Table Of Contentthe care of wounds t
A GUIDE FOR NURSES
h
FOURTH EDITION e
Carol Dealey c
a the care of
“This is an excellent text book…I have no reservation in recommending it” r
Journal of Wound Care e
“The photographs provide good illustrations of a variety of wounds and o
problems: ideal for nurses with a basic knowledge of wound management” f
wounds
Professional Nurse
w
The Care of Wounds addresses all aspects of holistic wound management. The
o
fourth edition of this successful clinical text continues to reflect current research and
u
evidence based practice, while incorporating the considerable developments which
n
have occurred in wound care practice since the publication of the previous edition.
d
This book includes chapters on the physiology of wound healing, general principles of
wound management, wound management products, and the management of patients s
with both acute and chronic wounds. Superbly illustrated with full colour illustrations
F
throughout, The Care of Wounds is of value to all nurses and healthcare professionals O
working in the field of tissue viability and wound healing. U A G U I D E F O R N U R S E S
R
T
• Comprehensive and clinically oriented
H
• Examines best practice in wound management E
D
• Incorporates national and international clinical guidelines where applicable IT FOURTH EDITION
I
• Superbly illustrated with full colour throughout O
N
Dr Carol Dealey is Senior Research Fellow at University Hospital Birmingham NHS D
Carol Dealey
Foundation Trust. She is a Council Member of the Tissue Viability Society and has e
served on the Boards of both the European Wound Management Society and the a
European Pressure Ulcer Society. l
e
y
Cover design: Meaden Creative
Cover images: Images 1, 2 and 3 courtesy of Carol Dealey. Image 4 © iStockphoto
ISBN 978-1-4051-9569-0
9 781405 195690
dealey_9781405195690_pb.indd 1 2/12/11 15:27:28
The Care of Wounds
A Guide for Nurses
In memory of my husband
The Care of Wounds
A Guide for Nurses
FOURTH EDITION
Carol Dealey
PhDMA BSc (Hons) RGN RCNT
University Hospital Birmingham
NHS Foundation Trust and University of Birmingham, UK
Thiseditionfirstpublished2012(cid:1)2012byCarolDealey
Wiley-BlackwellisanimprintofJohnWiley&Sons,formedbythemergerofWiley’s
globalScientific,TechnicalandMedicalbusinesswithBlackwellPublishing.
Registeredoffice: JohnWiley&Sons,Ltd,TheAtrium,SouthernGate,Chichester,West
Sussex,PO198SQ,UK
Editorialoffices: 9600GarsingtonRoad,Oxford,OX42DQ,UK
TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK
2121StateAvenue,Ames,Iowa50014-8300,USA
Fordetailsofourglobaleditorialoffices,forcustomerservicesandforinformation
abouthowtoapplyforpermissiontoreusethecopyrightmaterialinthisbookplease
see our website at www.wiley.com/wiley-blackwell.
Therightoftheauthortobeidentifiedastheauthorofthisworkhasbeenassertedin
accordancewiththeUKCopyright,DesignsandPatentsAct1988.
Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrieval
system,ortransmitted,inanyformorbyanymeans,electronic,mechanical,
photocopying,recordingorotherwise,exceptaspermittedbytheUKCopyright,
DesignsandPatentsAct1988,withoutthepriorpermissionofthepublisher.
Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedas
trademarks.Allbrandnamesandproductnamesusedinthisbookaretradenames,
servicemarks,trademarksorregisteredtrademarksoftheirrespectiveowners.The
publisherisnotassociatedwithanyproductorvendormentionedinthisbook.This
publicationisdesignedtoprovideaccurateandauthoritativeinformationinregardto
thesubjectmattercovered.Itissoldontheunderstandingthatthepublisherisnot
engagedinrenderingprofessionalservices.Ifprofessionaladviceorotherexpert
assistanceisrequired,theservicesofacompetentprofessionalshouldbesought.
LibraryofCongressCataloging-in-PublicationData
Dealey,Carol.
Thecareofwounds:aguidefornurses/CarolDealey.–4thed.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN-13:978-1-4051-9569-0(pbk.:alk.paper)
ISBN-10:1-4051-9569-X(pbk.:alk.paper)
I. Title.
[DNLM: 1. WoundsandInjuries–nursing. 2. WoundHealing–physiology. WY
154.2]
LCclassificationnotassigned
617.1–dc23
2011032157
AcataloguerecordforthisbookisavailablefromtheBritishLibrary.
Setin9.5/12.5ptPalatinobyThomsonDigital,Noida,India
1 2012
Contents
Preface vii
1 Thephysiologyofwoundhealing 1
Introduction 1
Definitionsassociatedwithwounds 1
Thestructureoftheskin 2
Woundhealing 3
Impairedwoundhealing 9
Conclusion 12
2 Themanagementofpatientswithwounds 15
Introduction 15
Physicalcare 15
Psychologicalcare 39
Spiritualcare 45
3 Generalprinciplesofwoundmanagement 61
Introduction 61
Woundassessment 61
Managingwounds 77
Documentation 85
Evaluatingthedressing 86
4 Woundmanagementproducts 93
Introduction 93
Thedevelopmentofdressingsthroughtheages 93
Traditionaltechniques 100
Theuseoflotions 102
Clinicallyeffectivewoundmanagementproducts 108
Modernwoundmanagementproducts 110
5 Themanagementofpatientswithchronicwounds 127
Introduction 127
Thepreventionandmanagementofpressureulcers 127
Themanagementoflegulcers 149
Diabeticfootulcers 165
Themanagementoffungatingwounds 170
v
vi Contents
6 Themanagementofpatientswithacutewounds 185
Introduction 185
Thecareofsurgicalwounds 185
Traumaticwounds 199
Theburninjury 205
Radiationreactions 216
7 Theorganisationofwoundmanagement 227
Introduction 227
Managingwoundsinthecommunity 227
Nursespecialistsinwoundcare 228
Multiprofessionalwoundcare 229
Woundhealingcentres 230
Conclusions 230
Index 233
Preface
Since writing the previous edition of this book there have been many
developments in wound care, especially an increase in the number of
guidelines available to healthcare professionals. There is also increasing
recognitionoftheimportanceofmultiprofessionalworking.Theadvances
incommunicationmeanthatwearemuchmoreawareofwhatishappening
around the world. I hope that I have reflected some of this in this new
editionofTheCareofWoundsandthatthisbookwillbeofusetothoseofyou
providingcaretopatientswithwounds.
CarolDealey
vii
