Dressings

Question 1

Define Occlusion

Answer 1

Ability of a dressing to transmit moisture vapor and gases from the wound bed to the atmosphere

Question 2

Dressing that is most occlusive

Answer 2

latex

Question 3

Dressing that is most nonocclusive

Answer 3

Loose-weave gauze

Question 4

Moisture-retentive dressings facilitate autolytic debridement withing __–____hours

Answer 4

72-96 hours

Question 5

Occlusive dressings lower infection rates, how? - 4 ways

Answer 5

1. Serve as bacterial barrier
2. Require less frequent changes
3. Retaining macrophages and neutrophils –> neutralization of microorganisms
4. Preserves endogenous enzymes –> removal of necrotic tissue

Question 6

Moisture-retentive dressings are contraindicate for infected wounds EXCEPT - 3

Answer 6

1. Semipermeable foams
2. Alginates
3. Antimicrobial dressings

Question 7

Benefits of nonwoven gauze

Answer 7

Synthetic fibers, greater absorbency

Question 8

Benefits of loose woven gauze

Answer 8

Aids in mechanical debridement of wet-to-dry by trapping debris and slough in large pores

Question 9

Superficial, nondraining wounds closed by primary or secondary intention, dressing?

Answer 9

Telfa - nonadherent gauze with little absorptive capabilities

Question 10

To facilitate healing by preventing wound bed trauma during dressing changes use

Answer 10

Petrolatum-impregnated gauze

Question 11

To treat venous insufficiency ulcers use

Answer 11

Zinc impregnated gauze

Question 12

What is xeroform gauze

Answer 12

Combo of bismuth and petrolatum

Question 13

T or F. It is NORMAL for brownish fluid to accumulate beneath a semipermeable film dressing.

Answer 13

TRUE

Question 14

Semipermeable film dressings should not be used on

Answer 14

cavity wounds or wounds with moderate to heavy drainage or those with frail skin

Question 15

Superficial wound such as skin tear, laceration and abrasion use

Answer 15

semipermeable film

Question 16

What would you use to soften a black eschar covered wound?

Answer 16

Amorphous hydrogel covered by a semipermeable film

Question 17

Partial thickness wounds, sutured wounds and donor graft sites use

Answer 17

semipermeable film

Question 18

T or F. Semipermeable films should be used on infected wounds.

Answer 18

False

Question 19

Amorphous hydrogels can be used as a coupling agent for

Answer 19

Ultrasound

Question 20

Sheet hydrogels can be used as padding for

Answer 20

contact casts and splints

Question 21

Abrasions, skin tears, blisters, donor sites, radiation burns, thermal burns, pressure ulcers, diabetic ulcers, mastitis, and surgery sites use

Answer 21

sheet hydrogels

Question 22

Hydrogels should not be used on

Answer 22

heavily draining wounds or infected wounds

Question 23

Semipermeable foam is permeable to ____ but not to ___

Answer 23

permeable to gas but not to bacteria

Question 24

Pressure Ulcers stage II and III use

Answer 24

semipermeable foam

Question 25

Granulating or slough-covered partial and full thickness wounds use

Answer 25

semipermeable foam

Question 26

T or F. Semipermeable foams can be used on infected ulcers.

Answer 26

True, but they should be changed daily

Question 27

Semipermeable foams are not indicated for

Answer 27

dry or eschar covered wounds

Question 28

Should you use a semipermeable foam on an arterial ulcer?

Answer 28

no, they tend to be very dry

Question 29

How do hydrocolloids absorb exudate?

Answer 29

Slowly by swelling into a gel-like mass

Question 30

Benefits of hydrocolloids

Answer 30

provide thermal insulation, impermeable to water, O2, and bacteria

Question 31

Hydrocolloids are indicated for

Answer 31

partial and full thickness wounds

Question 32

T or F. Hydrocolloids can be used on both granular and necrotic wounds.

Answer 32

True

Question 33

Hydrocolloids are MC used on

Answer 33

pressure ulcers - can be used on burn and venous insufficiency ulcers

Question 34

Hydrocolloids are contraindicated for

Answer 34

bleeding and heavily draining wounds, infected wounds | dry wounds - arterial ulcers, or 3rd degree burns

Question 35

Hydrocolloids may cause

Answer 35

hypergranulation

Question 36

What are alginate dressings?

Answer 36

Salts of alginic acid from brown seaweed converted into calcium/sodium salts

Question 37

How to alginate dressings work?

Answer 37

They react with serum and wound exudate to form a hydrophilic gel --> moist environment and traps bacteria

Question 38

How much can alginate dressing absorb?

Answer 38

20x their weight in exudate

Question 39

Which is better, alginate tipped applicator or cotton swabs? why?

Answer 39

Alginate - they do not cause an inflammatory response if wisps are left behind

Question 40

Do alginates require a secondary dressing?

