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Integ - Dressings > Dressings > Flashcards

Dressings Flashcards

1
Q

Define Occlusion

A

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

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2
Q

Dressing that is most occlusive

A

latex

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3
Q

Dressing that is most nonocclusive

A

Loose-weave gauze

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4
Q

Moisture-retentive dressings facilitate autolytic debridement withing __–____hours

A

72-96 hours

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5
Q

Occlusive dressings lower infection rates, how? - 4 ways

A
  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
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6
Q

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

A
  1. Semipermeable foams
  2. Alginates
  3. Antimicrobial dressings
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7
Q

Benefits of nonwoven gauze

A

Synthetic fibers, greater absorbency

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8
Q

Benefits of loose woven gauze

A

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

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9
Q

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

A

Telfa - nonadherent gauze with little absorptive capabilities

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10
Q

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

A

Petrolatum-impregnated gauze

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11
Q

To treat venous insufficiency ulcers use

A

Zinc impregnated gauze

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12
Q

What is xeroform gauze

A

Combo of bismuth and petrolatum

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13
Q

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

A

TRUE

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14
Q

Semipermeable film dressings should not be used on

A

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

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15
Q

Superficial wound such as skin tear, laceration and abrasion use

A

semipermeable film

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16
Q

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

A

Amorphous hydrogel covered by a semipermeable film

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17
Q

Partial thickness wounds, sutured wounds and donor graft sites use

A

semipermeable film

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18
Q

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

A

False

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19
Q

Amorphous hydrogels can be used as a coupling agent for

A

Ultrasound

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20
Q

Sheet hydrogels can be used as padding for

A

contact casts and splints

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21
Q

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

A

sheet hydrogels

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22
Q

Hydrogels should not be used on

A

heavily draining wounds or infected wounds

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23
Q

Semipermeable foam is permeable to ____ but not to ___

A

permeable to gas but not to bacteria

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24
Q

Pressure Ulcers stage II and III use

A

semipermeable foam

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25
Q

Granulating or slough-covered partial and full thickness wounds use

A

semipermeable foam

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26
Q

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

A

True, but they should be changed daily

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27
Q

Semipermeable foams are not indicated for

A

dry or eschar covered wounds

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28
Q

Should you use a semipermeable foam on an arterial ulcer?

A

no, they tend to be very dry

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29
Q

How do hydrocolloids absorb exudate?

A

Slowly by swelling into a gel-like mass

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30
Q

Benefits of hydrocolloids

A

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

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31
Q

Hydrocolloids are indicated for

A

partial and full thickness wounds

32
Q

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

A

True

33
Q

Hydrocolloids are MC used on

A

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

34
Q

Hydrocolloids are contraindicated for

A

bleeding and heavily draining wounds, infected wounds

dry wounds - arterial ulcers, or 3rd degree burns

35
Q

Hydrocolloids may cause

A

hypergranulation

36
Q

What are alginate dressings?

A

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

37
Q

How to alginate dressings work?

A

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

38
Q

How much can alginate dressing absorb?

A

20x their weight in exudate

39
Q

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

A

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

40
Q

Do alginates require a secondary dressing?

A

Yes, they are highly permeable and nonocclusive

41
Q

Can you use alginates on infected wounds?

A

yes

42
Q

Alginates are not indicated for

A

dry or minimally draining

43
Q

Alginates are not recommended for

A

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

44
Q

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

A

20mg/l

45
Q

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.

A

False

46
Q

When is a good idea to use silver?

A

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

47
Q

Can saline be used in combination with silver

A

No, it will deactivate the silver

48
Q

Primary reason to use charcoal dressings

A

odor control

49
Q

Benefits of Honey dressings

A

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

50
Q

Collagen dressings are good for

A

Stage III or IV pressure ulcers

51
Q

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

A

bovine or porcine tissue

52
Q

Are collagen dressings better than hydrocolloids?

A

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

53
Q

Tissue adhesives are appropriate for

A

acute linear wounds without tissue loss

54
Q

Growth factors are limited to

A

chronic wounds that do no respond to standard interventions

55
Q

Are growth factors recommended for pressure ulcers?

A

No, there is not enough evidence supporting this

56
Q

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

A

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

57
Q

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

A

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

58
Q

What is the primary goal of skin substitutes?

A

achieve rapid wound closure and restore normal skin function

59
Q

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

A

Moisture-retentive, keep for several days

60
Q

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

A

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

61
Q

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

A

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

62
Q

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

A
  1. It can assist with debridement

2. Helps attaining and maintaining a moist environment

63
Q

Which has a higher bioburdern? Granular or necrotic wound?

A

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

64
Q

Infected wounds are best covered with what dressing?

A

gauze - can change them daily or more

65
Q

Should you use tape whenever possible to secure dressings?

A

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

66
Q

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

A

c. moderate to copious draining

67
Q

Can tubular dressings be used if sterile techniques are required?

A

NO, tubular dressings are clean dressings, not sterile

68
Q

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

A
  1. Bacterial barrier
  2. Impermeable to urine and stool
  3. Facilitate neutralization of microorganisms
  4. Facilitate removal of necrotic tissue and debris
69
Q

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

A

Semipermeable film

70
Q

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

A

False - semipermeable foams are permeable to gas but NOT bacteria

71
Q

DuoDerm is an example of what type of dressing?

A

hydrocolloid

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

72
Q

Typically composite dressings have how many layers?

A
  2. Inner: nonadherent, prevents wound bed trauma
  3. Middle: maintain moisture (hydrogel)
  4. Outer: bacterial barrier (semi foam)
73
Q

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

A
  1. Sensitive to iodine
  2. Thyroid disease
  3. Large cavity wounds
74
Q

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

A

occlusive

75
Q

How do you prevent an abscess forming?

A

pack the wound with a dressing (gauze)

Integ - Dressings (1 decks)

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