N220 chpter 31

Acute and Chronic Wounds Acute

Acute and Chronic Wounds Acute wounds, such as surgical incisions, usually heal within days to weeks. The wound edges are well approximated (edges meet to close skin surface) and the risk of infection is low. Acute wounds usually progress through the healing process without interruption. Chronic wounds, in contrast, do not progress through the normal sequence of repair. The healing process is impeded. The wound edges are often not approximated, the risk of infection is increased, and the normal healing time is delayed (>30 days). Chronic wounds remain in the inflammatory phase of healing (discussed in the next section). Chronic wounds include any wound that does not heal along the expected continuum, such as wounds related to diabetes, arterial or venous insufficiency, and pressure injuries.

Open and Closed Wounds

An open wound occurs from intentional or unintentional trauma. The skin surface is broken, providing a portal of entry for microorganisms. Bleeding, tissue damage, and increased risk for infection and delayed healing may accompany open wounds. Examples include incisions and abrasions. A closed wound results from a blow, force, or strain caused by trauma such as a fall, an assault, or a motor vehicle crash. The skin surface is not broken, but soft tissue is damaged, and internal injury and hemorrhage may occur. Examples include ecchymosis and hematomas.