Pathophysiology
Clinical meaning
Wound care is a core practical nursing competency requiring knowledge of wound physiology, systematic assessment, evidence-based dressing selection, and patient education. Wounds are classified by etiology: surgical (intentional incisions), traumatic (lacerations, abrasions, avulsions, punctures, burns), pressure injuries (sustained pressure causing tissue ischemia), vascular ulcers (arterial insufficiency with poor blood supply, or venous insufficiency with venous hypertension and edema), diabetic ulcers (neuropathy-related, typically on plantar foot surfaces), and moisture-associated skin damage (incontinence-associated dermatitis). The TIME framework guides wound bed preparation for chronic wounds: T (Tissue -- is the wound bed viable? Remove necrotic tissue through debridement), I (Infection/Inflammation -- is infection or excessive inflammation present? Control bioburden with antimicrobials, address host factors), M (Moisture -- is the moisture balance optimal? Select dressings to maintain moist wound healing without maceration), and E (Edge -- are wound edges advancing? Assess for undermining, rolled edges indicating stalled healing, consider advanced therapies if edges not progressing). Wound healing by secondary intention (open wounds healing from the base up) requires granulation tissue formation (beefy red, moist, granular tissue indicating healthy healing), followed by epithelialization (new epithelial...