S1L1: Wound Management Flashcards
T/F: Cleansing method should be selected on its ability to support or return a wound bed to homeostasis
True
T/F: Whirlpool is a cleansing agent only
False: Both a cleansing agent and mechanical
debridement
T/F: Whirlpool use selective mechanical debridement
False: non-selective
T/F: In whirlpool, there is Large risk of contamination of wound
True
● Basically, it is a cleansing tool which uses suction to clear out well the debris from the irrigation process
● AKA Forceful irrigation
PULSATILE LAVAGE WITH SUCTION
Potential risk of PULSATILE LAVAGE WITH SUCTION
Overuse
If you over debride the wound you will risk the
removal of the viable tissues that the wound needs
to be able to heal
● Wound Irrigation + suction to clean out wound exudate &
debris, & delivers medication
● May aerosolize microorganisms
PULSATILE LAVAGE WITH SUCTION
● Pouring a solution over a wound using a bulb syringe or other device
Non-forceful irrigation
● Mostly used to treat wounds that are clean, & only need removal of endogenous fluids, or residue by cleaning products
NON-FORCEFUL IRRIGATION
● Topical solutions that are marketed for acute & chronic wounds
● Most have some antimicrobial effects but most have significant antimitotic effects
COMMERCIAL SKIN & WOUND CLEANSERS
Refers to the
● The removal of foreign matter & dead or damaged tissue
● More of a mechanical means
Wound debridement
● Removal of all types of tissue
● Quick, but painful & damages nearby tissue
● E.g. whirlpool
NONSELECTIVE DEBRIDEMENT
● Removes necrotic tissue in a controlled manner
● More comfortable & gentle
SELECTIVE DEBRIDEMENT
Application of a wet dressing that is allowed to dry on the wound
Wet to Dry Dressing
Wet to Dry dressing: Selective or Non selective?
Nonselective
● Rapid results for treating life-threatening necrosis, large wounds, tunneling wounds, & necrotic or infected bone
SURGICAL DEBRIDEMENT
● Nonselective debridement with cleansing
PULSATILE LAVAGE WITH SUCTION
● Through the use of agitation
● Can soften necrotic tissue prior to other forms of debridement
WHIRLPOOL
Gold standard of wound debridement
SHARP DEBRIDEMENT
Removal of dead, necrotic tissue with the use of a scalpel, scissors, or forceps (sterile)
SHARP DEBRIDEMENT
T/F: Sharp debridement is Contraindicated for vascular wounds with limited blood flow where the eschar may be covering a chronic open wound
True
Because eschar aids in healing of wounds
T/F: Sharp debridement is not appropriate for tunneling
true
Application of a topical agent using enzymes that act by dissolving necrotic tissue
CHEMICAL OR ENZYMATIC DEBRIDEMENT
T/F: Chemical or Enzymatic debridement is nonselective, discomfort is minimum, simple application procedure
False: Selective, discomfort is minimum, simple application procedure
T/F: in chemical/enzymatic debridement, there is a Potential development of dermatitis, frequent dressing changes disrupts wound bed
True
T/F: CHEMICAL OR ENZYMATIC DEBRIDEMENT is antimicrobial
False: Not antimicrobial.
Thus, can remove necrotic tissue but does not remove bacteria present in the area
Clean maggots are put in the wound and they are the
ones that are eating out the slough, eschar and other bad
tissues but leaving viable tissue to heal after
Maggot debridement therapy (Biosurgery)
Recommended for osteomyelitis & deep wound
infections that remain unresponsive to regular therapy
Maggot debridement therapy (Biosurgery)
Topical Agents: Antiseptic vs. Antibacterials
Povidone-Iodine
Antiseptic
Topical Agents: Antiseptic vs. Antibacterials
Gentamycin/Geramycin: currently effective against
all species of staphylococcus and streptococcus.
Antibacterial
Topical Agents: Antiseptic vs. Antibacterials
Bactroban/Mupirocin: currently effective against all
species of staphylococcus.
