Lecture 3 - Dressings Flashcards
Dressings should fill in any voids to promote _______ healing
prevent maceration of periwound
decrease bioburden
manage edema
bottom up healing
Primary vs secondary wound dressing
Primary dressing - comes in direct contact with the wound
Secondary dressing- placed over primary dressing to increase protection
Gauze advantages and disadvantages
advantage: cheap, easy, used with lots of material
disadvantages: can dry and rip out tissue
Semipermeable film advantages and disadvantage:
Advantages: Allows wound visualization: impermeable to fluids/bacteria, lasts longer (up to 7 days)
Disadvantage: no absorption, adherent to dry skin, may cause maceration
When to use: Stage 1 or stage 2 pressure ulcer
amorphous Hydrogels advantages and disadvantages
(may contain silver or alginate)
Advantages: hydration of wound, autolytic debridement, easily cleaned
disadvantages: may macerate, minimal absorption, requires secondary dressing, daily changes requires
When to use amorphous hydrogels or hydrogel sheets?
Stage 2 or 3 pressure ulcers, skin tear/abrasion
Hydrogel sheets vs amorphous hydrogels
sheets have self adherant border
Advantage and disadvantages of foam
advantages: Higher absorbant, can be used when infected
can be used in tunnels and undermining
Disadvantages: may require additional tape, may macerate, not recommended for dry eschar (will dry it out more)
When to use foam?
Stage 2,3,4, Pressure ulcer w/ heavy drainage
What is hydrocolloid?
Hydrophillic (absorbant) colloid particles bound to foam or film, it’s impermeable to bacteria
Hydrocolloids advantages and disadvantages
Advantages: creates moist enviroment, impermiable to bacterial, autolytic debridement, Can wear up to 7 days
Disadvantages: contraindicated for infection, will not handle a lot of drainage, difficult to remove from fragile skin, requires second product to fill space
What are alginates
Composite fibers derived from seaweed, cause exchange of sodium calcium ions
What are advantages and disadvantages of alginates
Advantages: Highly absorbant (x20), non-occlusive, can be used in infection, has hemostatic properties, useful in tunneling, atraumatic removal, facilitates autolysis
Disadvantages: requires secondary dressing, can dry out and adhere to woundbed, may macerate if hydrated too much
When to use alginate?
Stage 2 ,3, 4 Pressure ulcers that have moderate to heavy drainage/exudate
What is hydrofiber?
Simular to alginate: Costs more, more absorbant
__________ added to all other types of dressing make them antimicrobial
silver or cadexomer
What are honey impregnanted dressing
Made from manuka plants to be more anti-inflammatory
may decrease pain and healing time
“tastes just like honey” -steven lim
what are Collagen dressings
these type of dressings allow you to add collagen to the woundbed
Change weekly , only change secondary dressing during the week
What are the top 3 most permeable dressing?
- Loose-weave gauze
- Fine-weave gauze
- Calcium alginate
What are the most impermiable dressings?
- Latex
- Hydrocolloid
- Hydrogel (sheet)
What is a biological skin substitute
Combines novel materials with living cells
dermagraft and apligraft most common, are derived from neonatal forskin
APPLIED BY PHYSICIAN
What does biological skin substitute look like
may look like yellow crust on these wounds (this is growth factor) dont debride this!
What’s the difference between between an Apligraf and a full skin graft
Apligraf doesnt have langerhan cells, melanocytes, endolthelial cells
Apligraf is approved to treat venous ulcers
What is a dermagraft?
FDA approved to treat full thickness wounds
contains fibroblsts (no lymphocytes or macrophages)
T or F
OTC antimicrobials can improve a wound
F
OTC microbials like neosporin arent supported w/ research
perscription topicals are more effective
When and how should antiseptic agents be used
Should be diluted
only used short term, and when there’s no healthy tissue
example: early after bite wound
just after motorcycle accident
When you have multiple dressing options, what should you pick
Pick the one that allows the fewest dressing changes
best cost and ease of application
