Ch 13,14,15 Flashcards
Gauzes and nonwovens
Provides absorption of exudates. Supports debridement if applied and kept moist. Can be used to maintain moist wound surface. Can be used for cleansing, packing, and covering a variety of wounds.
E.G. curity, kling, kerlix
The four stages of the inflammation process?
Vascular response
cellular response
Formation of exudate
Healing
Nonadherent dressings
Woven or nonwoven dressings, may be impregnated with saline, petroleum, or antimicrobials. Are minimally absorbent. Used mainly on minor wounds or as a second dressing.
Adaptic, Vaseline gauze, xeroform
Transparent Films
Semipermeable membrane that permits gaseous exchange between wound and environment. Transparency allows visualization of the wound. Minimally absorbent so fluid environment is created in presence of exudate. Used for dry noninfected wounds or wounds with minimal drainage.
E.g. Bioclusive, Blisterfilm, CarraFilm, Omniderm, OpSite, Polyskin, Suresite, Tegaderm, Transeal
Hydrocolloids
Wafers, powders, or pastes composed of gelatin, pectin, or carboxymethylcellulose. Occlusive dressing does not allow O2 to diffuse from atmosphere to wound. Occlusion does not interfere with wound healing. Supports debridement and prevents secondary infections. Used for superficial and partial-thickness wounds with light to moderate drainage.
E.G. Comfeel, DuoDerm, Exuderm, Hydrocol, NU-DERM, RepliCare, Restore, Ultec
Foams
Sheets and other shapes of foamed polymer solutions (most commonly polyurethane) with small, open cells capable of holding fluids. Moderate to heavy amounts of exudates can be absorbed. The area in contact with the wound surface is nonadhesive for easy removal. Used for partial- or full-thickness wounds or infected wounds.
E.G. Allevyn, Curafoam, Flexzan, Hydrasorb, Lyofoam, Mepilex, Polyderm
Absorptive dressings
Large volumes of exudates can be absorbed. Maintain moist wound surface. Placed into wounds and can obliterate dead space. For partial- or full-thickness wounds or infected wounds.
E.G. ABD Combine Pads, Covaderm, Curity Abdominal Pads, Multipad
Hydrogel
Available as sheet, gel, and gauze designed to donate moisture to a dry wound and to maintain a moist healing environment. High moisture content serves to rehydrate wound tissue. Debridement because of moisturizing effects. Provides limited absorption of exudates. Most types require a secondary dressing. Used for partial- or full-thickness wounds, deep wounds with minimal drainage, and necrotic wounds.
E.G. AquaSite, Carrasyn Gel, Curasol Gel, Hypergel, Geliperm, IntraSite, Saf-Gel, SoloSite, Tegagel, Woun-Dries
Alginates
Nonwoven, nonadhesive pads and ribbons composed of natural polysaccharide fibers or xerogel derived from seaweed. On contact with exudate, form amoist gel. Easy to use over irregular-shaped wounds. Indicated for wounds with moderate to heavy exudates. (e.g. pressure ulcers; infected wounds). Generally require a secondary dressing.
E.G. AlgiCELL, CarraSorb, Kalginate, Maxorb, SeaSorb, Sorbalgon
Antimicrobials
Wound covers that deliver agents such as iodine, silver, and polyhexamethylene biguanide (PHMB), which have antibacterial properties. An advantage metals have is bacteria are not able to develop resistance. Indicated in partial- and full-thickness wounds, over skin line sites and surgical incisions, or around tracheostomies. Available as sponges, impregnated woven gauzes, film dressings, absorptive products, island dressings, nylon fabric, nonadherent barriers, or a combination of materials.
E.G. Acticoat, BIOPATCH, Curity AMD, Island Wound Dressing with Microban, Iotosorb, SilverDerm, Silverlon
Use for PRBCs and considerations
Severe or symptomatic anemia, acute blood loss.
One unit of RBCs can be expected to result in a hemoglobin increase of 1 g/dL or Hct increase of 3% in a typical adult. One unit of RBC can replace a blood loss of 500 mL.
Frozen RBCs use and considerations
Same as PRBCs, must be used within 24 hours of thawing. Autotransfusion/stockpiling
Use for platelets and considerations
Bleeding caused by thrombocytopenia; may be contraindicated in thrombic thrombocytopenic purpura and HIT (unless life-threatening hemorrhage)
Can be kept at room temperature for 1-5 days. Bag should be agitated periodically. Failure to have a rise in platelets could be due to fever, sepsis, splenomegaly, or DIC.
Fresh frozen plasma use and considerations
Rich in clotting factors but contains no platelets. Bleeding caused by deficiency in clotting factors (e.g. DIC, hemorrhage, massive transfusion, liver disease, vitamin K deficiency, excess warfarin)
What dressing is best for prevention of pressure wound?
Mepelex
