Module 2 - Solutions, Dressings, Devices Flashcards
Define sterile technique.
Free from all living micro organisms.
Define aseptic technique.
Process for keeping away disease producing micro organisms.
When/how is it appropriate to use Standard ANTT?
Technically simple procedures.
Short procedures.
Involve small key-sites and key-parts.
Aseptic field does not need to be managed critically.
General aseptic field.
Non-sterile gloves.
Essential use of micro critical aseptic fields and non-touch technique to protect key parts.
When/how is it appropriate to use Surgical ANTT?
Technically complex procedures. Extended procedure time. Large open key site. Large or numerous key parts. Critical aseptic field areas. Use of sterile gloves. Often full barrier precautions. Micro critical aseptic fields and non-touch technique may be applied.
Describe wound bed preparation.
T - Tissue Non-Viable or Deficient I - Infection or Inflammation M - Moisture Imbalance E - Epidermal Margin - non advancing or undermined
What are the dressing options to ensure appropriate moisture balance for dry, minimal, moderate and high exudate wounds?
Dry - Hydrogels, hydrocolloids, interactive wet dressings.
Minimal - Semipermeable films, hydrocolloids, calcium alginates
Moderate - Calcium alginate, hydrofibre, hydrocolloid (paste, powder & sheet), foams.
High - Hydrofibre, foams, extra absorbent dry dressings, wound/ostomy bag, negative pressure therapy
Describe primary, secondary and tertiary dressings.
Primary Dressing - Non-infected Wound
-Infected Wound
Secondary Dressing
- Low Exudate Absorption
- Mod Exudate Absorption
- High Exudate Absorption
- Super Absorption
Tertiary Dressing - Tape
- Retention Bandage
- Compression Bandage
Describe tulle gras and give product examples.
*Cotton (wide mesh) or synthetic (fine
mesh) tulle impregnated with
paraffin based products.
*Used as a non-stick primary dressing
Examples
- Jelonet (cotton) Atrauman & Adaptic
(synthetic) – can be left in situ for 2
days
- Antiseptic impregnated: Inadine
(PVP1), Bactigras (chlorhexidine) –
needs to be changed daily
Describe properties/uses for calcium alginate. Give examples of products.
- Absorbs low-mod exudate
- Capillary wicking so cut to shape
or pack into wound to avoid
maceration of surrounding skin - Alginate has haemostatic
properties - Primary dressing
Comes in - Flat dressings
- Ribbon & rope shape packing
dressings
Describe properties/uses for hydrofibre. Give examples.
- Primary dressing
- Vertical wicking –does not need to be cut to shape
- Absorbs mod-heavy exudate
- Not haemostatic
Examples - Aquacel, Durafibre
Describe properties/uses for hydrogels. Give examples.
- Donates fluid to dry wounds for moist wound healing or autolytic debridement purposes.
Examples - Amorphous gels (Intrasite gel)
- Gel impregnated gauze (Intrasite conformable)
- Gel sheet (Aquaclear)
Describe properties/uses for hydrocolloids. Give examples.
- Adhesive primary dressing
- Absorbs low –mod exudate
- Waterproof
- Moist wound healing
- Promotes autolytic debridement
- Conforms to body
- Don’t use on infected wounds
- Hydrocolloid paste & powder can be used to fill superficial cavities under sheet dressing
Examples - Duoderm, Comfeel, Stomahesive powder
Describe properties of chlorhexidine tulle.
- Primary dressing
- Impregnated tulle gras with chlorhexidine 0.5%
- Effective against gram + & -organisms
- Change daily
Describe properties of iodine.
- Elemental iodine or tinctures are a potent broad spectrum antiseptic
- Very chemically active and irritant to tissues
- Inactivated by blood and organic matter
- Iodophors are the result of joining iodine to a polymer –creates a water-soluble agent which releases free iodine slowly
Describe the properties/uses for povidone iodine (PVP 1). Give product examples.
Broad spectrum antimicrobial - Bactericidal (Gram +, Gram -) - Fungicidal - Sporicidal - Virucidal No resistant strains PVP 10% considered toxic to fibroblasts PVP 1% non toxic *Inactivated by organic matter* Can be systemically absorbed Acidosis has been reported in burns patients
Examples
- PVP1 impregnated tulle (Inadine)
- Betadine liquid/scrub etc
Describe the properties/uses for cadexomer iodine. Give product examples.
- Slow release of iodine –tissue friendly
- Converts to a gel –moist wound healing
- Facilitates debridement
- Reduces malodour
- Absorbs up to 6 times its weight
- A single applications should not exceed 50g
- Should not exceed 150g in 1 week
- Can remain in situ up to 3 days
- Duration of treatment should not exceed 3 months
Examples
-Iodosorb Paste/powder
Describe properties/uses of silver impregnated dressings. Give product examples.
