Traumatic wounds can challenge even the most skilled provider, whether small or extensive. Wounds are wounds, why should traumatic wounds be any different? The reasons is simple: these wounds can be an unstable from the beginning.
Burn wounds often infiltrate several layers of the skin and may vary in type within the same wound. Wounds caused by trauma may likely be filled with a cast of characters, such as grass, dirt, and gravel, which causes these wounds to be ‘dirty’ and requires immediate antibacterial care. The shape of these wounds can be countless, leading the clinician to rethink the square-shaped dressing.
The removal of nonviable tissue and treatment of inflammation while managing the bioburden of traumatic wounds is essential in the acute stage to promote healing. The use of active Leptospermum honey (ALH) can meet many of the needs of burn wounds and increase the capacity to heal. This atmosphere is created by the acidic action of ALH promoting acid base balance in the skin. This is an environment bacteria prefer not to live in, which provides a reduction in wound bioburden. The hydrophilic action of the ALH assists with debridement of the burn wound without the pseudoeschar that may present with other burn treatments. The versatile forms of ALH supports the clinician with the task of managing an inconsistent shape that burns and trauma wounds may take. Burns can be both hyper-moist or dry and scaly. Trauma wounds take on various forms from penetrating with high exudate or surficial with crust. Hydrocolloid, calcium alginate, foams, and gels provide a treatment for even the toughest irregularly shaped wounds.
As a pediatric clinician, there are several things I consider before applying any dressing; the first is pain with application or removal. The acidic nature of ALH may cause a stinging sensation with the initial use and is contraindicated with third-degree/full-thickness burns. Active Leptospermum honey may be used on pediatric patients, keeping in mind that some may be more sensitive to this sensation. With all those considerations in mind, ALH is a product that is versatile and useful in the trauma wound tool kit.
Ferne T. Elsass, MSN, RN, CPN, CWON, is a Clinical Practice and Education Specialist of Wound and Ostomy at the Children’s Hospital of The King’s Daughters in Norfolk, VA.
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