Goal: After nursing Interventions, improved wound healing:
- Luka shrink in size and increase in granulation tissue.
- Note the characteristics of the wound: determine the size and depth of the wound, and the classification of the influence ulcers
- Note the characteristics of the fluid that comes out secret
- Clean with a liquid anti-bacterial
- Rinse with 0.9% NaCl fluid
- Perform nekrotomi, if necessary
- Perform the appropriate tampon
- With sterile gauze dressing as needed
- Make dressing
- Maintain a sterile dressing technique when performing wound care
- Observe any changes in the packing
- Compare and note any changes in the wound
- Give position to avoid pressure
Assessment of injuries, will be more realible done by the same caregiver in the same position and the same techniques.