PHYSIOLOGICAL RESPONSES TO INJURY
Once the skin and tissue have been injured, the process of healing begins.
Many factors influence the body's ability to grow new tissue.
a. Age. Very young and very old people heal more slowly than those in other
age groups. People in these age groups have less ability to fight infection, and fighting
infection is a major part of the healing process. The endocrine functions in infants are
sluggish, and infants have limited reserves of fat, glycogen, and extracellular water--all
necessary to fight infection. Healing is slower in the elderly because cardiovascular,
renal, pulmonary, and musculoskeletal functions may be slowed down by chronic
disease or perhaps just the wearing out of body parts.
b. Malnutrition. Malnourishment and obesity, both forms of malnutrition, affect
wound healing. A person who is undernourished has less fat and carbohydrate reserve;
therefore, body protein (necessary for wound healing) must be used to provide energy
needed for basic metabolic functions. This results in an imbalance of nitrogen which in
turn depresses fibroblastic synthesis of collagen, the connective tissue for scar
formation. A person suffering from Vitamin C deficiency may not be able to produce
fibroblast causing a delay in wound healing. In obese individuals, fatty tissue may keep
foreign matter from being seen. Fatty tissue has relatively few blood vessels causing
such tissue to separate easily. Tissue which separates easily heals slowly.
c. Abnormalities in Endocrine Function. Healing is slower if there are such
abnormalities. In a person suffering from chronic vascular changes, the injured tissues
of the wound may not get enough blood to heal at a normal rate. Persons having
corticosteroid therapy will find that wounds heal more slowly.
d. Hormone Production and Carbohydrate Metabolism. The combined effect
of the increased hormone production is to increase the metabolism of carbohydrates.
The metabolism of carbohydrates is important in the body's response to trauma. If the
body's store of carbohydrates is depleted (severe crush injuries, starvation), the body
will begin to use fats and proteins in place of carbohydrates. Eventually, there will not
be enough carbohydrates to aid in the healing process.
GENERAL WOUND CARE
a. Immediate Care. Initially, control the bleeding from the wound. Nature
usually stops bleeding. For example, a person cuts his finger. Blood will gush from the
lacerated blood vessels. These vessels constrict which tends to lessen the bleeding.
The clotting process also stops bleeding. When blood escapes from an artery or vein,
the blood undergoes changes which cause it to clot. The blood clot seals off the injured
blood vessels, and bleeding stops. If the wound is large or clotting does not occur,
apply direct pressure over the wound to stop bleeding. Use sterile pads if possible, but
if they are not available, use a handkerchief, clean cloth, or even a bare hand as a last
resort. Then, check the entire body for injuries.