Week 2 Wound Dressings Flashcards
what is the purpose of a dressing
to provide the optimal environment of moisture, warmth, protection, odor, topical and pain. and one that changes with drainage response, temperature and bioburden
are dressings static or not? what does this mean
not, because they are applied in response to how the wound is changing
how often to we re-eval dressings
every visit
what are some considerations when choosing a wound dressing
educate (type and amount) bioburden tissue type (granular, tendon, non-viable) location, size depth peri-wound etiology and history allergies patient confort supplies and cost and schedule goals common sense
when might you need to change a dressing
when it is saturated, and there is strike through to keep a moist environment timeline for topical becomes soiled, contaminated or wet disrupted loose or falls doctors appointment bathing odor when concerned
what are some good things about regular gauze
readily available, many sizes, not much money.
non-occlusive and absorptive
can offer mechanical debridement
padding and can be cut to size.
what is tell
non-adherent, and little absorption, like the white part of the band aid
how often much you change gauze
every day
what are cautions around using gauze
drying, can absorb topical quickly, you can get fibers in the wound bed and you must apply roll gauze at an angle
what is impregnated gauze
it is adapted with petroleum or xeroform
what does impregnated gauze do
it has a atraumatic removal of the contact layer
can have many sizes
mild inclusiveness, and promotes moist healing
less permeable then regular
how long can you leave impregnated gauze
for several days
what does secondary impregnated gauze mean
that you need coverage over it because there is oil
what kinds of wounds is impregnated gauze usually used on
wounds with a lot of depth (and maybe to protect deeper named structures)
what are cautions with impregnated gauze
maceration, adherent if allowed to dry ( so can rip some skin off)
what is semipermeable film
thin and flexible and transparent and occlusive that is a barrier to the outside world
what kind of debridement does semipermeable film provide
autolytic
how long can you keep a semipermeable dressing on
7 days
is there a lot of a little absorption when you use a semipermeable film
little, unless combo with something else.
what kinds of wounds do you use a semipermeable dressing on
more superficial wounds.
does the semipermeable film feel comfortable, and how does it attach
yes, and to the peri-wound
what are cautions with semipermeable film
limit the wrinkles apply it with tension hard to apply not water proof must remove specifically (stretch skin and dressing perpendicular to not rip skin) can damage skin when you remove it
what are hydrogels
they can donate moisture, and absorb a small amount if fluid
what kind of debridement can hydrogels promote
autolytic
TF; hydrogels can decrease pain
true
what is the benefit of silver gel
it is antimicrobial
what do you get when you mix regular gauze, saline and hydrogel
moist dressing
must into nu-gauze for easy…
wound filling
can you use hydrogel as a primary dressing
no, needs to have another layer. it is secondary
what are some precautions with hydrogels
maceration, and sheets cannot be used on infected wounds
what are foam dressings
they are absorptive and can be used with most thicker topicals and ointments
what type of debridement do they promote
autolytic
describe the foam dressings
they are non-adherent, can be thick or thin and can add padding. they can also be used as a primary or secondary
how long can you leave foam on
up to 7 days
what are some cautions with foam
maceration and they can roll with friction
what are hydrocolloids
highly occlusive and highly adhesive, that promote autolytic.
what kind of hydrocolloid can be used for deeper wounds
paste
are hydrocolloids usually used as a primary or secondary
primary
what are some cautions with hydrocolloids
maceration
skin damage with removal
sheets are not for deep wounds
paste and particles will expand in deeper wounds
edges can roll with friction
linked with hyper granulation (skin growth above the wound opening)
what is alginate
highly absorptive dressing that can hold drainage and absorbs vertically and laterally
how can you use alginate in atraumatic removal, and what can happen
gel with absorption and you can trap bacteria
TF: alginate can assist some with clotting
true
how long can you leave alginate on
7 days
is alginate occlusive? what does this mean
no, so no autolytic comments.
what are some cautions with using alginate
maceration
not for highly draining wounds
wound desiccation
or the wound looks bad when wet
what are some contraindications with alginate
not over named structures or on neonates less than 38 weeks gestation
what is hydrofiber
highly absorptive that absorbs vertically.
which is more absorptive alginate or hydrofiber
hydrofiber
in what direction does hydrofiber absorb, and why does this mater
vertically, so less risk of maceration
what is aquacel (Conva TEC)
a new wound ribbon dressing that has stitch bonding to increase strength
when should you use an antimicrobial
with critical colonization, active infection, or a high risk of infection
when should you stop using antimicrobials
clean wounds, or epithelializing/granulating
when the risk is removed
short term dressings, so know when to stop and why you are using it
what are examples of antimicrobials
honey
silver
cadexomer iodine.
what is cadexomer iodine
a brand spectrum antimicrobial that has slow release of iodine and non-cytotoxic. turns white with absorption and can be cheaper than others. it can also stain the skin
can you combo cadexomer iodine with collagenase
no
what are some cautions with cadexomer iodine
allergy to iodine or shellfish
pregnant or breast feeding
younger than 6 months
prolonged use (HYPERTHYROIDISM)
what can prolonged use of cadexomer iodine cause
hyperthyroidism and cytotoxicity
what are contraindications of cadexomer iodine
thyroid disease, and deep wound cavities
what is silver
brand spectrum, in many forms like power, gel, alginate, hydrocolloids, foam, sheets and creams. can wear it daily to 7 days.
can you combine silver with collagenase
no
what are cautions to silver
toxicity with prolonged use
allergy
irrigate with sterile water
watch newborns, infants and young
what is honey
broad spectrum that can reduce odor and pain, and is anti-inflammatory and non toxic
what kind of debridement does honey promote
autolytic and it assists with the breakdown of nonviable tissue
what are cautions and contraindications to honey
cautions: initial stinging
contraindications: allergies to bees or honey
