Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Integumentary > Week 3 > Flashcards

Week 3 Flashcards

1
Q

What is negative pressure wound therapy?

A

Closed wound dressing system with suction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does negative pressure wound therapy do?

A

Applies controlled, sub-atmospheric pressure across open wounds
• 0-125 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the mechanisms of action and benefits of negative pressure wound therapy?

A 
• Removal of exudate
• Moist wound environment
• Decrease bacterial burden
• Reduce edema and excess interstitial fluid
  - Increases blood flow
• Increase in microvascular blood flow
• Stimulation of granulation tissue
  - Mechanical deformation
• Promotes wound contraction
• Reduces dressing change frequency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the general equipments used in negative pressure wound therapy?

A

• Pump provides suction
- Electric, battery
- Reusable, disposable; large, portable, tiny
• Wound filler or cover transfer pressure across wound bed &
allow fluid to move through & into canister
• Tubing – delivers suction, transports fluids
• Canister – holds evacuated fluids
• Occlusive sheeting provides air-tight seal
- Maintain sub-atmospheric pressure
• Application – simple to complicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the indications for negative pressure wound therapy with acute and chronic wounds?

A

• VI, pressure injuries, traumatic, surgical, burns,
• Mass casualty & high energy injuries - military
• Bone or tendon exposure – w/protection
• Over grafts – with protection
- removes fluid, compresses, stabilizes/splints
- Intermittent mode contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the indications for negative pressure wound therapy with acute and chronic wounds over sutures?

A

With protection, intermittent mode contraindicated
• For at-risk pts: removes fluid, approximation
• Disposable units, up to ~7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the indications for negative pressure wound therapy with pediatrics?

A
  • Special guidelines, lower pressure (50-125)
  • Based on age, wt, etiology, location
  • Dehydration (also in elderly)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the characteristics of negative pressure wound therapy and tissue protection?

A

• Can apply over any body tissue – with protection
- Adaptic
- Sometimes 3-4 layers
• White foam
- Less aggressive compared to black/green

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the precautions to take for negative pressure wound therapy?

A
  • Anticoagulants, low platelet count
  • Non-enteric & unexplored fistulas
  • Over named structures (bone, tendon, organs, vessels, etc.)
  • Requires several layers of barrier dressing or use of white foam
  • Monitor for bleeding
  • Avoid circumferential occlusive sheeting application due to increased risk of ischemia
  • Monitor skin condition when placed over bony prominences or prominent hardware due to compression
  • Sharp edges of exposed bone should be debrided prior to application to protect soft tissue during compression
  • MD notified if drainage in canister is sanguineous, fills w/n 1 hour, or if >2 canisters filled w/n 24 hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the precautions to take for negative pressure wound therapy in regards to arterial insuffuciency?

A

AI (not for moderate/severe AI)
• Compression at wound edge causes 1-2.5 cm area of hypoperfusion
- Not a good idea for AI wounds where surrounding tissue is already
compromised
- Use lower pressures
- Intermittent mode - if appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the contraindications of negative pressure wound therapy?

A

• >30% slough/necrotic tissue or over dry wounds
• Untreated osteomyelitis
• Gross inf w/or w/o frank pus or sepsis
• Malignancy except in palliative care
• Lack of hemostasis
• Blood dyscrasia as w/leukemia/hemophilia
• Directly over exposed vessels/by-pass grafts/organs/named structures
• Ischemic wounds w/significant proximal occlusion
• No intermittent over grafts due to high potential for disruption
• No suction devices/pumps in MRI, HBOT, or close to flammable anesthetics
(See specific vendor specifications)
• Any wound showing negative response to initial tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the pre-requisites to do when using negative pressure wound therapy with an infection?

A 
• Pt free of most systemic s/s of gross infection
• Necrotic tissue debrided
• Abscesses drained
• Adequate perfusion
• Can be combined w/Ag
- Silver dressings
• Instillation (V.A.C.)
- Wound wash w/o removal of dressing
     - Antibiotics, saline, etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the signs of wound deterioration?

A
  • Increased peri-wound erythema
  • Repeated need for sharp or surgical debridement
  • Increased drainage, bleeding
  • Newly observed infection/necrosis
  • Increased pain
  • Increased wound size
  • Newly observed undermining or tracts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do we know when to discontinue negative pressure wound therapy?