- Silver is bactericidal, fungicidal and virucidal
- Ag+ = ionic silver ( the silver cation)
-Increased surface area of Ag will increase the amount of Ag+ generated and released when exposed to moisture
-All silver dressings achieve their antimicrobial action by generating and releasing this silver cation.
Examples - Acticoat/Acticoat Absorbent
- Biatain Ag
- Aquacel Ag
- Atrauman Ag
- SilverCel
- Actisorb
Describe properties/uses for wound honey. Give product examples.
- Broad spectrum antimicrobial
- Effective against 250 strains
+ MRSA (48 strains)
+ VRE (20 strains)
+ Pseudomonas (20 strains) - pH 3.2-4.5 (av. 3.9)
- High osmolarity inhibits microbial growth (sugar molecules ‘tie’ up water molecules and result in insufficient water for survival)
- Honey action - Antibacterial action, Anti inflammatory, Deodorises, Debrides, Moist wound healing
Examples - Amorphous honey -Medihoney
- Alginate impregnated –Medihoney alginate
- Tulle impregnated -Activon
Describe properties/uses for hypertonic saline.
- 20% hypertonic saline –antiseptic
- Wet or dry impregnated gauze
- Impregnated hydrogel
- Promotes autolytic / osmotic debridement
- Do not use on bleeding wounds
- Can cause stinging
Describe properties/uses of PHMB. Give examples.
- Antiseptic cleanser or gel dressing
- Broad spectrum
- Effective against biofilm
- Soak gauze in cleanser and leave on wound for 15 mins for optimal effect
- Gel dressings changed daily
Example: - Prontosan
- PHMB impregnated foams or gauze
Describe properties/uses for dry dressings. Give examples.
Used as a primary & secondary dressing for: - Absorbency - Protection Examples - Gauze, Combine Disadvantages - Sheds fibres - Strike through of exudate - Dry dressings adhere to the wound & causes trauma
Describe properties/uses for non (low) adherent dressings. Give examples.
- A ‘non-stick’ agent bonded to contact surface
- Suitable for superficial wounds
- Absorbs low amounts of exudate
Examples - Melolin, Tricotex, Release
Used on ‘island’ dressings Bandaids, Primapore, Airstrip
Describe properties/uses for semi-permeable films. Give examples.
- Semi-permeable to gases
- Impermeable to liquids & organisms
- Suitable for low amounts exudate & superficial wounds
- Can be used as a secondary dressing to waterproof
- Transparent –aids inspection
Examples - OpSite, Tegaderm
Describe properties/uses for foams. Give examples.
- Primary or secondary dressings
- Adherent & non adherent forms
- Can be used on infected wounds
- Absorbs mod-heavy exudate
- One or two sided foams
Examples
Allevyn, Biatain, PermafoamVertical
Describe properties/uses for super absorbent dressings. Give examples.
- Used as a primary & secondary dressing
- Absorbs large amounts of exudate
- Protects
- Non-adherent
Examples - Zetuvit, Zetuvit Plus, Relevo
Describe properties/uses for combination dressings. Give examples.
- Adhesive & non-adhesive primary dressings
- Absorbs mod-heavy exudate
- Protection –some offloading of pressure
- Layers of different materials
Examples - Alione, Combiderm, Allevyn Life, Versiva
Describe properties/uses for silicone dressings. Give examples.
- Non-traumatic primary dressings
- Suitable for fragile skin –e.g. skin tears
- Foam –absorbs mod exudate
- Variety of shapes & sizes
Examples - Mepilex, Mepilex Border, Allevyn Gentle, Biatain Silicone
What is TOPICAL NEGATIVE PRESSURE THERAPY?
The use of controlled negative pressure wound therapy to assist and accelerate wound healing. Also known as vacuum assisted wound healing (VAC therapy).
- Controlled topical negative pressure is applied to the entire wound.
What are the benefits of topical negative pressure therapy?
- Increased local, functional blood perfusion
- Increased nutrient delivery to wounded tissue
- Accelerated granulation
- Decreased wound bacterial counts
- Reduces localised oedema
- Moist wound healing
- Aids contraction
- Facilitates epithelialisation
What are the contraindications of topical negative pressure therapy?
- Fistulae (occasionally used on gastrointestinal fistulae)
- Non-viable tissue
- Osteomyelitis
- Malignant wounds
- Caution in bleeding wounds
Describe properties/uses for ostomy or wound appliances.
- Contains large amounts of exudate
- Can record accurate FBC
- Protects surrounding skin
- Prevents maceration
- Optimises client comfort
- Reduces dressing change
