PLASTERS - HELP WITH ONE OF THE MOST COMMON TYPES OF WOUNDS (EPIDERMAL ABRASIONS)

A wound is a break in the anatomical continuity of tissues or their damage under the action of a damaging factor. The most important damaging factors include mechanical, thermal, chemical injury and radiant energy.

 

An abrasion is superficial damage to the skin caused by contact with a rough surface. The top layer of the skin is damaged. At the site of the defect, serous exudate with a small admixture of blood is present. Although the injury is shallow, abrasions are very painful and sometimes difficult to heal, which is often due to contamination remaining in the wound after the injury. They can become the cause of a serious infection. It is important to treat them properly. The management of minor epidermal abrasions is presented below

• Wash and rinse the wound using sterile saline, mild disinfectant, or tap water. The latest standards do not recommend the use of hydrogen peroxide or spirits for wound care. Do not rub a cotton ball, gauze pad, or towel over the area of skin damage.
• Washing and disinfecting the wound edges with aseptic agents that do not lead to tissue irritation or delayed healing
• Apply a dry sterile dressing - in the case of abrasions a dressing plaster is a suggested solution

Usually these measures and proper care are sufficient for self-healing of the wound within a few days. Unfortunately, sometimes even small and inconspicuous injuries can be very difficult to heal. It is always worth paying attention to whether the patient is at risk for a poorly healing wound. Attention should be paid to the possibility of infection as evidenced by the appearance of redness, skin warming, swelling, pain, and discharge/pus. If these symptoms occur, it is important to see a doctor or go to the emergency room if a tetanus vaccine needs to be administered, the wound edges need to be sutured, or a foreign body needs to be removed from the wound.

The wound healing process involves complex chemical reactions of locally active, biologically active substances and physical phenomena that include changes in skin elasticity and increased tensile strength. Three basic stages of wound healing can be distinguished:

• The exudation phase
• The cleansing phase
• The proliferative phase
• The remodelling phase

In the exudative phase, a local inflammatory reaction occurs, which usually lasts 4-7 days and is characterized by exudation and swelling. In normal healing wounds the exudate takes on a light, yellow-pink color. The presence of exudate positively influences the wound healing process. Inflammatory cells (neutrophils, monocytes, lymphocytes) appear, protecting the defect from contamination and pathogenic microorganisms. In the cleansing phase, there is an increased number of macrophages that eliminate incoming dirt and bacteria. Proper wound healing occurs in the proliferative phase lasting 3 to 6 weeks, where fibroblasts from adjacent tissues are activated and vascularization occurs.

Fibroblasts have the ability to produce proteolytic enzymes that support tissue regeneration and produce collagen fibers which are the basis for building and regenerating connective tissue, rebuilding damaged blood vessels and creating a scar at the site of injury. Thanks to this phase, the wound shrinks and epithelialization occurs. The final stage of wound healing is wound remodeling, in which collagen remodeling occurs from 3 weeks to several years.

Last update: 3/25/2021