Integumentary: Dressings Flashcards
Films: What it is
- Clear adhesive, semipermeable membrane
- Permeable to air and moisture
- Non permeable to Water, bacteria, and environmental contamination
Films: What they do
- Cover shallow wound beds
- Autolytic Debridement
Films: What types of wounds to use them on
- Stage 1 and II pressure ulcers (shallow wound beds)
Films: What types of wounds NOT to use them on
- Wounds with fragile surrounding skin or infected wounds
Films: Wet/Dry Wounds
- N/A
Films: Main Advantages
- Visual examination possible
- Protects against external fluids and bacteria.
- Promotes autolytic debridement
- Minimize friction
Films: Main Disadvantages
- Non absorptive
- May cause maceration
- Not to be used on wounds with depth, undermining, or tunneling.
Films: Considerations
- Secondary dressing not required
Hydrocolloids: What it is
- Adhesive wafers that contain hydro active absorptive particles that interact with wound fluid to form a gelatinous mass over wound bed.
- Occlusive or semi-occlusive
Hydrocolloids: What they do
- Cover shallow wounds with scant /small exudate
- As secondary dressing with alginate or hydrofiber.
- ## PROVIDE A MOIST ENVIRONMENT FOR FIBRINOLYSIS
Hydrocolloids: What types of wounds to use them on
- Partial thickness wounds
- Autolytic debridement
- Wounds with mild exudate
Hydrocolloids: What types of wounds NOT to use them on
- Not recommended for wounds with heavy exudate, sinus tracts, infections.
No recommended for wounds that expose bones or tendons. - Not recommended for words with fragile surrounding skin
Hydrocolloids: Wet/Dry Wounds
- Hydrocolloids should be used to moisten dry wounds or maintain moist environments in wounds that are already moist.
Hydrocolloids: Main Advantages
- Maintains a moist environment
- Autolytic debridement
Hydrocolloids: Main Disadvantages
- Yellow drainage on removal
- Odor on removal
Hydrocolloids: Considerations
- Characteristic Odor+Yellow exudate on removal normal.
- Change every 3-7 days based on leakage
- Avoid in wounds that are infected or have tracts
Hydrogels: What it is
- Water or glycerine based gels.
- Insoluble in water
- Absorptive capacity varies
Hydrogels: What they do
- Hydrate
- Insulate
- No residue left behind
Hydrogels: What types of wounds to use them on
- Partial and full thickness wounds (Full thickness is distinguishing factor between hydrocolloids and hydrogels)
- Wounds with necrosis and slough
- Burns and tissue damaged by radiation
Hydrogels: What types of wounds NOT to use them on
- Do not use Hydrogels on wounds with heavy exudate.
- Do not use sheet form on infected ulcers.
Hydrogels: Wet/Dry Wounds
- Used to rehydrate/moisten dry wounds.
Hydrogels: Main Advantages
- Rehydrate dry wounds
- Autolytic debridement
- Some absorption
- Amorphous form can be used with present infection
Hydrogels: Main Disadvantages
- Require a secondary dressing
- May adhere to surrounding wound bed
- May macerate surrounding skin
Hydrogels: Considerations
- Sheet form works well for partial thickness ulcers.
- Sheet form can promote growth of yeast
- Dressing change every 8-48 hours
- Skin barrier wipes on surrounding skin can decrease the chance of maceration.
Foams: What they are
- Semi permeable membranes that are either hydrophilic or hydrophobic
Foams: What they do
- Insulate+protect wounds
- Manage minimal to heavy exudate
- Can be used primary or secondary
Foams: What types of wounds to use them on
- Partial and full thickness wounds with minimal to moderate exudate (Exudate being what distinguishes them from Hydrocolloids and Hydrogels).
- ## Secondary dressing with packing to provide additional absorption.
Foams: What types of wounds to NOT use them on
- No to be used with wounds with dry eschar or wounds with no exudate
- Poor conformability with wounds that are deep
Foams: Wet/Dry Wounds
- Foam should be used on wound that are wet or very wet.
- Foams should NOT be used on wounds that are dry.
