W14 Wound Healing Flashcards
How can wounds be classified?
Aetiology (traumatic, burns)
Mode of injury (incision, laceration, abrasion)
Time since injury (acute or chronic)
Depth
Bacterial contamination
Exudate level
What are the different types of wounds? (6)
Amputation
Avulsion
Crush injury
Puncture
Abrasion
Laceration
What factors are involved in assessing the wound? (8)
Wound characteristics to assess visually and by history:
Type and cause
Dimensions and measurements
Stage of healing (granulation, epithelialisation etc.)
Exudate amount and colour
Presence of infection or critical colonisation
Condition of surrounding skin
Pain and odour
Previous treatments and response
Principles of wound management:
What are the 5 stages of healing?
Cleansing
Removal of debris
Granulation
Vascularisation
Epithelialisation
- Highly vasculargranulation tissue,fills the woundand provides ascaffoldfor further healing.
- New blood vessels form, the blood supply to the tissue within the wound improves
- Epithelial cells migrate from the wound edges to cover the wound defect
The Ideal Dressing is..? (6)
Moist with exudate, but not macerated
Free of clinical infection and excessive slough
Free of toxic chemicals, particles or fibres
Optimum temperature for healing
Undisturbed by the need for frequent changes
Optimum pH value.
What is dressing selection based on?
Type and stage of wound
Patient preference or tolerance
Site of wound
Cost
Stage of healing
Level of exudate
Presence of infection
Condition of surrounding tissue
Anatomical location
Low adherence dressings
Protect the wound bed from direct contact with secondary dressings.
Suitable for clean, granulating, lightly exuding wounds without necrosis
Avoid granulation tissue growing into the weave of these dressings.
Also available with silver
-Antimicrobial
(Can be for pink and red wounds with low exudate)
Soft polymer dressings
Soft silicone polymer
Suitable for use on lightly to moderately exuding wounds.
For moderately to heavily exuding wounds, an absorbent secondary dressing can be added
Should not be used on heavily bleeding wounds; blood clots can cause the dressing to adhere to the wound surface.
(can be for pink low-moderate exudate and red dressings- low exudate)
Hydrocolloid dressings:
- Hydrocolloid layer on a vapour-permeable film or foam pad.
- Semi-permeable to water vapour and oxygen
- forms a gel in the presence of exudate
- facilitates rehydration in lightly to moderately exuding wounds
(pink low, red low-heavy, yellow low-moderate and black low-moderate wounds)
Foam dressings
Contains hydrophilic polyurethane foam
Suitable for all types of exuding wounds, but not for dry wounds
Variation in ability to absorb exudate between products
Saturated foam dressings can cause maceration of healthy skin if left in contact with the wound.
Can provide a protective cushion for fragile skin.
A foam dressing containing ibuprofen is available and may be useful for treating painful exuding wounds.
(can be used on pink moderate exudate and red low-heaxy exudate wounds)
Also available with silver- Antimicrobial
( moderate-heavy exudate wound with sites of infection)
Alginate dressings
Non-woven or fibrous, non-occlusive, made from calcium alginate, derived from brown seaweed
Form a soft gel in contact with wound exudate.
Highly absorbent and suitable for use on exuding wounds
Cautions:
Blood clots can cause the dressing to adhere to the wound surface.
Alginate dressings should not be used if bleeding is heavy
Extreme caution is needed if used for tumours with friable tissue.
If the dressing does not have an adhesive border or integral adhesive plastic film backing, a secondary dressing will be required.
( pink moderate, red, yellow moderate-heavy wounds)
Also available with silver- Antimicrobial
(heavy exudate, infected wounds)
Hydrocolloid-fibrous dressings
Modified carmellose fibres resemble alginate dressings, but more absorptive and suitable for moderately exuding wounds.
(used on yellow moderate exudate wounds)
Capillary-acting dressings
Transport, lift and hold exudate by capillary action
Heavily exudating wounds
When slough is thick and fatty.
(used on yellow heavy exudate wounds)
Hydrogel dressings
Amorphous, cohesive topical application that can take up the shape of a wound.
A secondary, non-absorbent dressing is needed.
Donate liquid to dry sloughy wounds
Avoid in the presence of infection
Some also have the ability to absorb very small amounts of exudate.
Unsuitable for heavily exuding wounds
(used on black and yellow low exudate wounds)
Honey dressings
Antimicrobial and anti-inflammatory properties
Osmotic properties, producing an environment that promotes healing
Honey dressings should not be used on patients with extreme sensitivity to honey, bee stings or bee products.
Patients with diabetes should be monitored for changes in blood-glucose concentrations during treatment
(Used on low-moderate exudate wounds with sites of infection)