A
  • Goals have been met
  • Good granular bed achieved, even w/ skin surface
  • No appreciable benefit evident post 48 hrs
  • S/s of deterioration
  • Development of new infection post NPWT initiated
  • Pt discomfort/intolerance
  • When other dressings better suit current phase of healing
  • Progression too little/no drainage
  • Anticoagulants
  • Sanguineous drainage (indicating hemostasis has not been achieved), fills canister in 1 hour or > 2 in 24 hours (may require temporary hold on therapy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the different parameter choices for negative pressure wound therapy?

A
  • Filler & protective barriers
  • Mode of delivery
  • Frequency of change
  • Pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the different wound fillers used for negative pressure wound therapy?

A
  • Black, white, green foam
  • Gauze & JP “type” drain
  • Flat, simple, disposable “stick on” dressings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the modes of delivery of negative pressure wound therapy?

A 
• Continuous
  - always on
• Intermittent
  - on & off cycles
• Variable
  - up & down but not off
• Combination
  - continuous at first, then intermittent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the recommendations for the use of continuous negative pressure wound therapy?

A
  • 80-125 mmHg for most acute wounds & pressure injuries
  • 100-125 mmHg over grafts for first 3-5 days
  • 80 mmHg shown to give max effects on blood flow
  • 50-75 mmHg if pain issue
  • 50-75 mmHg for most chronic wounds
  • 40-50 mmHg for wounds w/decreased circulation
  • 75 mmHg for abdominal wounds due to presence of pressure receptors in abdomen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the recommendations for the use of intermittent negative pressure wound therapy?

A
  • 125 mmHg, 5 minutes on/2 minutes off

* 40-75 mmHg for mild arterial wounds (& lower pressures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the recommendations for the use of variable negative pressure wound therapy?

A

10-125 mmHg depending on etiology & pt comfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the recommendations for the use of combination negative pressure wound therapy?

A

125 mmHg x first 24 hours, 80 mmHg intermittent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the methods to help reduce pain at the dressing change of negative pressure wound therapy?

A

• Soak wound filler 3-5 minutes w/saline - infuse via tubing
• Protective layer – prevents adherence to fragile tissues
• Xeroform strips around wound edges (allows for more re-ep too)
• Pull occlusive sheeting parallel to the skin
• Skin protectant
• Frequent dressing change (24 verses 48 hours)
• Granulation ingrowth less likely w/gauze
- Greater compression/contraction w/foam compared, less pain
• Pain/discomfort at initial pressure application may last 20 minutes
• White foam may be less painful upon removal vs black foam
• Calcium alginate under foam may reduce removal pain
• At dressing change, cover tissue w/soak to prevent dehydration
• Pain meds prior to dressing change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the patient education tips to provide a patient that uses negative pressure wound therapy?

A
  • Basic operation, alarms, how to patch
  • Benefit wound healing
  • Device “on” 24 hours a day
  • Keep tubing open, no kinks
  • 24 hour troubleshooting assistance line (if vendor supplies)
  • Keep battery charged
  • What to do: bleeding, increased pain, etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the different depths recognized when it comes to burns?

A
  1. Superficial (1st degree)
  2. Partial thickness (2nd degree)
    - Superficial partial thickness
    - Deep partial thickness
  3. Full thickness (3rd degree)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the usual presentations of a superficial burn?

A
  • Typically pink or red with erythema, and blanching present. Sensation is usually intact and painful
  • Little to no risk of scarring or contracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does a superficial burn take to heal?

A

3-4 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the usual presentations of a superficial partial thickness burn?

A
  • They go into the papillary dermis
  • Can vary in shade, but are usually pink, may be moist and may have blistering present
  • Blanching may be present,
  • Intact with sensation, and very painful
  • Low risk of scarring or contracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How does a superficial partial thickness burn take to heal?

A

1- 3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the usual presentations of a deep partial thickness burn?

A
  • They go into the reticular dermis
  • Usually a mild white appearance
  • Blanching is absent
  • Sensation is diminished to insensate
  • May need surgical intervention
  • Moderate to high risk of scarring or contracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How does a deep partial thickness burn take to heal?

A

3- 9 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the usual presentations of a full thickness burn?

A
  • Vary in appearance, can be red and leathery looking
  • Blanching and sensation are completely absent
  • Require surgical intervention for healing
  • Scarring is typical and skin grafting is likely
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the different types of causes of burns?

A
  • Scald
  • Flame
  • Electrical
  • Chemical
  • Radiation
  • Contact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What types of burns does a PT treat?

A
  • Superficial partial thickness
  • Deep partial thickness
  • Full thickness (3rd degree)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the typical treatment methods for a partial thickness burn?

