Signs your wound is healing properly

Any break in the skin is a wound. Wound healing is a complex process that is completed in an organised manner. Every wound goes through typically 4 healing stages.

1. After a wound bleeds, a clot is formed making the basis of a scab (haemostasis).
2. Swelling, pain, redness and a clear discharge may occur during the wound repair stage (inflammation).
3. The next phase is where new tissue is formed and the wound starts to contract (proliferation).  
4. The final stage is phase over an extended period (up to 2 years) soon after the wound has closed up which involves repair and strengthening (remodelling or maturation).

Signs your wound is not healing properly

Different types of wounds require different treatment methods and if your wound healing process begins to slow or show negative signs it is important to seek help early.

• Increasing pain
• Discharge 
• Foul odour
• Redness or swelling
• Temperature
• Feeling unwell 

Why is my wound not healing?

If a wound does not heal within 4 weeks it can be defined as a non-healing wound (chronic).  The cause is most often found in untreated or unnoticed conditions that are underlying.  There may be more than one condition occurring at the same time which includes 

• Poor circulation
• Infection
• Oedema
• Inadequate nutrition
• Repetitive trauma to the wound 

How do I know if my wound is infected?

You should pay close attention to any negative signs and symptoms you are experiencing and alert your doctor as soon as possible to allow for early treatment without causing further complications and delays in healing. 

Signs of infection can be:

• Increase in pain instead of gradually improving
• Redness around the skin edges
• Heat around wound edges
• Swelling to the area
• Yellow ooze (pus) that may have an odour

Sometimes a swab (or sample) of the discharge is required to find out what germs are causing the infection. If you have an infection, it is important to seek medical advice as you may require antibiotics and more complex wound treatment.

How do I care for my wound?

Your surgeon, doctor or specialist wound care nurse will confirm the plan of care for your wound. The treatment plan will vary depending on whether your wound is a surgical incision, traumatic wound or another type of skin loss.  

• The deeper, larger, or dirtier a wound is, the more care it needs.
• Initially, it is best to limit movement that affects the area surrounding your wound to lower the chance of the wound opening up. 
• The wound must be kept clean and dirt free. 
• Do not pick the dressings or scabs 
• Keep the dressing dry and replace if it gets wet- most dressings are water-resistant and not water-proof and should be covered for showering
• Dressings and preferences vary with a wide variety of dressings and treatments available aiming for a specific goal.

How do I remove a stuck dressing?

The most effective way to remove a dressing that has adhered to the wound is to use a warm saline solution.

Dry dressings or gauze may stick to the wound as the wound fluid dries out.  To prevent this from occurring, using a non-adherent dressing may be advised.  Dressing choice is made based on the type of wound and amount of exudate.  Seek advice from your doctor or specialist wound care nurse if your wound is complex.

How often should I change a wound dressing?

It is very difficult to provide general recommendations of the frequency of dressing changes as this will vary according to the treatment plan. Check with your doctor or specialist wound care nurse.

As a general rule, a surgical incisional dressing should be left in place for at least 48 hours.
Some wounds, (such as an infected wound) may require daily or sometimes up to 4 times a day dressings, and other wounds maybe every few days to once a week.

To optimise wound healing a dressing is changed according to the amount of exudate or condition of the wound. “A week or a leak”!

How to shower with a wound dressing

Ensure you follow the instructions from your doctor in regard to showering with your wound. Showering following surgery will require the wound to be protected to prevent water from leaking into the dressing. Cover the dressing with a waterproof cover taking care to ensure the edges are secured.

Avoid having strong streams of water coming into contact with your wound and have a short shower.

Check the dressing after your shower and if it is wet it is advised that it is changed as soon as possible as this may increase the risk of germs entering the wound.

Where can I get help?

If you are concerned about a wound and not sure where to get help please see your GP as a starting point.

Resources available include specialist wound care nurses (a nurse that has completed further studies and has extensive experience in developing a treatment plan for complex and non-healing wounds) at most hospitals and some outpatient clinics. Community services are available for dressing care.