Wound Care
Wound care for geriatric adults By: Leah Applebaum
Different Types of Wounds
Contents
Stages of Healing
Major Considerations
Bacteria Balance
Necrotic Tissue
Moisture Balance
Treatments/Dressings
Game Time!
What is a wound?
Red Cross defines a wound as an injury that results when tissue of the body is damaged. This could be open or closed, both often result in bleeding.
+ info
4 Stages of Healing
Homeostasis
Proliferation
- first response- vasoconstriction - coagulation - lasts around 2 days
- angiogenisis- relies on fibroblast synthesis and collagen production
Maturation
Inflammation
- vasodilation- prevents infection - redness, swelling, heat, pain
- can last up to 2 years- restores durability and elasticity
Major Conciderations
Bacterial Balance
All wounds have bacteria, but how much?
There are three major considerations when it comes to treating a chronic wound. They are ensuring there is a bacteria balance, dealing with necrotic tissue, and determining if the moisture balance is correct.
Necrotic Tissue
Impedes the healing of all wounds.
Moisture Balance
Ensure the wound is not too dry or too wet.
Bacterial Balance
Bacterial balance is important in chronic wounds. All wounds contain some bacteria, but if there is too much it leads to infections that could prevent the wound from healing. Signs of an infection include pus or an odor coming from the wound. If the infection is superficial it can be treated with topical agents like hydrogen peroxide. If the infection is in the deep tissue they will be treated with either oral or IV antibiotics.
Necrotic Tissue
Necrotic tissue is a build up of dead tissue and cell debris. It will delay the healing process and must be removed before any further healing will occur. There are two types of necrotic tissues: eschar and slough. The best way to prevent necrotic tissue is to ensure the wound is hydrated. It is treated by first treating the underlying cause by administering antibiotics or antivenom medictions, then remove the necrotic tissue.
Moisture Balance
The best wound environment is something that is still being studied today. In the past it was thought that the best wound envirnoment was a dry environment, however, recent research says that healing is accelerated in a moist envirnment. If the envirnoment is too moist this could lead to maceration. The current goal treatment is to evaluate the environment of the wound and adjust it to the ideal amount of moisture.
Treatment and Dressing
Reduce Moisture
Increase Moisture
NPWT
Negative pressure wound therapy is when a foam or gauze dressing is applied to the wound using an airtight seal. Then either continuous or intermittent negative pressure is used to make the wound heal faster by removing excess interstitial fluid, improving blood flow, stimulating angiogenesis and increasing tissue perfusion.
- Calcium alginate dressings- Foam - Hydrofiber - Composite dressings - Synthetic skin graft
- Transparent films- Hydrocolloids - Hydrogel dressings
+ Info
+ Info
2 Truths and 1 Lie
2 Truths and 1 Lie
2 Truths and 1 Lie
Thank You
Sources:
1. Kelso M. Necrotic wounds. WoundSource. Accessed November 6, 2025. https://www.woundsource.com/patientcondition/necrotic-wounds#:~:text=Necrosis%20is%20the%20death%20of,this%20is%20known%20as%20gangrene. 2. Hayashi S. Wound healing is a complex process encompassing a number of overlapping... | download scientific diagram. Research Gate. Accessed November 6, 2025. https://www.researchgate.net/figure/Wound-healing-is-a-complex-process-encompassing-a-number-of-overlapping-phases-including_fig2_233976352. 3. Wcw-Admin-Support. Types of chronic non-healing wounds & how to treat them. West Coast Wound & Skin Care. March 19, 2024. Accessed November 6, 2025. https://westcoastwound.com/types-of-non-healing-wounds/. 4. Wounds: Symptoms, types, and first aid. Red Cross. Accessed November 6, 2025. https://www.redcross.org/take-a-class/resources/learn-first-aid/wounds?srsltid=AfmBOop6LceL2uyCO0k83PDmITVmMGXmlhFXH8shIgzr8gZ3Rd53iiZQ. 5. Wound Evolution. The four stages of wound healing. Wound Evolution - Wound Care and Hyperbaric Medicine: Wound Care Specialists. November 6, 2025. Accessed November 6, 2025. https://www.woundevolution.com/blog/the-four-stages-of-wound-healing/. Beebe M, Gist, Tio-Matos, Cameron, Beebe M, Falzgraf. Wound care in the geriatric client. Clinical Interventions in Aging. Published online June 2009:269. doi:10.2147/cia.s4726
Types of Non-Healing Wounds
Types of Healing Wounds
- Pressure ulcers- prolonged pressure on an area - Arterial ulcers- damage to the arteries - Venous ulcers- damage to blood circulation, mostly around the ankles - Neuropathic ulcers- sensory - insensate foot - motor - deformities in the foot - autonomic - decrease in sweat
- Abrasion - scrapes or burns - Laceration- cuts or skin splits - Avulsion- skin is torn away - Puncture- a foregin object pierces the skin
Transparent film dressing
Hydrogel dressings
Hydrocolloids
Calcium alginate dressings
Foam dressings
Hydrofiber dressings
Composite dressings
Synthetic skin grafts
Wound Care
Leah Apple
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Transcript
Wound Care
Wound care for geriatric adults By: Leah Applebaum
Different Types of Wounds
Contents
Stages of Healing
Major Considerations
Bacteria Balance
Necrotic Tissue
Moisture Balance
Treatments/Dressings
Game Time!
