*11.PTA 200-Wound Management Part 4 Flashcards
PROTECT the wound:
prevent additional wound contamination
keep microorganisms in the wound from infecting other sites
prevent further injury to the wound.
provide a “barrier” to the outside environment.
Dressings also function to ABSORB wound drainage
in some cases they may be used to control bleeding (pressure dressings/bandages)
Moisture Retention – often you have primary and secondary dressings.
non-specific MECHANICAL DEBRIDEMENT. Dressings may be used alone, or in conjunction with the application of a topical agent.
Will be “primary” or “secondary” dressings
Functions of wound dressings
next to wound
Primary dressing
often serve to hold primary dressing in place
Secondary dressing
absorb exudate and allow for its evaporation. Upon removal from the wound, secondary trauma can occur by their adherence to the desiccated tissues. In some instances, like the initial treatment of some wounds when infection is present, gauze dressings may be the material of choice when mechanical debridement is indicated.
conventional gauze dressing
can be done with gauze dressings
Mechanical Debridement
One layer of gauze with saline or other topical agent covered by a second layer moistened with the same material. Danger: pain upon removal; possible detachment of viable epidermal surface cells.
Wet-to-Dry
Both layers are moistened from wetting agent and they are continually bathing the wound surface. They are not allowed to dry. Least painful but may cause maceration and least effective with mechanical debridement
Wet-to-Wet
Gauze is applied directly to wound surface (two layers). Most effective; most painful; most danger of removing viable tissue.
Dry-to-Dry
Occlusive Dressings are on a continuum regarding impermeability to water.
Know this…
See-through films allow better visualization of the wound – not all occlusive dressing are “see-through”
fewer dressing changes (cost effective)
ability to shower/bathe without removal of dressing.
They maintain tissue hydration.
Advantages of occlusive dressings
Highlights from Youtube video: -most common form of occlusive dressing -moist dressing (keeps wound moist) -creates gel -conforms to body shape Used for: pressure ulcers, minor burns, venous insufficiency ulcers, small cavity wounds, donor sites. -Not suitable for bleeding -Need good skin integrity -contraindicated for infected wounds
Hydrocolloid dressing
Occlusive Dressings- Semipermeable Film Dressings
Benefits: Moisture retentive, encourage autolytic debridement, reduce friction, allow visualization of wound bed, waterproof, cost less over time.
Uses: skin tears, donor sites, areas of friction, abrasions, over intravenous catheters to allow bathing/whirlpool, over wounds for ultrasound.
Occlusive Dressings- Semipermeable Foams:
Benefits: moisture retentive, provide thermal insulation, many provide cushioning, available in both adherent and nonadherent forms, absorb moderate amounts of exudate.
Uses: burns, skin grafts, donor sites, ostomy sites, pressure ulcers, venous insufficiency ulcers, neuropathic ulcers
Occlusive Dressings- Semipermeable Hydrogel;
Benefits: moisture retentive, encourage autolytic debridement, reduce pressure, non or minimally adherent.
Uses: minimally to moderately exudating wounds, pressure ulcers, blisters, abrasions, skin tears, burns, donor sites, coupling medium for ultrasound, padding for splints and total contact casts, amorphous hydrogels can be used to soften eschar and provide a moist environment to dry wounds.
Occlusive Dressing- Impermeable Hydrocolloids;
Benefits: moisture retentive, impermeable to urine, stool, and bacteria, provide thermal insulation, waterproof, some have beveled edges to prevent dressing from rolling up, provide moderate absoption.
Uses: pressure ulcers, burns, venous insufficiency ulcers, for use on periwound to attach adhesive tape in the case of large wounds.
