Wound Classification and Closure Methods

Study Notes

Superficial Wound: Trauma affects only the epidermis; often associated with sunburn.
Partial-thickness Wound: Involves the epidermis and dermis; examples include skin tears and blisters.
Full-thickness Wound: Extends through the epidermis and dermis into subcutaneous tissue.
Subcutaneous Wound: Extends beyond the integumentary structures into underlying bone, muscle, or tendons.

Primary Intention: Wound edges are reapproximated and closed using sutures, staples, or adhesives; commonly associated with surgical procedures.
Secondary Intention: Wound heals independently without closure; typically occurs with nonviable margins or infections.
Tertiary Intention: Wound is initially left open to resolve risk factors (e.g., edema or infection) before closure through primary intention.

Sharp Debridement: Involves surgical instruments to remove devitalized tissue or debris; effective for necrotic tissue, infections, or cellulitis; performed by physical therapists in most states.
Enzymatic Debridement: Utilizes topical agents for breaking down dead tissue.
Autolytic Debridement: Engages the body’s own mechanisms for tissue removal using moisture-retentive dressings; effective but slower healing, not for infected wounds.

Hyperbaric Oxygen Therapy: Involves inhalation of oxygen; indicated for conditions like osteomyelitis and diabetic wounds; contraindicated in certain health conditions such as cancer and pregnancy.

Alginates: Highly absorptive and moisture-retentive; ideal for partial or full-thickness wounds, especially infected ones, facilitating autolytic debridement.
Hydrocolloids: Retains moisture for healing; suitable for partial or full-thickness wounds, not recommended for infected wounds.
Hydrogels: Moisture-retentive, appropriate for superficial and partial-thickness wounds; not for heavily draining wounds.
Transparent Film: Breathable but water and bacteria-proof; intended for superficial or partial thickness wounds with minimal drainage; not for infected wounds.

Silver Dressings: Antimicrobial; effective on infected wounds like MRSA.
Pressure Garments: Essential for burn healing and scar remodeling; to be worn for 12-18 months post-injury.

Autograft: Tissue graft harvested from the same individual.
Allograft: Graft derived from another human (e.g., cadaver tissue).
Heterograft/Xenograft: Graft obtained from a different species (e.g., pig tissue).

Hydrofiber Dressing: Alginate-like dressings activated by moisture, suited for wounds with high exudate.
Usage Caution: Not appropriate for dry wounds.