A
  • Irrigation
  • Debridement (blisters or dead skin)
  • Anti microbial ointment or cream
  • Impregnated gauze
  • Dry gauze
  • Elastic netting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does a PT do for the treatment of a full thickness burn?

A

Prepare for grafting and dress the wound to prevent infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are PTs responsible for in the treatment of burns?

A

Early ROM and splinting for contracture and functional limitations prevention.
- Apply dressing to allow movement (do in a figure 8 style)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How are skin grafts typically dressed?

A

Dressed with soaked gauze and irrigated frequently, splinting incorporated for protection and often finished with compression. Elevation if possible and changed every 1-2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How is a graft treated after adherence of the graft (vascularized)?

A

Ointment with impregnated gauze, gauze wrap and netting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How is wound care for the donor site done?

A

Moist wound healing principles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the most common treatments for scar management and prevention?

A
  • Compression
  • Massage
  • Silicone
  • Exercise
  • Splinting
  • Positioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the compression recommendation for scar management after a wound?

A

23 hours a day during maturation, 5-40 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the massage recommendation for scar management after a wound?

A

Evidence lack for impact on scar, but is useful for mobilizing superficial tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the things to consider when prescribing exercise for a burn patient?

A
  • Consider the phase of healing
  • Stretching to blanching, slow sustained elongation
  • Note over aggressive stretching is linked to heterotopic ossification
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the most recommended position for most burn patients?

A

Fully extended, elongating along the burn areas to avoid contractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the most recommended position for burn patients that sustained a burn to the posterior neck?

A

Flexed to prevent a contracture

46
Q

What is the primary intention of surgical wound healing?

A

Edges approximated during surgery

• Sutures, staples, dermal glues

47
Q

What is the secondary intention of surgical wound healing?

A

Left open after surgery, healing with scar tissue

48
Q

What is the tertiary or delayed primary closure of surgical wound healing?

A

Initially wound left open then after a short time edges are

approximated

49
Q

What are the parameters of surgical site assessment?

A

• Screening
- Onset, fever, pain, last dressing change
- Complicating factors
• Observations
- Epithelialization/wound closure, exudate
- Wound tissue, periwound, surrounding skin
- S/s of infection (clinical & critical colonization)
• Measurement of incision
• Palpation
- Incision & surrounding area

50
Q

What are the positive signs of surgical healing within days 1-4?

A 
• Edges approximated
• Normal inflammation
• Minimum to moderate
drainage (Bloody progressing to
serosanguineous)
51
Q

What are the negative signs of surgical healing within days 1-4?

A
  • No signs of inflammation

* Tension along the incision line

52
Q

What is the primary dressing used during days 1-4 of surgical healing?

A

Dry or non-adherent gauze

53
Q

What are the positive signs of surgical healing within days 5-9?

A 
• No inflammation
• No drainage
• New epithelium along entire
incision line
• Healing ridge present
- Firmness along incision line
from collagen deposition
   - Feels like a pencil under the
incision line
54
Q

What are the negative signs of surgical healing within days 5-9?

A
  • Drainage
  • Little or no new pink epithelium
  • Absent or partial healing ridge
  • S/s of infection
  • Dehiscence
55
Q

What are the positive signs of surgical healing within days 10-14?

A
  • Sutures/staples removed
  • Pink incision site
  • Tiny openings post removal
56
Q

What are the negative signs of surgical healing within days 10-14?

A 
• Signs of inflammation or
infection
• Drainage
• Dehiscence
• Absent or partial healing ridge
57
Q

What are the positive signs of surgical healing within days 15 up to 1-2 years?

A 
• Pale pink scar
progressing to
white/silver
- Will be darker in darkly
pigmented skin
- Note: Scar will always be
weaker. Only up to 80% of
full strength
58
Q

What are the negative signs of surgical healing within days 15 up to 1-2 years?

A

Keloid or hypertrophic scarring

59
Q

What are the typical suture removal timeframe (in days) following a surgical wound?

A
  • Face: 3-5
  • Scalp: 7
  • Chest: 7-10
  • Abdomen: 7-10
  • Extremities: 7-10
  • Ear: 10-14
  • Back: 12-14
  • Foot: 12-14

*7-10 days is typical

60
Q

What are the most common forms of dressing surgical wounds?

A
  • Dry or non-adherent gauze
  • Bordered foam
  • May see beta-dine dabs along incision line as well
61
Q

When is a moist dressing of a surgical wound appropriate?

