Wundversorgung zu Hause: Ratgeber für Angehörige

Wound care (also wound treatment or wound management) refers to all measures that contribute to the cleaning, treatment, and healing of a wound. The goal is to prevent infections, promote healing, and minimise scarring.

When providing initial wound care, the following basic rules apply:

• Clean hands: Wash your hands thoroughly or wear disposable gloves before treating a wound
• Stop bleeding: Press a sterile compress onto the wound to stop the bleeding
• Clean the wound: Gently rinse the wound with clean water or sterile saline solution. Remove visible foreign bodies
• Disinfection: Use a suitable wound disinfectant (e.g. Octenisept or Betadine)
• Cover: Cover the wound with a sterile plaster or wound dressing

When is professional help needed? For deep, heavily bleeding or contaminated wounds, bite wounds, suspected foreign bodies in the wound, or if your last tetanus vaccination was more than 10 years ago, you should consult a doctor.

Primary wound healing (also healing by first intention) is the ideal form of wound healing. It occurs in clean, smooth wounds where the wound edges lie close together, such as in cut wounds or surgical sutures.

Characteristics of primary wound healing:

• The wound edges lie directly against each other or are held together by sutures, staples, or adhesive strips
• The wound heals relatively quickly (usually within 6-8 days)
• Only a small amount of scar tissue forms
• The risk of infection is low, provided the wound is kept clean
• The cosmetic result is usually good

Requirements for primary wound healing are: smooth wound edges, no foreign bodies in the wound, good blood circulation in the surrounding tissue, and no infection.

Secondary wound healing (healing by second intention) occurs in open wounds where the wound edges do not lie directly against each other. This applies to abrasions, burns, pressure ulcers (decubitus), or infected wounds.

In secondary wound healing, the wound goes through three phases:

• Cleansing phase (exudation phase): The body cleanses the wound of dead tissue, bacteria, and foreign bodies. The wound weeps heavily
• Granulation phase: New connective tissue (granulation tissue) fills the wound from the bottom up. The tissue is pink to red and well supplied with blood
• Epithelialisation phase: New skin cells grow from the wound edge over the granulation tissue and close the wound

Secondary wound healing takes significantly longer than primary healing — weeks to months depending on wound size. More scar tissue forms and the cosmetic result is usually less good. Especially in elderly or care-dependent people with impaired circulation or diabetes, secondary wound healing can be significantly delayed.

Aseptic (germ-free) wound care is a central component of professional wound treatment. The aim is to prevent the introduction of germs into the wound and thus prevent infections. Aseptic wound care is used for clean, non-infected wounds.

Basic principles of aseptic wound care

• Hand disinfection: Thorough disinfection of hands before and after every dressing change
• Sterile materials: Use of sterile compresses, wound dressings, and instruments (tweezers, scissors)
• Non-touch technique: The wound and the wound-contact sides of dressings must not be touched with fingers
• Sterile work surface: Prepare materials on a clean, disinfected surface

Required materials

• Sterile compresses and wound dressings
• Wound disinfectant and hand disinfectant
• Sterile tweezers
• Disposable gloves (non-sterile for external work, sterile for wound contact)
• Fixation material (plasters, gauze bandages, fixation fleece)
• Disposal container for used materials

Not every wound can or should be treated by yourself. Professional wound treatment is required when the following warning signs appear:

• Increasing redness and swelling: If the redness spreads around the wound, this may indicate an infection
• Pus formation: Yellowish-green or foul-smelling discharge from the wound
• Fever: Elevated body temperature can be a sign of a systemic infection
• Red streaks: Red lines leading away from the wound indicate lymphangitis (blood poisoning) — see a doctor immediately!
• Delayed healing: If a wound shows no tendency to heal after 2-3 weeks
• Chronic wounds: Wounds that persist for more than 8 weeks (e.g. decubitus, leg ulcer)
• Heavy or unstoppable bleeding: If the bleeding does not stop despite pressure

Especially for care-dependent persons, chronic wounds, decubitus (pressure ulcers), and poorly healing wounds should always be assessed and treated by a professional. Spitex offers professional wound management at home.