wound care dressing Flashcards
advantages/disadvantages of alginates
- advantages
- highly absorbent
- easy to use
- slows bleeding
- layered for more absorption
- used for more packing
- disadvantages
- none listed
contraindications/indications for alginates
- contraindications
- dry eschar
- third-degree and full-thickness burns
- heavy bleeding
- minimal exudate or dry wounds
- indications
- moderate to heavy drainage
- infections
- slough or granulation
- partial- and full-thickness wounds with moderate to heavy exudates
- bleeding wounds
advantages/disadvantages for antimicrobials
- advantages
- controls bacteria
- reduces or prevents infection
- disadvantages
- none listed
contraindications/indications for antimicrobials
- contraindications
- known sensitivity
- silver can cause staining in wound/skin
- indications
- infected wounds
- wounds at risk for infection
advantages/disadvantages for collagen
- advantages
- encourages deposition and organization of newly formed colalgen fibers and granulation tissue
- absorbant
- non-adherent
- conforms well to wounds
- helps maintain moisture
- disadvantages
- requires secondary dressing
advantages/disadvantages of composites
- advantages
- includes non-adherent contact layer, middle absorptive layer, outer bacterial barrier
- disadvantages
- none listed
advantages/disadvantages of contact layer
- advantages
- protects
- disadvantages
- none lsited
advantages/disadvantages of enzymatic topical
- advantages
- breaks down proteins
- slow results
- disadvantages
- sensitivity to ingredients
- cannot be used with silver-based products
- expensive
advantages/disadvantages of foam
- advantages
- absorbs moisture
- helps with maintaining moisture through insulation
- can be impregnated or layered with other materials
- non-adhesive (may be available with adhesive borders)
- can be used as a filler
- can help reduce granulation tissue
- can be used under compression
- disadvantages
- expensive for daily dressing changes
advantages/disadvantages of gauze
- advantages
- highly permeable, non-occlusive
- inexpensive
- disadvantages
- none listed
advantages/disadvantages of honey
- advantages
- hydrates wound bed
- decreases pH - helps with healing
- disadvantages
- slow results
advantages/disadvantages of hydrocolloids
- advantages
- very adhesive
- also available in powders and pastes
- promotes autolytic debridement
- can be used under compression
- good for contoured areas
- can be cut to fit
- helps to maintain moisture and thermal insulation
- disadvantages
- may encourage hypertrophic granulation
- may cause maceration
- may increase risk for anaerobic infection
advantages/disadvantages of hydrogel
- advantages
- cooling effect
- promotes autolytic debridement
- hydrates wound bed
- absorbs minimal fluid
- may help decrease wound pain
- non-adhesive
- good filler material
- disadvantages
- less effective bacterial barrier
- may cause maceration
- may require daily dressing change
- requires secondary dressing
advantages and disadvantages of hydrofiber and alginate
- advantages
- absorbs moisture
- used for packing
- disadvantages
- none listed
advantages and disadvantages of impregnated gauze
- advantages
- highly comfortable
- non-adherent
- maintains moisture
- disadvantages
- none listed
advantages and disadvantages of silicone gel sheets
- advantages
- soft cover
- disadvantages
- may require secondary dressing
- may cause maceration or rash
advantages/disadvantages of transparent films
- advantages
- hydrates wound bed
- sticks to dry skin but doesn’t adhere to moist surface
- highly elastic
- impermeable to liquid and bacteria, but permeable to vapor/gases
- promotes autolytic debridement
- prevents/reduces friction
- disadvantages
- may cause maceration
advantages and disadvantages of wound fillers
- advantages
- available in many forms
- often include a time-release antimicrobial
- helps maintain a moist environment and manage exudate
- disadvantages
- requires secondary dressing
(contra)indications of collagen
- contraindications
- wounds with heavy eschar
- third degree burns
- sensitivity to bovine products
- indications
- chronic non-healing wounds
- partial and full thickness wounds
- granulating or necrotic wounds
- infected and non-infected wounds
- tunneling wounds
- wound with minimal to heavy exudate
contra/indications for enzymatic topical
- contraindications
- not recommended for heavily infected wounds
- indications
- eschar
contra/indications for foam