A

When viable tissue is exposed
• Impregnated gauze cut to fit over opening
• Dry gauze over the rest

62
Q

What are the characteristics of steri-strips after surgical wound?

A 
• PT placement
- Post suture/staple removal
- Sometimes placed over/w/sutures & staples
• Removal post closure
- When they fall off
- Ok to shower
• For ~2 wks after suture or
staple removal
63
Q

Why aren’t surgical wounds closed via primary intention?

A 
• Risk of infection
• Too much tissue removed
- Deep cavity
• Closure would result in too much tension
- Edema
64
Q

What are the complications that can come with taking an incision from simple to complex?

A
  • Dehiscence
  • Surgical site infection
  • Obesity
  • DM
65
Q

What are the causes of a wound dehiscence?

A
  • Tension, edema
  • Smoking
  • Infection/osteomyelitis
  • Trauma (pressure)
  • HTN
  • Stress
  • Malnutrition
  • Decreased healing potential (DM, etc.)
66
Q

What are the risk factors for an abdominal dehiscence?

A 
• Advanced age
• Anemia
• Chronic pulmonary disease
• Infection
• Increased intra-abdominal pressure
  - Obesity, ascites, coughing, etc.
• Drains
  - Continuous draining of fluids to reduce edema/tension
  - Can be located anywhere
  - Different types – negative pressure bulb, tubing
67
Q

What is the most common type of surgical site infection?

A

Nosocomial infection

68
Q

Majority of SSI related to ___

A

Majority of SSI related to incision
• IV abx 1 hr prior to first cut (Sussman, 2012)
- Good infusion into tissue
- Continued throughout surgical procedure

69
Q

What are the parameters of preoperative hair removal in order to avoid surgical site infection (SSI)?

A

Clip when you can instead of shave

70
Q

What are the basic incision care guidelines to follow?

A 
• Keep dry
- Dry gauze, telfa
- Abx ointment (slight amt) &
impregnated gauze (Xeroform, Adaptic) if tissue exposure
• Protection
- Reduce tension (edema), steristrips
• Cleansing & debridement
- Clean water, wipe toward incision line
- Remove loose debris/scab
• Monitor
-  (+) & - signs of healing, s/s of infection
71
Q

When should the PT contact the MD in regards to a surgical wound?

A
  • Early increased bloody drainage
  • Change to purulent drainage
  • Drainage after days 5 - 6
  • Absence of healing ridge by day 9
  • Infection: local s/s post day 4, systemic s/s anytime
  • Dehiscence
  • Increased pain
  • Consider contributions of increased mobility

Always use clinical judgment

72
Q

How do we go about scar management in an incision line?

A 
• Minimize inflammation
• Encourage quick closure
• Functional mobility during healing
- Upright posture, ROM, etc.
- Moisturize lightly
- STM
73
Q

What are the guidelines of pt education for self care of a surgical wound?

A
  • Infection: signs and symptoms & action to take
  • Showering/bathing
  • Nutrition/social habits
  • Wound cleansing, dressing changes, protection
  • Antibiotics
  • Pain meds
74
Q

What are the treatment options for bites?

A 
• Short term use of antiseptics
  - If at risk for infection
• Thorough irrigation:
  - PLWS, syringe & catheter, etc.
• Aggressive debridement
• Test sensation, monitor for s/s of infection – educate!
  - 24 hr follow-up
• Medical Management
  - Systemic complications
     - Antibiotics, steroids, anti-inflammatories, anti-histamines
75
Q

What are the characteristics of a cat bite?

A

• Tiny, sharp teeth
- Deep puncture wounds difficult to irrigate – higher rate of infection w/puncture wounds
• Consider opening w/scalpel for easier cleaning
- Surgical consult

76
Q

What are the characteristics of a dog bite?

A
  • Lacerations, punctures, crush injuries
  • Rabies status, behavior, known dog, etc.
  • Very low infection rate with tx 6-13%
  • Need to involve local health authorities
77
Q

What are the characteristics of a human bite?

A

• 3rd most common bite (Tabbara, 2012)
- Dog, cat are 1 and 2
- Can be worse than animal bites
• Antibiotics & tetanus is typical
- High risk of infection: 10-20%
- s/p 72 hrs & no s/s: hold antibiotics
• Determine health status of other person
- Hepatitis
- Higher transmission rate than HIV (still low)
- 75% have detectable antigen in saliva
• HIV
- 1 in 250 people in US; 1 in 5 unaware of status
- Not saliva alone, bld/saliva mix

78
Q

What are the characteristics of bite wounds?

