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Wound care fundamentals
Audience: nurses-allied, students-learners ยท Review state: published
How wounds heal
Wound healing moves through overlapping phases: bleeding stops, inflammation clears debris and defends against infection, new tissue grows to fill the gap, and the scar remodels and strengthens over months. Clinical references on wound care build every intervention around supporting that sequence rather than interrupting it.
Healing by first intention, clean edges brought together, as in a closed surgical wound, is faster and neater than healing by second intention, where an open wound fills in from the base.
Assessment before dressing
Every dressing decision follows an assessment: the wound's size, depth and edges; the tissue in its bed; the amount and character of exudate; the condition of surrounding skin; and signs of infection, spreading redness, increasing pain, pus, odor or fever.
The patient's own factors matter as much as the wound: diabetes, poor circulation, smoking, malnutrition and certain medicines all slow healing and change the plan.
Dressing principles
The modern principle is moist healing: a wound kept moist, not wet and not dry, heals fastest. Dressing choice follows the exudate, absorbent foams for wet wounds, hydrating gels for dry ones, with barrier protection for the surrounding skin.
Dressings are changed at intervals that balance moisture management against disturbance, and every change is a fresh assessment, not a mechanical task.
Escalation and referral
Wounds that stall, worsen or show infection need escalation: spreading cellulitis, systemic signs, exposed deeper structures, or no progress over two to four weeks despite correct care all warrant review by a wound specialist or the surgical team.
Documentation with measurements and photographs where permitted tracks progress objectively, and patient teaching, keep the dressing dry, do not pick, report specified warning signs, is part of every episode of care.
Limitations
Educational reference for care staff and students; it does not replace institutional protocols or wound-specialist assessment.