Wound Care (Lab Info--Teri) Flashcards
Primary Dressing
- material used to cover wound
- often to control exudate, prevent environmental contamination
Secondary Dressing
- material used to cover/secure primary dressing
- may or may not be sterile
Requirements for Optimal Wound healing
- optimal moisture
- get necrotic tissue out
- fill dead space
- protect periwound skin
- manage wound bacteria (bioburden)
- protect and insulate
Purposes of Secondary Dressing
- protect injured area
- hold splint/primary dressing in place
- exert pressure to prevent/decrease edema/bleeding
- support (sling)
- limit motion
- maintain body heat
- decrease blood supply (tourniquet)
Purposes of Primary Dressing
- decrease contamination potential
- absorb fluid
- apply medication to wound
- keep area warm
6 Helpful Hints in Dressing Selection
- identify purpose of proposed treatment
- consider wound-related factors
- consider product-related factors
- consider patient-related factors
- avoid complications
ID purpose of dressing (11)
- produce rapid and cosmetically acceptable healing
- remove/contain odor
- reduce pain
- prevent/combat infection
- contain exudate/drainage
- debridement
- cost
- minimum distress/disturbance to pt
- compression
- pressure distribution
- safety
5 Wound-related factors
- wound type
- wound description
- wound characteristics
- Wound location
- bacterial profile
Wound Types
- superficial
- full thickness
- cavity/tunnel
Wound Description
- eschar
- slough
- granulating
- epithelializing
Wound Characteristics
- dry
- moist
- heavy drainage
- malodorous
- excessively painful
- difficult to dress
- bleeds easily
Bacterial Profile
- sterile
- colonized (bacteria, but not infected)
- infected
- infected w/ potential to cross-infect
Product-Related Factors
- conformability
- mass or volume
- fluid-handling properties
- sensitization potential
- odor-absorbing properties
- antibacterial activity
- hemostatic properties
- permeability to tissue fluid and microorganisms
- ease of use
- pain related factors
- non-toxic
Patient-Related Factors
- activity level
- state of continence
- mental status
- known sensiivity to medicated dressings
- fragile or easily damaged skin
- need to bathe/shower frequently
- compliance
- caregiver
Cost
- unit cost
- reimbursement
- application cost
- availability
13 Wound Product Categories
- alginates
- biological
- collagens
- contact layer
- films
- foams
- gauzes
- hydrocolloids
- hydrogels
- silver and cadexomer iodine (antimicrobials)
- skin cleansers
- skin sealants/protective barriers
- wound debridement products
Debridement Types
- non-selective (mechanical)
- selective
- sharp
Non-Selective Debridement
- Mechanical
- whirlpool, wet-to-dry, pulsed lavage, ultrasound mist, scrubbing
Selective
- Autolytic
- Enzymatic
- BIosurgical
Sharp
- scalpel, scissors, forceps
- conservative: remove dead tissue
- surgical: into live tissues
Autolytic Debriedement
-uses own enzymes to break down nonviable tissue
Enzymatic Debridement
-topical ointments use enzymes to break down non-viable tissue while preserving healthy cells
Biosurgical debridement
-sterile maggots
Physical Agents, Mechanical Modalities and other Adjunctive Interventions
- compression wraps
- E-stim, US, UV agents
- negative pressure wound therapy
- Hydrotherapy
- Hyperbaric oxygen therapy
- offloading devices (orthoses, casts)
Order of dressing changes
-cleanest to dirtiest
Secondary Dressings:
Cylindar
-neck, trunk, wrists, lower legs, fingers, toes
Secondary Dressings:
Cone
- forearm, legs, thighs, feet
- (Hands combo of cylindar/cone)
Secondary Dressings:
Ovoid
-head, fingertips/toetips
Techniques for Applying Secondary dressings
- circular
- spiral
- recurrent
- figure 8
Indications for Ace Wraps
- edema
- varicose veins
Edema
- distal to proximal
- leave toes (ex.) visible to check circulation
- may leave heal open to wear shoe
Varicose Veins
- elevate to drain first
- equal pressures
- overlap exactly 1/2 with each turn