A

• Can lead to serious infection (can develop rapidly)
- Inoculation of oral (& skin) flora into the body
- Local infection, abscess, pain, loss of function
- Osteomyelitis, meningitis, sepsis, endocarditis, brain abscess, disease transmission, etc.
• Use antiseptics & antimicrobial topicals
• Check lymph nodes adjacent to injury
• Follow-up 24-48 hrs post injury

79
Q

What are the general treatment guidelines of traumatic wounds?

A 
• History, review of systems
• Wound exam
• Functional exam
  - As PTs we address the whole person
  - Mobility plays a role in wound healing
• Irrigation?
• Debridement?
• Moisture balance?
• Dressing?
• Others: edema, positioning, ROM, strength, function
80
Q

What is the purpose of a wound dressing?

A

Provide optimal environment
• Moisture, neutral warmth, protection/barrier, odor, delivery of topicals, reduce pain,
• Not Static - applied in response to changing wound status/needs
• Changes w/drainage amount/type, healing phase,
activity, temp, tissue, bioburden, etc.

81
Q

When should the re-eval of dressings be done?

A

Every visit

82
Q

What are the considerations of deciding upon a dressing?

A
  • Exudate: type & amount
  • Bioburden
  • Tissues: granular, tendon, nonviable, etc.
  • Location, size, depth
  • Peri-wound & surrounding skin
  • Etiology & tx hx
  • Allergies
  • Pt comfort, age, pt/caregiver ability
  • Supplies, cost & coverage, schedule, goals
  • Secondary dressing, retention, compression
  • Common sense
83
Q

When do we change a dressing?

A 
• When saturated – “strike through”
• Maintain moist environment
• Timeline for topicals or combo dressings
• Becomes soiled, contaminated, wet
• Disrupted – loose/falls off, MD visit
• Bathing
• Odor
• When concerned
  - New tx, trying longer change schedule, etc.
84
Q

What are the general categories of a dressing?

A
  • Gauze
  • Impregnated gauze
  • Film
  • Hydrogel
  • Foam
  • Hydrocolloid
  • Alginate
  • Hydrofiber
  • Antimicrobial
85
Q

What are the characteristics of a “regular” gauze?

A
  • Readily available, various sizes, inexpensive
  • Non-occlusive & absorptive (drying)
  • Mechanical debridement
  • Padding, primary (with hydrogel) or secondary dressing (wet-todry)
  • Cut to size
  • Telfa: non-adherent, little absorption
  • Changed daily as primary dressing
86
Q

What are the cautions to take when using a regular gauze?

A

Drying, can absorb topicals quickly, fibers, roll gauze

applied at an angle

87
Q

What are the characteristics of an impregnated gauze?

A

• Atraumatic removal – “contact layer”
• Multiple sizes, cut to fit
• Mild occlusiveness, promotes moist wound healing
• Less permeable then “regular” gauze (fluid held underneath)
• Can be combined with topicals
• Can be primary or secondary (requires coverage)
• Some can be left in place several days
• Typically used on wounds w/o a lot of depth
- Some used to protect deeper named structures
• Ex: Adaptic, Xeroform

88
Q

What are the cautions to take when using an impregnated gauze?

A

Maceration, adherent if allowed to dry

89
Q

What are the characteristics of a semipermeable film dressing?

A

• Thin, flexible, multiple sizes, cut to size
• Transparent, occlusive (promotes autolytic debridement)
• Barrier to outside world, can stay in place up to 7 days
• Little absorption if used alone, can be combined w/other dressings
• Primary or secondary dressing
• Usually for more superficial wounds
- Requires primary dressing for cavity/deep wounds
• Highly conformable, adherent to peri-wound/surrounding skin

90
Q

What are the cautions to take when using a semipermeable film dressing?

A

Limit wrinkles, applied w/o tension, difficult to apply, not

water proof, specific removal technique, damage skin w/removal

91
Q

What are the characteristics of a hydrogel dressing?

A 
• Donate moisture
- Can absorb small amounts of drainage
- Decrease pain
- Promote autolytic debridement
• Gel & sheet forms
• Can be combined w/other dressings
- Silver powder + hydrogel = silver gel
- Regular gauze + saline + hydrogel = moist dressing
- Mush into nu-gauze for easy wound filling – but adds moisture
• Requires secondary dressing
92
Q

What are the cautions to take when using a hydrogel dressing?