Antibacterial
Topical Agents: Antiseptic vs. Antibacterials
Sulfamylon/Mafenide acetate: diffuses easily
through eschar, primarily for thermal injuries.
Antibacterial
Topical Agents: Antiseptic vs. Antibacterials
Furacin/Nitrofurazone: cytotoxic in animal studies.
Antibacterial
Topical Agents: Antiseptic vs. Antibacterials
Silvadene/Silver Sulfadiazine: primarily for thermal
injuries, silver is selectively toxic to bacteria but may
inactivate topical proteolytic enzymes.
Antibacterial
Topical Agents: Antiseptic vs. Antibacterials
Bacitracin/Baciguent: associated with allergic
reactions
Antibacterial
Topical Agents: Antiseptic vs. Antibacterials
Hydrogen Peroxide
Antiseptic
Topical Agents: Antiseptic vs. Antibacterials
Acetic Acid Solution
Antiseptic
Topical Agents: Antiseptic vs. Antibacterials
Sodium Hypochlorite Solutions = bleach solution,
contains antimicrobial properties
Antiseptic
● Stimulates cellular activity, accelerates inflammation
● Skin repair & wound contraction
● Strengthens scar tissue
● Cover the wound with a sheet of hydrogel
ULTRASOUND
● Acute & chronic wounds
● Eliminate bacterial load, promote granulation, decrease
inflammation, reduce wound related pain, augment blood
flow
ELECTRICAL STIMULATION
ES: Applied using a soaked gauze or a hydrogel dressing, direct or indirect?
Direct
ES: Periwound area, direct or indirect?
Indirect
T/F: Thermal & Nontheemal diathermy is Not indicated for patients with arterial insufficiency
True
Increase fibroblast proliferation, collagen formation,
tissue perfusion, & metabolic rate
THERMAL & NON-THERMAL DIATHERMY
● Cutaneous & bactericidal effects
● Increased blood flow, granulation tissue formation, destruction of bacteria, stimulation of vitamin D production, & stratum corneum
ULTRAVIOLET RADIATION
● Controlled amount of negative pressure is applied
● It aids in wound contraction by pulling the sides of the
wound in towards the middle
NEGATIVE WOUND PRESSURE THERAPY
● Enhances granulation tissue formation, promote wound
edge approximation, remove edema, & improve oxygen levels
NEGATIVE WOUND PRESSURE THERAPY
T/F: In Negative wound pressure therapy, Changed every 12 hrs (infected) to 24 hrs (non-infected)
wounds
True
● Promoted for augmenting wound healing
● Reversing peripheral neuropathy in people with diabetes ● Decreases pain
COLD LASER THERAPY
Leaves contaminating fibers, contributes to desiccation, permeable to bacteria, adheres to the wound, releases bacteria to air upon removal (used for wet to dry, if you remove it, other tissues may come with), causes loss of normothermia, painful on removal
GAUZE/FIBER
T/F: Gauze/Fiber
○ Cannot be used to lightly pack tunneling wounds
○ Can be used as a secondary dressing (not used in
isolation)
False
True
● Designed to be less adherent
● Cellulose acetate + vaseline
● Minimally absorptive, minimal protection
● Primary dressing over new sutures to prevent them
catching
Impregnated Gauze
T/F: Impregnated Gauze Does not enhance a moist environment
True
● Transparent membrane with acrylic adhesive layer
● Facilitate a moist wound environment
● Autolytic debridement
TRANSPARENT FILMS
● Promotes angiogenesis & wound bed homeostasis
● Protects the skin from shearing, friction, & the effects of
incontinence
● Careful removal
● Usually used when applying IV lines so it won’t get removed
TRANSPARENT FILMS
Highly absorbent pads of polyurethane, create an occlusive environment
Foam
T/F: Foam is used alone for a dry wound
False: Not used alone for a dry wound because it will absorb whatever moisture the wound will excrete
● Amorphous, gel-like
● Thin sheet of polymer containing 90% water
Hydrogel
T/F: Hydrogel must be contained with a secondary dressing to keep it in place
True
Used to increase moisture on a dry wound bed, soften necrotic tissue, & support autolytic debridement
Hydrogels
Considered the most occlusive of the moisture-retentive dressing
Hydrocolloid
Consist of absorbent colloidal material with a film/foam backing
Hydrocolloid
T/F: Hydrocolloid is:
● Used as occlusive dressings over infected wounds without increasing bacterial load
● Not used during MDT (Maggot Debridement Therapy)
True
False
Alginates is derived from
marine algae
Can Absorb 20-30x their own weight
Alginates
Chemical reactions form a gel substance to
keep wound environment moist
Alginates
T/F: Alginates provide barrier against bacteria
False
T/F: Alginates do not require a secondary dressing
False
