Your wound has been left to close and heal naturally as your body knows how to heal itself.

Your wound has damaged the tiny blood vessels (capillaries) that bring oxygen and food to growing cells. To help your body heal itself, the wound needs to be kept warm and moist to allow the cells and tiny blood vessels to regrow.

Healing time

Healing time depends on your general health and age. It could take weeks or sometimes months to heal.

Dressings

A dressing will be used to protect your wound from further damage and to keep it warm and moist. Modern dressings are specially designed to last longer.

The dressing will only be changed when necessary to avoid damaging the repair work in your wound, as every time your dressing is changed it can take up to 90 minutes for the wound to warm up and start healing again.

Do not remove your dressing unless advised to do so because it will slow healing.

Cleaning your wound

To help your wound heal, your nurse will only clean your wound if it is very dirty or messy. Unnecessary cleaning can remove the body's natural cleansers and healing factors, and can damage repairing cells.

Growing cells are very delicate and antiseptics (Savlon, Dettol and similar products) are strong and may damage healing wounds.

Changing your wound dressing

You or a relative may be asked to perform your dressings between clinic appointments.

The items needed are:

• a clean surface
• gauze swab(s)
• lukewarm water run for 30 seconds before use, unless a cleansing solution has been provided
• forceps or probe (if deep cavity)
• dressing(s).

If necessary, dressings can be bought from a chemist, pharmacy or supermarket.

Dressing procedure

Step 1 - The person doing the dressing change must wash their hands with soap and warm water and dry thoroughly with a paper towel or clean towel. Alternatively, alcohol gel can be used, however hands must not be visibly dirty.

Step 2 - Remove soiled dressing(s) and dispose of them in normal household waste.

Step 3 - Gently irrigate wound(s) in the shower or under lukewarm tap water, unless a cleansing solution has been provided.

Step 4 - If a cleansing solution has been provided, use this as directed.

Step 5 - Pat area(s) dry with gauze swab(s) or kitchen towel.

Step 6 - The person doing the dressing change must wash their hands with soap and warm water and dry thoroughly with a paper towel or clean towel again. Alternatively, alcohol gel can be used, however hands must not be visibly dirty.

Step 7 - Please redress wound(s) with:

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Step 8 - If you have cavity wound(s), lightly lay the dressing into the wound cavity leaving a 2cm (1 inch) tail for easy removal. Use forceps or a probe if needed.

Step 9 - Cover with outer dressing(s).

Step 10 - The person doing the dressing change must wash their hands with soap and warm water and dry thoroughly with a paper towel or clean towel again. Alternatively, alcohol gel can be used, however hands must not be visibly dirty.

How often to change dressing(s)

Most dressings are designed to be left in place for up to seven days.

Change the dressing when it is marking 1cm (1/2 inch) from an edge, if it leaks, or sooner if directed by your healthcare professional.

Removal of your clips, stitches and steri-strips

You may have been referred to the wound clinic to have your clips, stitches (sutures) or steri-strips removed following a surgical procedure or a traumatic injury.

You may have been given a date for removal by your consultant or nurse in A&E. However, the wound therapy nurse who is treating your wound may decide to leave your clips, stitches (sutures) or steri-strips in for a while longer if they think your wound has not healed. Do not worry, as this is quite common.

Clips, stitches (sutures) or steri-strips can stay in for up to 14 days unless otherwise stated by your consultant. Different parts of the body heal at different speeds. In some rare cases stitches can migrate (move) to the surface of the skin. In these instances, please contact the clinic for the next available appointment on the number overleaf.

Caring for your scar

When your wound has healed you may be left with a scar. Scars can appear different on different skin types and after different wounds. You can help reduce scarring by massaging the scar daily with either bio oil or a moisturiser. It is no longer recommended that vitamin E cream is used.

Once scar tissue has formed, it is important to protect the area from sun exposure and use a high-factor sun cream.

If you have any problems with scarring or need further advice, please talk to the wound clinic.

Pain

If you are experiencing pain from your wound that is not controlled by over-the-counter pain relief, please inform the wound clinic staff or your GP.

Infection/Sepsis

An infection is a disease caused by the colonisation (invasion) of the body by pathogenic organisms such as viruses or bacteria (germs). There are billions of bacteria on and in the human body which are needed to keep us healthy and do not harm us, such as the bacterial flora in the intestine and on the skin.

We all develop infections at times, but mostly our body is able to fight them off rapidly.It is only considered an infection if the colonisation harms the host in a way that affects their health.

Remember, good hand hygiene can help prevent infection.

Wound infection signs

Look out for signs of infection:

• redness
• heat
• swelling
• discharge
• odour
• pain or feeling generally unwell.

If any of these signs occur, contact your GP, 111 or the wound clinic service.

Infections may also occur in other parts of the body

In the throat or chest

• sore throat or chest
• cough
• coughing up phlegm
• feeling generally unwell.

In the bladder

• passing urine frequently
• blood in the urine
• lower abdominal or back pain
• feeling generally unwell.

If any of these signs occur, contact your GP, nurse or healthcare professional caring for you. They will decide on the severity of your infection and treat accordingly.

Severity of infection

Mild infection

The body's immune system can clear most infections, including ear, throat, chest and skin infections.

More serious infection

If your infection does not improve or gets worse, you may need oral antibiotics.

Systemic severe infection (SSI)

This is when the infection has invaded the body and you begin to feel quite unwell.

This includes infections such as pneumonia, urine infection, meningitis, cellulitis, septic arthritis and infected wounds. These may require oral or intravenous antibiotics.

High risk infections

Some people are at higher risk of infection:

• people with a disease causing a reduced immune response or people receiving chemotherapy
• people with diabetes
• recent surgery or invasive procedure
• an indwelling medical device, for example a catheter or medication line
• a history of fever or rigors (shaking)
• a history of MRSA.

If you suspect the infection is severe, contact your GP or call NHS 111 for an urgent appointment.

Sepsis

Infections in people with a higher risk, who are not promptly treated, could develop into sepsis.

Sepsis is an extremely rare but potentially life-threatening condition triggered by an infection.

In sepsis, the body's immune system goes into overdrive, causing total body inflammation that can affect vital organs such as the brain, heart and kidneys.

Trigger signs of suspected sepsis:

• feeling very hot or very cold
• temperature below 35.5°C or above 38.3°C
• rapid breathing
• pulse or heart rate above 90 beats per minute
• acute confusion or drowsiness.

If you suspect the infection could be sepsis, call 999. Prompt action could increase the chance of survival.

Wounds and your mental health

If you are feeling stressed or anxious about your wound please talk to the wound clinic team or your GP.

What can you do to help your wound heal?

Eating well

Eating a healthy balanced diet will help your wound to heal. Foods

that are high in protein and vitamins A, B, C & E are known to aid

skin regrowth and healing.

For more on healthy eating please talk to your health care

professional or go to NHS eat well live well

Smoking cessation

Smoking is a factor in poor wound healing it can lead to poor

oxygenation of the tissues and increase the risk of scarring. If you

want to discuss giving up or want further information please discuss

with the wound clinic team.

 

Helplines/ further advice

NHS advice

Talking Therapies self-referral

Mind mental health support

Five ways to wellbeing self help guide

Action for happiness website

For any emergency help please call 999