A

Maceration, sheets not used on infected wounds

93
Q

What are the characteristics of a foam dressing?

A

• Absorptive
- Can be used with most thicker topicals (ointments)
• Flexible, variety of sizes, cut to size
• Non-adherent, thick & thin
• Primary or secondary dressing
- Padding, additional absorption
- Can be combined w/other dressings (layered over primary dressing)
• Insulating
- Promote autolytic debridement
• Can be left in place up to 7 days

94
Q

What are the cautions to take when using a foam dressing?

A

Maceration, can roll w/friction

95
Q

What are the characteristics of a hydrocolloids dressing?

A

• Highly occlusive
- Promote autolytic debridement
• Highly adhesive
• Sheets: various sizes, cut to fit, thick & thin
• Paste: can be used for deeper wounds
• Primary or secondary dressing (usually as primary)

96
Q

What are the cautions to take when using a hydrocolloids dressing?

A

Maceration (not as absorbent as some say), skin damage
w/removal, sheet forms not for deep wnds, paste/particles
expand in deeper wnds, edges can roll w/friction, linked
w/hypergranulation

97
Q

What are the characteristics of an alginate dressing?

A

• Highly absorptive
- Hold drainage in dressing, absorb vertically/laterally
- Gel w/absorption for atraumatic removal, may trap bacteria w/n dressing,
• Some assist w/clotting
• Sheet & rope, various sizes, cut/tear to fit
• Frequently combined in or w/other dressings
• Can be left in place up to 7 days
• Non-occlusive
• Contour easily to wound surfaces, can be layered into deeper wounds

98
Q

What are the cautions to take when using an alginate dressing?

A

Maceration if placed outside of wound margins, for highly draining wounds, wound desiccation, look “bad” when wet

99
Q

What are the contraindications of an alginate dressing?

A

Not to be used over bone, tendon, etc. or on neonates (<38wks gestation

100
Q

What are the characteristics of a hydrofiber dressing?

A

• Highly absorptive (more than alginate)
• Absorb vertically (less risk of maceration vs alginate)
• Different sizes, cut to size
- Sheets
• Aquacel (ConvaTec)
- New wound ribbon dressing
- “stitchbonding” to increase strength

101
Q

When should an antimicrobial dressing be used?

A
  • Critical colonization (trial ~ 2 wks)
  • Active infection
  • High risk of infection
102
Q

When should an antimicrobial dressing be discontinued?

A
  • Clean wound, epithelializing/granulating
  • Risk is removed
  • Short term dressings – clear reason to use them, know when to stop
103
Q

What are some examples of an antimicrobial dressing?

A
  • Cadexomer Iodine
  • Silver
  • Honey
104
Q

What are the characteristics of a cadexomer iodine dressing?

A

• Broad spectrum antimicrobial
- Slow release of iodine, non-cytotoxic
• Absorptive
- Turns white w/absorption
• Various forms
• Can be cheaper than others depending on dressing frequency
• Can stain skin, cannot combo w/collagenase

105
Q

What are the cautions to take when using a cadexomer iodine dressing?

A

Allergy to iodine/shellfish, pregnancy/breast feeding, < 6

months old, widespread prolonged use (hyperthyroidism/cytotoxicity)

106
Q

What are the contraindications of a cadexomer iodine dressing?

A

Thyroid disease, deep cavity wounds

107
Q

What are the characteristics of a silver dressing?

A

• Broad spectrum
• Various forms (combined w/other dressings)
- Powder, gel, alginate, hydrocolloid, foam, sheets, creams, etc.
• Various wear times: daily – 7 days (Depending on method of release)
• SSD (Silvadene, Silversulfadiazine)
- Cream must be thoroughly removed daily
- Adds moisture
• Some require pre-moistening
• Cannot combine w/collagenase

108
Q

What are the cautions to take when using a silver dressing?

A

Toxicity risk w/prolonged use, allergy, irrigate w/sterile

water, use on newborns/infants/young children

109
Q

What are the characteristics of a honey dressing?

A

• Broad-spectrum antimicrobial
• Various forms/combinations
- Some can absorb exudate
• Can reduce odor, pain
• Anti-inflammatory, nontoxic, decreases odor
• Promotes autolytic debridement
- Assists w/break down of nonviable tissue

110
Q

What are the cautions to take when using a honey dressing?

A

Initial stinging

111
Q

What are the contraindications of a honeydressing?

A

Allergy to bees or honey

Integumentary (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions