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Fall 2024 > CS2 - Wound dressing > Flashcards

CS2 - Wound dressing Flashcards

1
Q

What are the primary wound dressing options?

A

Alginates
Biosynthetic
Collagens
Foams
Hydrocolloids
Hydrogels
Dressing gauze

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2
Q

What is the best option for a wound that is infected or highly exudative?

A

Alginates

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3
Q

Describe the qualities of alginate wound dressings

A

Derived from seaweed
Highly absorbent/malleable
Provides a moist environment

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4
Q

How long can biosynthetic wound dressings be placed?

A

up to 10 days

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5
Q

What process are biosynthetic wound dressings most helpful with?

A

Epithelialization

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6
Q

What type of wounds are biosynthetic dressings used for?

A

Burns
Pressure ulcers
Tears
Epithelializing wounds

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7
Q

What specifically do collagen dressings help with?

A

increasing collagen deposits and promoting new tissue growth

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8
Q

What is required in addition to collagen dressings?

A

secondary dressing for exudative absorption
example - foam

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9
Q

What type of wound is best for collagen dressing use?

A

open wounds +/- infection

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10
Q

Describe foam as a wound dressing

A

Absorbent material that is nonadherent to wound bed

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11
Q

What type of wound is foam best for?

A

Open wounds with drainage

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12
Q

What material makes up hydrocolloid wound dressings?

A

gelatin
pectin
carboxymethylcellulose

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13
Q

How long can a hydrocolloid be placed?

A

up to 10 days

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14
Q

How do hydrocolloids and hydrogels help heal wounds?

A

Provide a moist environment to encourage granulation and debridement of necrotic tissue

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15
Q

When should hydrocolloid wound dressings be avoided?

A

infected wounds with large amounts of drainage

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16
Q

What material is used for hydrogels?

A

Water or glycerin based gels

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17
Q

What type of wounds are best for hydrogels?

A

Necrotic wounds
Deep wounds
Radiation burns

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18
Q

What are the options for secondary dressings?

A

Foams
transparent films
Dressing gauze
Tubular gauze
Flexible collodion

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19
Q

What material makes up transparent films?

A

Polyurethane membrane

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20
Q

What is the benefit of a transparent film?

A

Provides a semipermeable environment that allows water vapor to pass the membrane but inhibits bacterial passage

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21
Q

Transparent films allow what, but should not be used when?

A

Allow direct visualization of the wound
Should not be used if thin skin or infection

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22
Q

What materials make up dressing gauze?

A

Various from adherent to nonadherent with various impregnated substances

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23
Q

What are the secondary uses for dressing gauze

A

Secure/stabilize dressings or pack wounds

24
Q

What is the function of tubular gauze and when is it typically used?

A

Secures underlying dressing circumferentially with the use of a metal cage applicator
Ideal for wounds on digits

25
Q

What material makes up flexible collodion?

A

Nitrocellulose in alcohol and ether

26
Q

What is the function of flexible collodion and when is it typically used?

A

Provides a plastic like barrier over wound
Scalp lacerations

27
Q

What is negative pressure wound therapy?

A

Application of negative pressure to surface of wound to aid in healing

28
Q

What types of wounds benefit from negative-pressure wound therapy?

A

Open abdominal incisions
Reconstructive surgery
S/P surgical debridement

29
Q

In what situations is negative-pressure wound therapy contraindicated?

A

Exposed organs
Malignancy
Ischemic wounds
Active infection

30
Q

How should infected vs contaminated/deep vs closed wounds be cleaned?

A

infected - saline flushes
contaminated/deep - irrigation with soap and water
closed - hydrogen peroxide

31
Q

What is the most important aspect of follow-up with wound dressings?

A

Patient education:
-signs/symptoms or infection
-phases of wound healing
-when to change dressings
-cleaning the wound
-avoid soaking the wound

32
Q

When should a dressing always be changed?

A

Always if the dressing becomes contaminated

33
Q

What can be done if additional care is needed for a wound?

A

Consider home nursing services or wound care referral

34
Q

What should be done if a wound is infected?

A

Consider antibiotics
flush with NSS four times per day

35
Q

What should always be considered with any wound?

A

Tetanus status

36
Q

What are some potential complications of wound dressings?

A

Poor wound healing
Infection
Bleeding
Dehiscence (wound edges open back up)
Fistula formation

37
Q

What are the stages of wound healing

A
  1. Inflammatory Stage
  2. Proliferative Stage
  3. Maturation Stage
38
Q

What days does the inflammatory stage occur?

A

0-6

39
Q

How does a wound appear during the inflammatory stage?

A

red, inflamed tissue which is painful to the patient

40
Q

What are the key features of the inflammatory stage?

A

Hemostasis via platelets
PMN leukocytes decrease bacterial growth
Day 4 - Macrophages produce growth factors

41
Q

What days does the proliferative stage occur?

A

4-24

42
Q

How does the proliferative stage present?

A

beefy, red, moist appearing tissues; Granulation tissue

43
Q

What are the key features of the proliferative stage?

A

Fibroblasts produce collagen
Wound margins begin to contract
Epithelization occurs

44
Q

When does the maturation stage occur?

A

day 21 to 24 months

45
Q

How does the maturation stage present?

A

Intact skin integrity; possible scar presentation

46
Q

What are the key features of the maturation stage?

A

Collagen fibers continue to remodel and shape to improve skin integrity, strength, and function

47
Q

What is the difference between open and closed wounds?

A

skin integrity disrupted vs intact

48
Q

What are examples of open wounds?

A

Incised wound
Abrasion/superficial wound
Laceration/tear
puncture wound
gunshot wound
penetration wound

49
Q

What are examples of closed wounds?

A

Contusion/bruise
Hematoma/blood tumor
crush injury
acute wound
chronic wound

50
Q

What is a necrotic wound

A

A wound with dead cells present

51
Q

What is an infected wound

A

microorganisms have colonized in wound tissue

52
Q

What is a granulating wound

A

A wound that has started the healing process with the presence of new connective tissue

53
Q

What is an epithelializing wound

A

A wound with new epithelial cells present

54
Q

What is a complex wound

A

A complicated wound that does not respond to traditional interventions:
Diabetic ulcer
pressure ulcer
gangrene
Fournier infection

55
Q

Wound dressing indications

A

Prevent infection
Cosmetic
Protect wound
Immobilize surrounding skin/provide support
Apply pressure to aid in hemostasis

56
Q

Wound dressing contraindications?

A

Blood flow compromise
Skin allergy to dressing material
Application of adherent gauze directly to wound bed

57
Q

When to use caution with wound dressings?

A

Adhesive tape on thin, fragile skin
Persistent povidone use

Fall 2024 (34 decks)

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