W25 Wound Dressings (AM) Flashcards
How are polymers versatile?
Polymer implants
Pegylation
Oral lyophilisates
Transdermal patches
Dressings
Y1 (Dressings, Drugs, Suspending agents, Film coatings, Packaging, Adhesives, Implants, Tablets)
How are chronic wounds defined?
- Wound that has not healed in 6 weeks- 3 months
- Acute is the other type
What are the features of an Ideal wound dressing? (9)
a. Provide or maintain moist environment
b. Enhance epidermal migration
c. Promote angiogenesis and connective tissue synthesis
d. Allow gas exchange between wounded tissue and environment
e. Maintain appropriate tissue temperature
f. Provide protection against bacterial infection
g. Non-adherent and easy to remove after healing
h. Must provide debridement action to enhance leucocytes migration
i. Must be sterile, non-toxic and non-allergic.
How are sterile dressing packs described by the BNF? (SDPs)
Where is this prescribing info found?
BNF: The role of dressing packs is very limited (in treatment)
Drug Tariff specification 10 and 35
Contents unchanged for decades-little place in modern wound management
What are contained in SDP’s? (2)
- Cotton tissue / wool / balls feature prominently in both specifications
- Made from BP grade absorbent cotton
- Gauze swabs
Non- drug tariff=gloves, aprons, forceps, kidney trays, measuring tapes
Other traditional dressings?(2)
- Absorbent Lint BPC
- BNF: Cotton cloth of plain weave with
nap raised on one side from warp yarns - Non-extensible bandages
- Open-wove Bandage Type 1 BP 1988
Selecting an appropriate dressing
What are the 5 types of wound?
(Hint-colours)
- PINK (epitheliasing)
- RED (granulating)
- YELLOW (Sloughy)(granulating)
- BLACK (Necrotic/ Eschar)
- Wounds with signs of infection
Describe a PINK (epitheliasing) wound:
- Final stage of healing – epithelial cells spread across the wound
- This pink/ white tissue is very delicate so care when cleansing
wound
Describe a RED (granulating) wound:
- Describes the bumpy tissue bed as new vasculature formed (angiogenesis)
- Granulation primarily consists of collagen and elastin
Describe a YELLOW (Sloughy)(granulating) wound:
- Slough is the yellow or white material on the wound bed
- Dead cells that are sticking to the wound exudate
- If excessive may require manual debridement
Describe a BLACK (Necrotic/ Eschar) wound:
- Dead tissue usually caused by lack of blood supply – source of nutrients for bacterial growth
- Needs removal rapidly to promote healing in tissue below
- Congealed blood can sometimes have the appearance of necrotic tissue
Describe the symptoms of Wounds with signs of infection?
- Heat, pain, erythema and swelling
- Patient has pyrexia (fever)
- Purulent drainage, i.e. pus discharge, and malodour.
- Signs of delayed healing and wound breakdown
What are Low adherence dressings?
- These are non-absorbent and placed directly on the wound and then covered with a secondary dressing
- Suitable for low exudate epitheliasing or
granulating wounds - These dressings prevent the secondary dressing (there to absorb the exudate) from direct contact with the wound
- Tulle gras dressings, e.g. Jelonet are typically cotton and impregnated with white soft paraffin or yellow soft paraffin to help prevent adherence to the wound Jelonet gauze dressing
What are Vapour-permeable films?
- Allow water vapour and oxygen to permeate but not microbes and water
- Helps ensure a moist environment to promote healing
- Film is often made of polyurethane – that is the case with Opsite – and may have an adhesive coating
- Often used as a secondary dressing over more absorbent dressings, e.g. alginates
What are Soft polymer dressings?
- Dressings with soft polymer (often silicone) in contact with the wound
- These are either non-adherent or gently adherent
- Suitable for use on low to moderately exuding wounds and usually used with a secondary absorbent dressing
- An alternative is the soft polymer dressing with a combined absorbent pad (often polyurethane)
