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7313/7333 Bringman > 1.25 Topical Agents/Modalities > Flashcards

1.25 Topical Agents/Modalities Flashcards

1
Q

What are the common topical agents?

A
  • hydrogen peroxide
  • provodine/iodine
  • acetic acid
  • Daikin’s
  • antibacterials
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2
Q

characteristics of hydrogen peroxide

A
  • oxidizing agent

- cytotoxic

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3
Q

problem with hydrogen peroxide?

A

People put it on all the time and it kills cells

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4
Q

problem with idodine?

A
  • same as peroxide, cytotoxic

- shouldn’t use it all the time

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5
Q

acetic acid as a topical agent

A

vinegar, not used often

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6
Q

What is Daikin’s?

A

.025% bleach (.05% at most) + saline

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7
Q

Use of Daikins

A
  • generally soak a bandage in it
  • must stop using after a few days of the treatment
  • perianal area: may need longer to prevent fecal contamination in the wound
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8
Q

problem with Daikin’s

A
  • kills bad AND good stuff

- stunts granulation tissue growth

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9
Q

Most antibacterials are ______

A

triple antibiotics

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10
Q

Why would it not be a good idea to use triple antibiotics like Neosporin?

A

creation of stronger superbugs due to adaptation

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11
Q

common antibacterials

A
  • Neosporin
  • Bacitracin
  • Bactriban
  • Genomycin
  • Silvadene
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12
Q

bacitracin

A

single antibiotic

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13
Q

genomycin

A

topical

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14
Q

silvadene

A

aka silver surfer

  • white cream used a lot with burns and ulcers
  • impregnate gauze with it before applying
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15
Q

Why can’t you spread silvadene in a wound?

A

gauze would just slide around in the goop

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16
Q

Why is silver used in topical agents?

A
  • antibacterial
  • keeps it from getting infected
  • keeps it moist
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17
Q

What are growth factors in wound care?

A
  • put it on the wound, helps tissue grow
  • all work differently, have different chem structures
  • support different body function
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18
Q

two types of dressings

A
  • primary

- secondary

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19
Q

primary dressing

A
  • against the wound bed
  • most often the dressing creating the desired effect
  • keeps the wound dry
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20
Q

What happens if the primary dressing gets dried out?

A

need to apply moisture before taking it off

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21
Q

function of the secondary dressing

A
  • holds primary dressing in in place and attaches to the outside skin
  • can be an occlusive barrier if necessary
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22
Q

We always want the secondary dressing to be _____

A

dry

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23
Q

strikethrough

A
  • fluid gets through the secondary dressing

- if both are wet, infection gets into the wound bed

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24
Q

What should be done if strikethrough happens?

A
  • reinforce the bandage until it stops bleeding through

- re-evaluate the next dressing change

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25
Q

As the wound heals, what happens to moisture content?

A

different cycles of moisture content

26
Q

categories of dressings

A
  • gauze
  • transparent film
  • foam
  • hydrogels
  • hydrocolloids
  • alginates
  • skin substitutes
27
Q

putting gauze in a wound

A
  • should have some moisture

- don’t push in (create pressure and occlusion)

28
Q

qualities of gauze

A
  • good for filling space

- doesn’t absorb much

29
Q

impregnated gauze

A
  • usu with vaseline

- won’t stick to the wound

30
Q

removal of gauze

A

NEVER remove dry bandage off a wound bed

31
Q

transparent film

A
  • one side sticky, the other completely sticky
  • looks like saran wrap
  • keeps bad stuff out but oxygen in
32
Q

foam

A
  • absorbs fluid
  • may need to put thin film on the periwound to keep moisture off so the water that’s collected doesn’t macerate the tissue
33
Q

hydrogels

A
  • aqueous solution that adds water
  • has its own structure
  • can fill in the area and not put as much dressing on it
34
Q

When should you not use hydrogels?

A
  • somewhere there’s going to be some weight on it

- wouldn’t put it on someone’s butt

35
Q

application of hydrogel

A

coat wound bed

fill with gauze

36
Q

hydrocolloids

A
  • absorbs moisture
  • thin, low profile dressing
  • doesn’t absorb as much as foam
  • whole thing is sticky
37
Q

benefit to hydrocolloids

A

because it absorbs moisture, won’t stick to the wound bed

38
Q

alginates

A
  • made of calcium alginate (seaweed)
  • absorbs moisture and keeps it there
  • comes in sheets, ribbons, etc
39
Q

Where are alginates commonly used?

A

venous ulcers

40
Q

What must you do with a wound that is undermined?

A
  • fill in the undermined area

- make sure to document how many items you’ve put in

41
Q

best way to approach a tunneled/undermined wound

A
  • long piece of gauze with a tail outside the wound bed

- packing strips: cut, moisten, put in tunnel

42
Q

What is the specialized dressing we talked about?

A

Unna boot

43
Q

what is an unna boot?

A
  • gauze impregnated with zinc
  • long roll
  • nonflexible
  • great for venous ulcers
  • wrap entire leg, toe up, no compression
  • add self adherent bandage on top
44
Q

purpose of zinc in the unna boot

A
  • antibacterial

- protects skin

45
Q

What is done after the unna boot is put on?

A
  • walked for 10-30 mins

- if they can’t walk, have them do ankle pumps

46
Q

Why do they need to exercise after unna boot is applied?

A
  • muscles contract to walk

- compression pushes everything up

47
Q

Who would you not use an unna boot on?

A

someone with CHF

48
Q

modalities for wound care

A
  • whirlpool
  • ultrasound
  • e-stim
  • UV radiation
  • hyperbaric oxygen threrapy (HBO)
  • negative pressure wound therapy (wound vac)
  • cold laser therapy
49
Q

whirlpool guidelines for wound care

A
  • usu body temp

- 15 mins

50
Q

continuous ultrasound

A
  • thermal

- increase circulation

51
Q

pulsed ultrasound

A
  • nonthermal
  • could be used for venous ulcer that’s just starting to push stuff away from interstitial space
  • can put the gel directly in the wound
52
Q

When would you not use pulsed US on a wound?

A

huge one

53
Q

e-stim in wound care

A
  • depends on polarity

- negative: repels bugs and helps clear out a wound

54
Q

UV radiation in wound care

A
  • can kill bugs
  • heal tissue in proper dosages
  • just know it’s there, same as diathermy
55
Q

HBO

A

hyperbaric oxygen therapy

56
Q

How does HBO work?

A
  • forces oxygen to distal blood supply
  • get better blood flow to the area
  • increase pressure/permeation to improve healing
57
Q

problems with HBO?

A
  • most insurance companies don’t cover (expensive, but works)
  • time intensive (few hours a day)
58
Q

wound vac: how it works

A
  • white foam underneath as a barrier
  • black foam cut to shape of wound, primary dressing
  • film laid down and around, airtight
  • tube fed through with a pump and vacuumed out
  • foam collapses and pulls fluid to and away from the wound bed at the same time
59
Q

How long will a wound vac be left on?

A

2-3 days at first then 3-5 days each time

60
Q

What is so great about wound vacs?

A
  • heals a wound very quickly
  • occlusive (won’t get feces or urine in it)
  • covered a lot more by insurance companies now
61
Q

What can happen if a wound vac works too well?

A

can get hypergranulation outside the wound bed that would have to be cauterized by an MD

usu with shallow wounds

7313/7333 Bringman (56 decks)

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