23. Skin Care Around the Wound

Caring for the skin around the wound is just as important as treating the wound itself. The surrounding skin, also known as periwound skin, can easily be overlooked but is crucial for proper wound healing. The skin surrounding the wound can be affected by a number of factors, including maceration, infection, trauma, and exposure to wound exudate. Therefore, protecting and maintaining periwound skin integrity is essential for preventing further complications and promoting wound healing.

First, it is important to understand what periwound skin is. This is the skin surrounding the immediate wound, usually within 4 cm of the wound edge. This skin can be affected by the wound environment and exudate, which is the fluid that leaks from the wound. The exudate can cause maceration, which is the softening and discoloration of the skin caused by prolonged exposure to moisture. This can make the skin more susceptible to damage and infection.

To protect the periwound skin, the following steps must be followed:

1. Cleaning: The skin around the wound should be cleaned regularly to remove any exudate or debris. Cleaning should be done with a mild, non-irritating cleanser to prevent damage to the skin. Warm water and mild soap are usually sufficient to clean the skin. Avoid using strong antiseptics as they can damage the skin and delay healing.

2. Drying: After cleaning, the skin must be dried completely. Excessive moisture can cause maceration and increase the risk of infection. Use a clean, dry towel to gently dry the skin, avoiding rubbing or scratching.

3. Protection: Apply a barrier cream or ointment to the skin to protect it from wound exudate. The barrier cream should be water-based to allow the skin to breathe. Avoid petroleum-based products as they can interfere with the skin's ability to absorb oxygen, which is crucial for healing.

4. Regular Check: Periwound skin should be checked regularly for signs of deterioration such as redness, swelling, pain or maceration. If there are signs of infection, such as pus or a fever, seek medical attention immediately.

Also, it is important to remember that the skin around the wound can be sensitive and can be easily damaged by adhesives or dressings. Therefore, when applying or removing bandages, be gentle and careful to avoid causing further damage to the skin. If the skin is very sensitive, it may be helpful to use a silicone bandage, which is gentler on the skin.

In short, care for the skin around the wound is an essential component of wound care. By keeping your periwound skin clean, dry, and protected, you can help prevent complications and promote wound healing. Remember, every wound and every skin is unique, so it's important to work with a healthcare professional to develop a care plan tailored to your individual needs.

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47Ethics and Legality in Wound Care

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