Foams: Main Advantages
- Insulate+protect wounds
- Manage minimal to heavy exudate
- Can be used primary or secondary
Foams: Main Disadvantages
- Non transparent
- Non adherent
- May cause desiccation and maceration
Foams: Considerations
- Change every 1-5 days as needed for leakage
- Protect intact surrounding skin to prevent maceration
Alginates and Hydrofibers: What it is
- Alginates: Soft, absorbent, non woven dressings, derived from seaweed that react with wound exudate to to form a viscous hydrophilic gel mass over the wound area.
Hydrofibers: Same as alginates by composed of polymer
Alginates and Hydrofibers: What they do
- Absorbs from wounds with HEAVY exudate.
- Support debridement
Alginates and Hydrofibers: What types of wounds to use them on
- Wounds with moderate to large amounts of exudate
- Wounds with combined exudate and necrosis
- Wounds that require packing and absorption
- Infected and non-infected exuding wounds.
Alginates and Hydrofibers: What types of wounds NOT to use them on
- Not recommended for dry or LIGHTLY exuding wounds.
- Can dry wound bed
Alginates and Hydrofibers: Wet/dry wounds
- Should be used on very wet wounds for purposes of drying exudate.
- Should not be used on dry wounds as it may over dry.
- Can be combined with alginate in wet wounds to create balance between drying and hydration
Alginates and Hydrofibers: Main Advantages
- Absorbs from wounds with HEAVY exudate.
- Support debridement
- Can be used in infected wounds
Alginates and Hydrofibers: Main Disadvantages
- Require secondary dressing
- Can dry wound bed
- May desiccate wound
- Can macerate
Alginates and Hydrofibers: Considerations
- May use gauze or transparent film as secondary dressing
- Change schedule varies from every 8 hours to every 2-3 days.
Gauze: What it is
- Made of cotton or synthetic fabric that is absorptive and permeable to water and oxygen
- Can be used with several other agents.
Gauze: What it does
- Several tasks
Gauze: What types of wounds to use them on
- Exudative wounds
- Wounds with dead space, tunneling, or sinus tracts
- Wounds with a combination exudate or necrotic tissue
Gauze: What types of wounds to use them on: Wet to Dry
- Mechanical debridement of necrotic tissue and slough
Gauze: What types of wounds to use them on: Continuous Dry
- Heavily exudating wounds
Gauze: What types of wounds to use them on: Continuous Most
- Protection of clean wounds
- Autolytic debridement of slough or eschar
- Delivery of topical needs
Gauze: What types of wounds to NOT use them on
- Avoid direct contact with granulating tissue.
Gauze: Wet/dry wounds
- Can be used on varying wet/dry wounds
- Can be combined with moistening agents to keep wounds moist
Gauze: Main Advantages
- Can be used on infected wounds
- Good mechanical debridement if properly used
- Filler for large wounds
- Effective delivery of topicals if kept moist
Gauze: Main Disadvantages
- Delay healing if used improperly
- Require secondary dressing
- Increased infection rates when compared to semi occlusive.
- Leaves behind microfibers creating a chronic inflammatory state
Gauze: Considerations
- Pack loosely. Tight packing compromises blood flow
- Continuous roll for packing large wounds to insure complete removal.
- Can macerate
- Wide mesh=Debridement
- Fine Mesh=protection
Specialty Dressings: When to use
- When conventional dressings do not show signs of aiding healing of wound.
- Partial thickness should heal 1-2 weeks
- Full thickness should heal 2-4 weeks
Specialty Dressings: Main Advantages
- Reduced abnormal biological activity in wounds.
Specialty Dressings: Main Disadvantages
- Expensive
- May not be readily available
Specialty Dressings: Considerations
- Application precautions specific to product
Collagen: What it is
- Protein found in connective tissues that comes in various dressings.
Collagen: What it does
- Stimulates fibroblasts
Collagen: What types of sounds to use them on
- Recalcitrant wounds
Collagen: What types of wounds NOT to use them on
- Do not use on necrotic wounds
Collagen: Wet/dry Wounds
- Dry wounds=Pre- moistened collagen
- Wet wounds=Collagen of granulated
Collagen: Main Advantages
- Low risk of allergic reaction
Collagen: Main Disadvantages
- Requires secondary dressing
Collagen: Considerations
- May require moisture additive
Antimicrobial Dressings
- Silver
- Iodine
Antiseptics
- Dakins solution
- Acetic Acid
- Povidone Iodine
- Chlorhexadine
Peri-wound Protection
- ZInc Oxide
- Petroleum
