Bandages, Dressings, Drains Flashcards
why do we use bandages? list 6 reasons
promote healing, protect the wound, absorb exudate, manage dead space, apply pressure, provide support
list the layers of a bandage and what their function is
primary–>contact with the skin/wound
secondary–> absorption
tertiary–>hold the bandage in place
the tightness of a bandage is proportional to two things and inversely proportional to two things. list these
proportional to: number of layers, tension
inversley proportional to: radius of the limb, width of bandage material
what kind of bandage is a “wet to dry” bandage? is this a good choice in most cases?
an adherent bandage
no, these are old school and not commonly used
what is the logic behind using an adherent bandage?
to mechanically debride the wound (but they are painful and rip off healthy tissue too!)
if you MUST use an adherent bandage, where should you NOT place one?
on granulation tissue or epithelialized tissue
list 2 kinds of non adherent primary layers
telfa pads ot jellonet (gauze + vasilene)
when are occlusive bandages used?
when there is a lot of exudate, they absorb fluid and “waterproof” the wound, more common in people. think of a blister band aid
the secondary layer of a bandage is usually applied ______ with _____ overlap
circumfrencially, 50%
when you are applying a seconday layer, you should start ____ and go ____
distal, proximal
if you are placing a splint, what layer should it go on top of?
the secondary layer
what is the classic example of a secondary layer?
cotton white gauze
which layer sets the pressure of the bandage?
the tertiary layer
when should you change a bandage?
it is wound dependent and absroptive capacity of the bandage, whether there is infection, and type od dressing. AKA it depends
there are several types of bandage anchors. name 5
stirrups (tape), tape overlay, figure of 8, hair overlay, and tie over
what is autolytic debridement?
endogenous enzymes debriding the wound for you
are hyperosmotic saline dressings antimicrobial? what do they do? when is it best used?
it is antimicrobial if 20% saline or higher
helps with autolytic debridement
best if used in the inflammatory phase
what kind of dressing is sugar? what are it’s properties and what phase is it best used in?
hyperosotic
NOT antimicrobial, possibly supplying nutrients to the wound bed
best for inflammatory phase
honey is an antimicrobial dressing. list the 4 properties that make it antimicrobial
contains peroxide (H2O2), hyperosmotic, low pH, and inhibin content
what phase is honey best used in as a wound dressing?
inflammatory phase
honey decreases 2 things and enhances 2 things. list them
decreases inflammation and edema
enhances granulation and epithelialization
why would you use a topical antibiotic?
to reduce microbial burden during the inflammatory phase
are topical antibiotics sufficient to treat most infections?
no! you may just want to use oral antibiotics if there is an infecton in the wound!
what is silver used for
for infected wounds, silver is directly antimicrobial. usually used in human patients and burn victims
what are enzymatic agents?
they eat necrotic and dead tissue, can be given additional to surgery in the inflammatory phase
why would you use a hydrogel?
to provide EXOGENOUS moisture to promote epithelialization in partial thickness wounds
what are hydrocolloids and alginates used for?
to absorb exudate and enhace the autolytic debridement process, can promote granulation
negative pressure wound therapy is good for what 4 reasons?
improve perfusion, reducing edema, stimulate granulation tissue, clear exudate
what is the purpose of a drain?
to get rid of fluid or gas from body cavities OR the sub Q space
list 3 benefits of drains
they remove blood and serum, relieve pressure, and remove inflammatory mediators
what is the difference between passive and acitive drainage?
passive is just letting gravity or body movement do the job
active is sucking out the stuff from the wound
how should you use a penrose drain properly?
NEVER use it for a dirty or infected wound
NEVER fenestrate the tube
DON’T use it in exchange for proper wound management or aseptic technique
place them DEEP
suture only the EXIT
MUST have a bandage to cover it!
list 5 reasons why closed active drains are better than penrose drains
less ascending bacterial infection
less skin complications
decreased seroma and hematoma formation
you can quantify the fluid
it’s the only drain that can be used in body cavities like a septic abdomen or pleural efusion
when you place a bandage what should you tell the owner to look out for?
swelling, worsening lameness, slipping, sudden discomfort, systemic illness signs, smell, if it gets wet (especially the secondary layer)
list 4 bandage complications
too tight, cut off blood supply
rub sores
slipping
stiffness of joints being immobolized
