CS2 - Wound dressing

Question 1

What are the primary wound dressing options?

Answer 1

Alginates
Biosynthetic
Collagens
Foams
Hydrocolloids
Hydrogels
Dressing gauze

Question 2

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

Answer 2

Alginates

Question 3

Describe the qualities of alginate wound dressings

Answer 3

Derived from seaweed
Highly absorbent/malleable
Provides a moist environment

Question 4

How long can biosynthetic wound dressings be placed?

Answer 4

up to 10 days

Question 5

What process are biosynthetic wound dressings most helpful with?

Answer 5

Epithelialization

Question 6

What type of wounds are biosynthetic dressings used for?

Answer 6

Burns
Pressure ulcers
Tears
Epithelializing wounds

Question 7

What specifically do collagen dressings help with?

Answer 7

increasing collagen deposits and promoting new tissue growth

Question 8

What is required in addition to collagen dressings?

Answer 8

secondary dressing for exudative absorption
example - foam

Question 9

What type of wound is best for collagen dressing use?

Answer 9

open wounds +/- infection

Question 10

Describe foam as a wound dressing

Answer 10

Absorbent material that is nonadherent to wound bed

Question 11

What type of wound is foam best for?

Answer 11

Open wounds with drainage

Question 12

What material makes up hydrocolloid wound dressings?

Answer 12

gelatin
pectin
carboxymethylcellulose

Question 13

How long can a hydrocolloid be placed?

Answer 13

up to 10 days

Question 14

How do hydrocolloids and hydrogels help heal wounds?

Answer 14

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

Question 15

When should hydrocolloid wound dressings be avoided?

Answer 15

infected wounds with large amounts of drainage

Question 16

What material is used for hydrogels?

Answer 16

Water or glycerin based gels

Question 17

What type of wounds are best for hydrogels?

Answer 17

Necrotic wounds
Deep wounds
Radiation burns

Question 18

What are the options for secondary dressings?

Answer 18

Foams
transparent films
Dressing gauze
Tubular gauze
Flexible collodion

Question 19

What material makes up transparent films?

Answer 19

Polyurethane membrane

Question 20

What is the benefit of a transparent film?

Answer 20

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

Question 21

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

Answer 21

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

Question 22

What materials make up dressing gauze?

Answer 22

Various from adherent to nonadherent with various impregnated substances

Question 23

What are the secondary uses for dressing gauze

Answer 23

Secure/stabilize dressings or pack wounds

Question 24

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

Answer 24

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

Question 25

What material makes up flexible collodion?

Answer 25

Nitrocellulose in alcohol and ether

Question 26

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

Answer 26

Provides a plastic like barrier over wound Scalp lacerations

Question 27

What is negative pressure wound therapy?

Answer 27

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

Question 28

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

Answer 28

Open abdominal incisions Reconstructive surgery S/P surgical debridement

Question 29

In what situations is negative-pressure wound therapy contraindicated?

Answer 29

Exposed organs Malignancy Ischemic wounds Active infection

Question 30

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

Answer 30

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

Question 31

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

Answer 31

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

Question 32

When should a dressing always be changed?

Answer 32

Always if the dressing becomes contaminated

Question 33

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

Answer 33

Consider home nursing services or wound care referral

Question 34

What should be done if a wound is infected?

Answer 34

Consider antibiotics flush with NSS four times per day

Question 35

What should always be considered with any wound?

Answer 35

Tetanus status

Question 36

What are some potential complications of wound dressings?

Answer 36

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

Question 37

What are the stages of wound healing

Answer 37

1. Inflammatory Stage 2. Proliferative Stage 3. Maturation Stage

Question 38

What days does the inflammatory stage occur?

Answer 38

0-6

Question 39

How does a wound appear during the inflammatory stage?

Answer 39

red, inflamed tissue which is painful to the patient

Question 40

What are the key features of the inflammatory stage?

Answer 40

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

Question 41

What days does the proliferative stage occur?

Answer 41

4-24

Question 42

How does the proliferative stage present?

Answer 42

beefy, red, moist appearing tissues; Granulation tissue

Question 43

What are the key features of the proliferative stage?

Answer 43

Fibroblasts produce collagen Wound margins begin to contract Epithelization occurs

Question 44

When does the maturation stage occur?

Answer 44

day 21 to 24 months

Question 45

How does the maturation stage present?

Answer 45

Intact skin integrity; possible scar presentation

Question 46

What are the key features of the maturation stage?

Answer 46

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

Question 47

What is the difference between open and closed wounds?

Answer 47

skin integrity disrupted vs intact

Question 48

What are examples of open wounds?

Answer 48

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

Question 49

What are examples of closed wounds?

Answer 49

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

Question 50

What is a necrotic wound

Answer 50

A wound with dead cells present

Question 51

What is an infected wound

Answer 51

microorganisms have colonized in wound tissue

Question 52

What is a granulating wound

Answer 52

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

Question 53

What is an epithelializing wound

Answer 53

A wound with new epithelial cells present

Question 54

What is a complex wound

Answer 54

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

Question 55

Wound dressing indications

Answer 55

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

Question 56

Wound dressing contraindications?

Answer 56

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

Question 57

When to use caution with wound dressings?

Answer 57

Adhesive tape on thin, fragile skin Persistent povidone use