Bandages/ Drains Flashcards
What can happen to unbandaged wounds?
What can happen to unbandaged
wounds?
* Desiccation
* Delayed wound healing- Wound dependent
* Higher incidence of infection
Why do we bandage wounds?
- Compression/ Pressure
- Reduce edema/ deadspace
- Debrides wound
- Protection: Trauma, dessication, contamination, irritants.
- Protects Drains
- Stabilizes fractures
- Immobilization/ movement restriction (joints)
- Absorb exudate
- Vehicle for antiseptic
Why should you use bandages in hospital?
Prevent nonsocomial infections
What are important things to remember when applying a bandage ?
1.) Use Stirrups
2.) Distal to proximal
3.) Medial to lateral
4.) 50% overlap
5.) No wrinkles
6.) Use adequate padding to avoid pressure sores.
7.) If digits out, only tips of 3 and 4
8.) Correct tightness ( too tight will cause damage, too lose will come off)
9.) Fracture - immobilize joints above and below fracture
10.) Casts and splints usually for fractures below stifle and elbow
11.) Fractures and luxations require rigid support.
How do you make stirrups?
When do you place the bottom pieces of stirrup onto the bandage?
after 2nd layer before elastic layer is placed.
What is the contact or primary layer of a bandage?
Dressing in direct contact with wound
* “Wound dressing”
What is the function of the primary / contact layer?
Functions:
* Debride necrotic wound
* Deliver medication
* Absorb exudate
* Protect granulation tissue
* Non adherent dressing
What guides your choice of material for your primary/ contact layer?
Choice of material depends on…
* Presence or absence of wound
* Stage of wound healing
* Amount of exudate
* Necrosis/infection
Protects against iatorgenic infection
Post op ect.
What are the types of wound dressings?
Absorbant
Adherent
Non adhesisve
Occlusive
Semiocclusive
What is an absorbent dressing? When would you use it?
Absorbent dressings will absorb large quantities of exudate. They are usually for wounds that are contaminate/infected and wounds that you want alot of debridement. Typically a foam dressing.
What is an adherent dressing? When would you use it?
An adherent dressing is a dressing that is used on wounds that require debridement. You will see this used for necrotic wounds. These bandages can be wet to dry or dry to dry bandages.
What is an non- adherent dressing? When would you use it?
You would use a non adherent dressing on a healthy wound with granulation tissue. You choose this because it has less debridement to underlying tissue. Telfa pads are typically what is used.
What is an occlusive dressing? When would you use it?
Air and water tight seal -> maintains moist wound surface but prevents water vapor transmission
* Partial thickness wounds without necrosis or infection
What is a semi-occlusive dressing? When would you use it?
Allows the wound to “breath” but is protecting it from outside liquids
* Hydrophilic foam
When using an adherent contact layer what are the resons for this? How often would you change it? What is important to remember about this dressing? When do you switch to a non adhesive dressing?
Necrotic / open wounds. Wounds that need debridement.
Painful when removed.
Short term use only ( change SID to BID until granulation tissue appears then switch to nonadhesive dressing.)
What is important to remember about debridemebt?
Debridement is non selective. It will remove healthy and unhealthy tissue.
What is a dry to dry dressing?
Dressing with direct contact to the wound. The layer is dry (ie. sterile dry gauze + wrap around)
What is a wet to dry bandage?
Wound dressing is moist, primary layer is in direct contact with the wound and is moistened, usually with sterile saline or some other topical agent. You place dry guaze then continue with 2nd and 3rd layer.
What is the goal of wet to dry bandages and dry to dry bandages?
Goal is to accelerate healing.
What is the mechanism of a wet to dry bandage?
- Devitalized tissue has no blood supply, so moisture will move to the dry guaze then there will be movement of gross devitalized tissue to dry bandage.
What is a non adherent contact layer used for? What are semi and occlusive dressings used for? How long should these bandages be changed? What is important to remember about changing these bandages?
Used for : clean wounds, over suture lines, open wounds with granulation tissue.
Semi occlusive/ occlusive dressings help retain moisture at wound site to promote moist wound healing.
Change ever 3-7 days, but if you are concerned about the bandage condition just change it.
What is your intermediate/ secondary layer of a bandage? What is its function?
True or False: Your second layer of bandage should minimally come into contact with your wound.
FALSE
