need care can receive it from someone they trust. To find a program for which you might be eligible, please fill out this form or contact us for more information.

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