What is a wound?
Red Cross defines a wound as an injury that results when tissue of the body is damaged. This could be open or closed, both often result in bleeding.
+ info
4 Stages of Healing
Homeostasis
Proliferation
- first response- vasoconstriction - coagulation - lasts around 2 days
- angiogenisis- relies on fibroblast synthesis and collagen production
Maturation
Inflammation
- vasodilation- prevents infection - redness, swelling, heat, pain
- can last up to 2 years- restores durability and elasticity
Major Conciderations
Bacterial Balance
All wounds have bacteria, but how much?
There are three major considerations when it comes to treating a chronic wound. They are ensuring there is a bacteria balance, dealing with necrotic tissue, and determining if the moisture balance is correct.
Necrotic Tissue
Impedes the healing of all wounds.
Moisture Balance
Ensure the wound is not too dry or too wet.
Bacterial Balance
Bacterial balance is important in chronic wounds. All wounds contain some bacteria, but if there is too much it leads to infections that could prevent the wound from healing. Signs of an infection include pus or an odor coming from the wound. If the infection is superficial it can be treated with topical agents like hydrogen peroxide. If the infection is in the deep tissue they will be treated with either oral or IV antibiotics.
Necrotic Tissue
Necrotic tissue is a build up of dead tissue and cell debris. It will delay the healing process and must be removed before any further healing will occur. There are two types of necrotic tissues: eschar and slough. The best way to prevent necrotic tissue is to ensure the wound is hydrated. It is treated by first treating the underlying cause by administering antibiotics or antivenom medictions, then remove the necrotic tissue.
Moisture Balance
The best wound environment is something that is still being studied today. In the past it was thought that the best wound envirnoment was a dry environment, however, recent research says that healing is accelerated in a moist envirnment. If the envirnoment is too moist this could lead to maceration. The current goal treatment is to evaluate the environment of the wound and adjust it to the ideal amount of moisture.
Treatment and Dressing
Reduce Moisture
Increase Moisture
NPWT
Negative pressure wound therapy is when a foam or gauze dressing is applied to the wound using an airtight seal. Then either continuous or intermittent negative pressure is used to make the wound heal faster by removing excess interstitial fluid, improving blood flow, stimulating angiogenesis and increasing tissue perfusion.
- Calcium alginate dressings- Foam - Hydrofiber - Composite dressings - Synthetic skin graft
- Transparent films- Hydrocolloids - Hydrogel dressings
+ Info
+ Info
2 Truths and 1 Lie
2 Truths and 1 Lie
2 Truths and 1 Lie
Thank You
Sources:
1. Kelso M. Necrotic wounds. WoundSource. Accessed November 6, 2025. https://www.woundsource.com/patientcondition/necrotic-wounds#:~:text=Necrosis%20is%20the%20death%20of,this%20is%20known%20as%20gangrene. 2. Hayashi S. Wound healing is a complex process encompassing a number of overlapping... | download scientific diagram. Research Gate. Accessed November 6, 2025. https://www.researchgate.net/figure/Wound-healing-is-a-complex-process-encompassing-a-number-of-overlapping-phases-including_fig2_233976352. 3. Wcw-Admin-Support. Types of chronic non-healing wounds & how to treat them. West Coast Wound & Skin Care. March 19, 2024. Accessed November 6, 2025. https://westcoastwound.com/types-of-non-healing-wounds/. 4. Wounds: Symptoms, types, and first aid. Red Cross. Accessed November 6, 2025. https://www.redcross.org/take-a-class/resources/learn-first-aid/wounds?srsltid=AfmBOop6LceL2uyCO0k83PDmITVmMGXmlhFXH8shIgzr8gZ3Rd53iiZQ. 5. Wound Evolution. The four stages of wound healing. Wound Evolution - Wound Care and Hyperbaric Medicine: Wound Care Specialists. November 6, 2025. Accessed November 6, 2025. https://www.woundevolution.com/blog/the-four-stages-of-wound-healing/. Beebe M, Gist, Tio-Matos, Cameron, Beebe M, Falzgraf. Wound care in the geriatric client. Clinical Interventions in Aging. Published online June 2009:269. doi:10.2147/cia.s4726
Types of Non-Healing Wounds
Types of Healing Wounds
- Pressure ulcers- prolonged pressure on an area - Arterial ulcers- damage to the arteries - Venous ulcers- damage to blood circulation, mostly around the ankles - Neuropathic ulcers- sensory - insensate foot - motor - deformities in the foot - autonomic - decrease in sweat
- Abrasion - scrapes or burns - Laceration- cuts or skin splits - Avulsion- skin is torn away - Puncture- a foregin object pierces the skin
Transparent film dressing
Hydrogel dressings
Hydrocolloids
Calcium alginate dressings
Foam dressings
Hydrofiber dressings
Composite dressings
Synthetic skin grafts