Alginate + ____ = antibacterial properties
Silver
Commonly used for copious wounds or very
heavy exudation
Alginates
○ Hydroactive dressings
○ Selective absorptive capacity
Hydrofibers
Combined positive characteristics of alginate, foam, and gel dressings
HYDROFIBERS
● Absorb exudate & align themselves perpendicularly to the
wound surface
● Allow growth factors & peptides to survive on the wound
bed for better healing environment of the wound
HYDROFIBERS
● Bioengineered tissues
● Temporary wound cover
SKIN SUBSTITUTES
● Used on wounds that have not responded to conventional
therapy such as a chronic diabetic foot ulcer, venous leg ulcers, & deep burns
SKIN SUBSTITUTES
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
An absorbent secondary dressing for exudating or oozing wounds
A
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Appearance: A sponge with a transparent film attached to a pump
H
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Appearance: Woven and fibrous
G
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Appearance: Thin roll with a single adhesive side
F
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Appearance: Soft pad
D and E
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Appearance: Moist gauze. May contain antiseptic, e.g. iodine
C
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Appearance: Transparent film
B
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Appearance: Woven tissue
A
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Expensive Disruptive to patient
H
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Contraindicated in drier wounds
G
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Not a sole dressing
F
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Relatively expensive. Often cause localized erythematous reaction
E
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Cannot be used on dry wounds
D
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Non-occlusive. Require fixation dressing
C
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Fluids will become trapped and macerate. Allogenic
B
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Desiccating and adherent
A
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Removes heavy exudate, oedema and infected material. Promotes angiogenesis
H
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Highly absorbent. Haemostatic
G
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Can be cut to any shape
F
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Promote autolytic, conformable
E
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Promote autolytic debridement
D
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Non-adherent. May be antiseptic
C
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Allows monitoring of skin. Conformable. Cheap
B
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Highly absorbent, Cheap
A
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Uses: Large, deep, contaminated wounds. Highly exudative wounds
H
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Uses: Exudating or mildly bleeding wounds
G
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Uses: Holding a non-adhesive dressing in place
F
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Uses: Ulcers or other chronic wounds
E
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Uses: Ulcers, leg ulcers, stoma sites
D
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Use: To maintain a moist environment in dry wounds
C
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
Uses: For small, minimally exudative wounds as a primary dressing. As secondary dressing for other wounds
B
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
Absorbency (High)
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
A. Gauze
G. Calcium alginate
H. Negative pressure dressing
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
Absorbency (Minimal)
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
B. Semipermeable polyurethane film
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
Absorbency (Moderate)
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
D. Hydrocolloid
E. Foam
SUMMARY OF WOUND DRESSINGS’ PROPERTIES BY CATEGORY
Absorbency (Nil)
A. Gauze
B. Semipermeable polyurethane film
C. Moist Gauze
D. Hydrocolloid
E. Foam
F. Fixation
G. Calcium alginate
H. Negative pressure dressing
C. Moist Gauze
F. Fixation