When it comes to global health care systems, chronic wound is a substantial burden. The complexities, and prevalence of wounds are expected to rise, as you grow old. 

The basics related to care of wound can be simplified into five principles, while wide range of treatment options and products are available in the market. These principles can assist doctors to perform comprehensive wound care to patients, in a holistic way. 

The article discusses about five guiding principles of care of wound, which all podiatrists and wound care specialists need to know in detail. 

Wound Management: An Overview 

It is seen that when there is a disruption in the continuity of epithelium, a wound normally appears in your body. When it comes to normal physiological wound healing process, you will know that it consists of four stages. 

They are:

  • Inflammation
  • Homeostasis
  • Remodeling 
  • Proliferation 

The wound healing mechanism is disrupted in case of chronic wound. There will be disruption, which will be result in protracted and prolonged healing. When there is delayed wound healing, several complex etiologies can become causative factors. 

It is necessary to take a systematic assessment and approach to wound management, which will help to streamline diagnostic process. 

Assessment of the Wound

The detailed assessment of characteristic of patient factors, and wound will be the most significant, and initial step in the management of wound. Doctors will use mnemonic that will help them to in assessment of wounds in clinical way. 

The method is called TIME principle. It includes, presence of infection, assessment of moisture and wound tissue and edge of wound respectively. 

It is seen that would pros deploy qualified, and licensed doctors, who will provide consultation, and wound care treatment services as well. It is done at patient’s bedside in long- term care facilities. 

There are specially – trained health care doctors who will consult, and guide patient treatment, develop treatment plans, and deliver wound care in perfect way. 

As these doctors need to provide diagnostic clue for further management of wound, they will assess the location, size, and depth of wounds. It is seen that there can be possibilities of development of diabetic ulcers on regions of foot, which has sustained high pressure. 

On the other hand, venous ulcers develop in the gaiter region. When you have non- healing, and chronic wound, it is suggestion of malignancy. If the wound fails to heal despite proper treatments, doctors will suggest tissue biopsy. 

Cleaning of the Wound

While optimizing the pH at the wound site, wound cleansing will minimize the wound infection rate, and bacterial loads as well. Wound cleansing will also help in the removal of external contaminations as well. 

After each dressing change, it is necessary to perform irrigation of wound with normal saline. It is seen, while normal saline will not interfere with the healthy, and granulation tissues, you will know that normal saline is isotonic solution. 

It is seen doctors, in clinical setting will carry out wound irrigation through fluid jet. There will be removal of debris, and bacterial contaminants from wound surface. Some doctors also suggest the use of tap water, which will act as wound cleanser for bacterial colonization. 

Regular Change of Dressing 

While there will be reduction of infection, doctors will do timely dressing changes. They will also inspect, and review wounds regularly. It is necessary to change soiled dressings. Doctors need to give analgesics, as dressing changes can be painful for patients. 

When removing the adhesives, doctors need to take care. The removal process can become easier, if doctors soak the dressing. Doctors can use barrier films so that they can safeguard peri -wound skin. 

While there will be minimalization of skin trauma, there will be improvement of adherence of dressing materials as well. 

Selection of Appropriate Wound Dressing

When it comes to dressing of wound, a wide range of materials are available in the market. There can be complication in selection of perfect dressing material. Podiatrists, and doctors will find it easy to get the appropriate dressing if they know the characteristic of wound. 

You should know that an ideal dressing is hypoallergic, non- toxic, cheap, and easy to use. There will be minimal pain, and discomfort, at the time of removal of dressing. During dressing selection, doctors may take patient wishes into their consideration. 

Antibiotic Use

When it comes to wound care treatment guidelines, doctors should mandate the use of antibiotics as well. Before doctors prescribe antibiotics, they need to inspect for signs of infection. 

If you have little evidence of clinical infection, it is common for doctors to prescribe indiscriminate use of antibiotics. Doctors will check the symptoms, and signs of infection, as they will prescribe antibiotics. 

There may be increased risk of antibiotics – resistant infections if you are using regular antibiotics. It is seen that doctors will recommend irrigation with antimicrobial if you have chronic wounds. 


When it comes to advanced wound technology, caring for wound has become increasing complex. It is necessary that doctors should include five basic principles for wound management at the end. 

Dr Orlando Cedeno who is a well – known podiatric surgeons is also proficient in wound management as for patients as well. He has served as Medical Director of Sentara RHM Wound Healing Center.”