History of wound care
The history of wound care spans from
prehistoryto modern medicine. As wounds naturally healby themselves, regardless of whether recovery from the scaror recovery from lost body tissue was a possibility, hunter-gatherers would have noticed several factors and certain herbal remedies would speed up or assist the process, especially if it was grievous. In ancient history, this was followed by the realisation of the necessity of hygieneand the halting of bleeding, where wound dressing techniques and surgerydeveloped. Eventually the germ theory of diseasealso assisted in improving wound care.
Ancient medical practice
The treatment of acute and chronic wounds is an ancient area of specialization in medical practice, with a long and eventful clinical history that traces its origins to
ancient Egyptand Greece. The Papyrus of Ebers, circa 1500 BC, details the use of lint, animal grease, and honeyas topicaltreatments for wounds. The lint provided a fibrous base that promoted wound site closure, the animal grease provided a barrier to environmental pathogens, and the honey served as an antibiotic agent. The Egyptiansbelieved that closing a wound preserved the soul and prevented the exposure of the spirit to "infernal beings," as was noted in the Berlin papyrus. The Greeks, who had a similar perspective on the importance of wound closure, were the first to differentiate between acute and chronic wounds, calling them "fresh" and "non-healing", respectively. Galen of Pergamum, a Greek surgeon who served Roman gladiators circa 120-201 A.D., made many contributions to the field of wound care. The most important was the acknowledgment of the importance of maintaining wound-site moisture to ensure successful closure of the wound. There were limited advances that continued throughout the Middle Agesand the Renaissance, but the most profound advances, both technological and clinical, came with the development of microbiologyand cellular pathologyin the 19th century.
Honey’s antibacterial properties help promote healing infected wounds.
author=Peter Charles Molan | title=Honey as a topical antibacterial agent for treatment of infected wounds | journal=Nurs Times| year=2001 | pages=96 | volume=49 | issue=7-8
] Honey used as an topical ointment.
The first advances in wound care in this era began with the work of
Ignaz Philipp Semmelweis, a Hungarian obstetricianwho developed sterile surgical procedures, and Louis Pasteur, a French scientist known as the "father of microbiology" for his germ theory of disease. Semmelweis's work was furthered by an English surgeon, Joseph Lister, who began treating his surgical gauze with carbolic acid, known today as phenol, and subsequently dropped his surgical team's mortality rate by 45%. Building on the success of Lister's pretreated surgical gauze, Robert Wood Johnson, co-founder of Johnson & Johnson, began producing gauze and wound dressings treated with iodine. These innovations in wound-site dressings marked the first major steps forward in the field since the advances of the Egyptians and Greeks centuries earlier. The next advances would arise from the development of polymersynthetics for wound dressings and the "rediscovery" of moist wound-site care protocols in the mid 20th century.
With advancements in material and tissue sciences, the field of wound-site dressings increased considerably. The ability to bolster wound-site re-epithelialization has been improved as well as improving their clinical efficacy. With the advent of
fibroussynthetics of nylon, polyethylene, polypropylene, and polyvinyls in the 1950s, researchers and doctors in the field of wound care are able to significantly accelerate the natural wound healing process. Following the research and articles of George Winterand Howard Maibachin the 1960s, testing the efficacy of synthetic "wet" polymer wound dressings, the 1970s and 1980s represented the dawn of modern wound care treatment. In the 1990s, improvements in composite and hybrid polymers expanded the number of available materials for wound dressings. These improvements, coupled with the developments in tissue engineering, have given rise to a new class of wound dressings called "living skin equivalents." Often cited as a misnomer because they lack key components of whole living skin, "living skin equivalents" represent the future of wound dressings and possess the potential to serve as cellular platforms for the release of growth factors essential for proper wound healing. Other new developments have been focusing on handling patients concerns. Affected individuals often report pain as dominant in their livesKrasner, D. 1998. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=9678007 Painful venous ulcers: themes and stories about living with the pain and suffering] . "Journal of Wound, Ostomy, and Continence Nursing", Volume 25, Issue 3, Pages 158-168. Accessed January 1, 2007.] and the pain associated with chronic wounds should be handled as one of the main management priorities. Symptomatic treatment of pain as part of patient centered concerns must go hand-in-hand with treating the underlying etiology or cause of the wound.
*Ovington, L. G. (2002). "The evolution of wound management: ancient origins and advances of the past 20 years." "Home Healthcare Nurse". 20, p 652-656.
*Sipos, P., Gyory, H., Hagymasi, K., Ondrejka, P., and Blazovics, A. (2004). "Special wound healing methods used in ancient Egypt and the mythological background." "World Journal of Surgery". 28, 211-216
* [http://www.ucihs.uci.edu/com/pathology/sherman/home_pg.htm Maggot Therapy Project]
* [http://www.monarchlabs.com/ Suppliers of Medical Maggots]
* [http://www.bterfoundation.org/ BioTherapeutics Education and Research Foundation]
* [http://www.ewma.org/ European Wound Management Association (EWMA)]
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