Answer 40

Yes, they are highly permeable and nonocclusive

Question 41

Can you use alginates on infected wounds?

Answer 41

yes

Question 42

Alginates are not indicated for

Answer 42

dry or minimally draining

Question 43

Alginates are not recommended for

Answer 43

full thickness, or neonates born less than 38 weeks gestation, the dressing may alter electrolyte balance

Question 44

Silver dressings with greater than ___mg/l have the best results

Answer 44

20mg/l

Question 45

T or F. There is a great amount of research showing that silver is effective against multiple organisms within the same wound or against biofilms.

Answer 45

False

Question 46

When is a good idea to use silver?

Answer 46

Pressure ulcers that are heavily colonized in patients at high risk of infection

Question 47

Can saline be used in combination with silver

Answer 47

No, it will deactivate the silver

Question 48

Primary reason to use charcoal dressings

Answer 48

odor control

Question 49

Benefits of Honey dressings

Answer 49

decrease wound pain, reduce wound healing time, improve scar formation

Question 50

Collagen dressings are good for

Answer 50

Stage III or IV pressure ulcers

Question 51

If a patient is sensitive to _____ or _____ then collagen dressings are contraindicated

Answer 51

bovine or porcine tissue

Question 52

Are collagen dressings better than hydrocolloids?

Answer 52

No, study showed that there is no benefit to collagen, but they cost 40% more

Question 53

Tissue adhesives are appropriate for

Answer 53

acute linear wounds without tissue loss

Question 54

Growth factors are limited to

Answer 54

chronic wounds that do no respond to standard interventions

Question 55

Are growth factors recommended for pressure ulcers?

Answer 55

No, there is not enough evidence supporting this

Question 56

Why are biological dressings believed to be better than moisture-retentive?

Answer 56

They restore the skin's natural barrier properties, prevent water loss, heat loss, protein and electrolyte loss and bacterial contamination

Question 57

When would you use a skin substitute (skin graft)?

Answer 57

nonhealing, uninfected partial and full thickness venous ulcers, neuropathic ulcers, burns and traumatic wounds

Question 58

What is the primary goal of skin substitutes?

Answer 58

achieve rapid wound closure and restore normal skin function

Question 59

Autolytic debridement, you would use moisture-retentive or gauze dressing?

Answer 59

Moisture-retentive, keep for several days

Question 60

Enzymatic debridement, you would use moisture-retentive or gauze dressing?

Answer 60

Gauze, it must be changed 1-3 times a day

Question 61

What is the most common reason for a granulating wound to be heavily draining?

Answer 61

Infection is present, may be the only sign of silent infection (think immunocompromised)

Question 62

Why would you want to use enzymatic debridement on a necrotic nondraining wound?

Answer 62

1. It can assist with debridement | 2. Helps attaining and maintaining a moist environment

Question 63

Which has a higher bioburdern? Granular or necrotic wound?

Answer 63

Necrotic - be aware of infection especially with draining because wet wound bed is ideal environment for microbes to proliferate

Question 64

Infected wounds are best covered with what dressing?

Answer 64

gauze - can change them daily or more

Question 65

Should you use tape whenever possible to secure dressings?

Answer 65

No, avoid using tape. May be too aggressive, and traumatize even healthy skin

Question 66

Which type of wounds are alginate ropes good for? a. minimal draining b. nondraining c. moderate to copious draining d. wounds with exposed tendon/bone

Answer 66

c. moderate to copious draining

Question 67

Can tubular dressings be used if sterile techniques are required?

Answer 67

NO, tubular dressings are clean dressings, not sterile

Question 68

Why do occlusive dressings have lower infection rates compared to nonocclusive? 4 ways

Answer 68

1. Bacterial barrier 2. Impermeable to urine and stool 3. Facilitate neutralization of microorganisms 4. Facilitate removal of necrotic tissue and debris

Question 69

What type of dressing can be used over IV catheters or over wounds for ultrasound treatments?

Answer 69

Semipermeable film

Question 70

T or F, semipermeable foams are permeable to gas and bacteria.

Answer 70

False - semipermeable foams are permeable to gas but NOT bacteria

Question 71

DuoDerm is an example of what type of dressing?

Answer 71

hydrocolloid | It is an effective barrier against urine, stool, MRSA, hepatitis B, HIV-1, and Pseudomonas.

Question 72

Typically composite dressings have how many layers?

Answer 72

3. 1. Inner: nonadherent, prevents wound bed trauma 2. Middle: maintain moisture (hydrogel) 3. Outer: bacterial barrier (semi foam)

Question 73

When would you be cautious about using cadexomer iodine? - 3

Answer 73

1. Sensitive to iodine 2. Thyroid disease 3. Large cavity wounds

Question 74

If a wound is infected you should avoid using, occlusive or nonocclusive dressings?

Answer 74

occlusive

Question 75

How do you prevent an abscess forming?

Answer 75

pack the wound with a dressing (gauze)