Lecture 3 - Dressings

Question 1

Dressings should fill in any voids to promote _______ healing

prevent maceration of periwound

decrease bioburden

manage edema

Answer 1

bottom up healing

Question 2

Primary vs secondary wound dressing

Answer 2

Primary dressing - comes in direct contact with the wound

Secondary dressing- placed over primary dressing to increase protection

Question 3

Gauze advantages and disadvantages

Answer 3

advantage: cheap, easy, used with lots of material

disadvantages: can dry and rip out tissue

Question 4

Semipermeable film advantages and disadvantage:

Answer 4

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

Question 5

amorphous Hydrogels advantages and disadvantages

Answer 5

(may contain silver or alginate)

Advantages: hydration of wound, autolytic debridement, easily cleaned

disadvantages: may macerate, minimal absorption, requires secondary dressing, daily changes requires

Question 6

When to use amorphous hydrogels or hydrogel sheets?

Answer 6

Stage 2 or 3 pressure ulcers, skin tear/abrasion

Question 7

Hydrogel sheets vs amorphous hydrogels

Answer 7

sheets have self adherant border

Question 8

Advantage and disadvantages of foam

Answer 8

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)

Question 9

When to use foam?

Answer 9

Stage 2,3,4, Pressure ulcer w/ heavy drainage

Question 10

What is hydrocolloid?

Answer 10

Hydrophillic (absorbant) colloid particles bound to foam or film, it’s impermeable to bacteria

Question 11

Hydrocolloids advantages and disadvantages

Answer 11

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

Question 12

What are alginates

Answer 12

Composite fibers derived from seaweed, cause exchange of sodium calcium ions

Question 13

What are advantages and disadvantages of alginates

Answer 13

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

Question 14

When to use alginate?

Answer 14

Stage 2 ,3, 4 Pressure ulcers that have moderate to heavy drainage/exudate

Question 15

What is hydrofiber?

Answer 15

Simular to alginate: Costs more, more absorbant

Question 16

__________ added to all other types of dressing make them antimicrobial

Answer 16

silver or cadexomer

Question 17

What are honey impregnanted dressing

Answer 17

Made from manuka plants to be more anti-inflammatory

may decrease pain and healing time

“tastes just like honey” -steven lim

Question 18

what are Collagen dressings

Answer 18

these type of dressings allow you to add collagen to the woundbed

Change weekly , only change secondary dressing during the week

Question 19

What are the top 3 most permeable dressing?

Answer 19

1. Loose-weave gauze
2. Fine-weave gauze
3. Calcium alginate

Question 20

What are the most impermiable dressings?

Answer 20

1. Latex
2. Hydrocolloid
3. Hydrogel (sheet)

Question 21

What is a biological skin substitute

Answer 21

Combines novel materials with living cells

dermagraft and apligraft most common, are derived from neonatal forskin

APPLIED BY PHYSICIAN

Question 22

What does biological skin substitute look like

Answer 22

may look like yellow crust on these wounds (this is growth factor) dont debride this!

Question 23

What’s the difference between between an Apligraf and a full skin graft

Answer 23

Apligraf doesnt have langerhan cells, melanocytes, endolthelial cells

Apligraf is approved to treat venous ulcers

Question 24

What is a dermagraft?

Answer 24

FDA approved to treat full thickness wounds

contains fibroblsts (no lymphocytes or macrophages)

Question 25

T or F

OTC antimicrobials can improve a wound

Answer 25

F

OTC microbials like neosporin arent supported w/ research

perscription topicals are more effective

Question 26

When and how should antiseptic agents be used

Answer 26

Should be diluted

only used short term, and when there’s no healthy tissue

example: early after bite wound

just after motorcycle accident

Question 27

When you have multiple dressing options, what should you pick

Answer 27

Pick the one that allows the fewest dressing changes

best cost and ease of application