- contraindications
- dry wounds
- third degree or full thickness burns
- sinus tracts
- indications
- partial and full thickness wounds
- minimal to heavy exudate wounds
- softened necrotic tissue
- infected wounds
contra/indications for gauze
- contraindications
- minimally draining/dry wounds
- indications
- none listed
contra/indications for hydrocolloids
- contraindications
- burns or dry wounds
- wounds with heavy exudate
- tunneling wounds or sinus tracts
- infected wounds
- wounds with exposed tendon or bone
- wounds with fragile periwound skin
- indications
- partial and full thickness wounds with or without necrotic tissue
- skin tears
- lacerations
- dry, necrotic wounds
- minimal exudate
- clean granulating wounds
contra/indications for hydrogel
- contraindications
- moderate to heavy exudate
- full thickness burns
- indications
- minimally draining
- dry wounds
- eschar
- partial and full thickness wounds that are dry or moist
- granulating wounds
- wounds with necrosis
- minor burns, skin tears, donor sites
- infected wounds
contra/indications for impregnated gauze
- contraindications
- heavy exudate
- indicates may vary depending on dressing
- indications
- painful wounds
- burns
- dry wounds
- minimal drainage
- alginates
contra/indications silicone gel sheets
- contraindications
- silicone allergy/sensitivity
- unhealed, open wounds
- indications
- prevention or improvement of appearance of old and new hypertrophic and keloid scars
contra/indications for transparent/films
- contraindications
- wounds with moderate to heavy exudate
- not ideal for infected wounds
- full thickness burns
- indications
- wounds with little/no exudate
- wounds with necrosis
- cover donor sites, lacerations, abrasions
- protect intact blisters
- partial thickness
contra/indications for wound fillers
- contraindications
- dry wounds
- indications
- partial and full thickness wounds
- infected wounds
- draining wounds
- deep wounds
cloth tapes
- soft surgical cloth
- no latex, hypoallergenic
- porous
- good for areas that stretch
- good for wear and tear, repeated re-dressing
silicone tape
- can be removed and re-applied with less pain or skin irritation
- breathable
- allergy concern with silicone
foam tape
- cushions
- flexes and stretches
- waterproof
- good for moisture control
silk tape
- most economical option
- high strength - careful on delicate skin
- high adhesive
- hypoallergenic
- great for bulky dressings and tubing
- breathable, conforming
- bi-directional tearing
paper tape
- good for repeated applications on sensitive skin and elderly patients
- allows for moisture evaporation
- breathable
- minimal adhesive residue left behind
clear plastic surgical tape
- latex-free
- hypoallergenic
- transparent
- perforated
- strong adhesive
- bi-directional tearing
- water resistant
labelling dressings
- date
- time
- initials - whoever put dressing in place
- number of pieces in wound (if applicable)
- info like removal direction (if applicable)
- limit time open to air between dressings
negative pressure wound therapy - wound vac
- promotes granulation tissue
- for large wounds - for pretty clean wounds
- special foam - can have silver, white foam good for extensions
PPE and other equipment
in the order of putting on:
1. gowns
2. mask - if any chance of splash/spray
3. goggles or face shield - if any chance of splash/spray
4. gloves - always
maybe headlamp or other light (don before gloves if used)
clean technique
- reduces overall number of microorganisms - prevent or reduce risk of microorganism transmission
- handwashing
- maintain clean field
- clean gloves, dressing
- sterile instruments
- prevention of direction contamination of materials and supplies
research inconclusive on which technique is better
sterile technique
- reduces and maintains objects and areas as free from microorganisms as possible
- handwashing
- use of sterile field
- sterile gloves, dressings, and instruments
- avoid sterile materials touching any nonsterile surface/product
disposal of medical waste
- sharps
- needles/syringes
- scalpels, curettes
- pieces of bone, stables
- anything with a sharp edge/point
- trash
- contains blood or other biological waste - red bio bag
- no blood/bio - regular trash
patient-dedicated equipment
- tape, sprays, creams, and other wound care products
- open dressing containers must be resealed - some cannot be saved/reused
- store in clean area of room (acute care) - other areas may have assigned bins for each patient