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Clinical
Quick Reference Guide
Recommendations for Practice: Preparing the Wound Bed
- Assess the patient for adequate blood supply and host factors for
healability.
- Assess and monitor the wound history and physical characteristics
(location, size, base, exudate, the surrounding skin, staging, and pain).
- Correct treatable causes of tissue damage.
- Provide education and support for patient-centred care to increase
compliance.
- Debride healable wounds, removing necrotic and nonviable tissue.
- Assess the wound for bacterial balance and infection.
- Cleanse wounds with normal saline or water. The use of topical antiseptics
should be reserved for wounds that are nonhealable or those in which
the local bacterial burden is a greater concern than the stimulation
of healing.
- If MRSA is present, assess the patient for colonization or infection.
Select appropriate topical and/or systemic agent for treatment.
- Use only nonsensitizing topical antibacterial agents for local symptoms
and signs of infection or increased bacterial burden.
- Use systemic antibiotics if symptoms or signs of infection extend
beyond wound margin or the ulcer probes to bone.
- Select appropriate dressings for local moisture balance to stimulate
granulation tissue and re-epithelialization.
- Evaluate expected rate of wound healing to determine if treatment
is optimal.
- Use biological agents when other factors have been corrected and healing
does not progress at the expected rate.
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