Wound Care Part 4 Flashcards
what is the primary purpose of a wound covering/dressing?
to maintain a moist environment and a homeostatic environment
if the wound bed is too wet, what can occur?
maceration of the tissue
when the tissue is too wet and becomes macerated, what has to be done?
it has to be dried out or debrided
most dressings today are what kind of dressing?
semi-occlusive dressings
what does it mean that a dressing is semi-occlusive?
air and gas can go from the inside of the wound to the outside, but nothing can come into the wound
how can we make the right choice with our dressings?
match the dressing fxn to the wound need
if a wound is dry, we should…
add moisture
if a wound is wet, we should…
dry it out
if a wound has black flat eschar, we should…
cross hatch and add autolytic debridement
if a wound is black, dry, and shriveled up, we should…
apply betadine to keep it clean and dry to allow auto amputation
if there are copious amounts of fluid in a wound, we should…
apply foam to absorb the fluid for a couple days
t/f: wound needs change over time
true
t/f: wound need vary by wound etiology
true
what are the exudate absorptive dressings?
alginates
foams
specialty absorptives
what are alginates?
absorptive derived from brown seaweed that interacts with wound fluid to create gel
what should we warn the pt/fam/nursing about with alginates?
that they will turn brown but it is NOT infected
what are foams?
an absorptive that is nonlinting, absorbant, and nonadherent used to drain minimal to heavy drainage
what are specialty absorptives?
multi-layers with highly absorptive fibers, cellulose, cotton, rayon (same materials as a baby diaper)
what dressing promotes autolytic debridement?
hydrocolloid patches (Duaderm)
what are hydrocolloids?
occlusive, semi-occlusive dressing that is composed of gelatin, pectin, and carbamethylcellulose that helps manage wounds with necrosis and slough with light to moderate exudate
how can we get better adherence of bandages?
hold your hand over it for about 30 sec to allow your body heat to increase its adherence
what are antimicrobials?
topical wound care products derived from iodine, silver, and polyhexethylene biguanide
what are the 2 main antimicorbials we use?
silver and providing iodine
what is the preferred topical solution for dry gangrene?
providine iodine
how do we apply providine iodine?
paint the entire wound area, allow it to dry by air, and cover it with a dry gauze as protection
how do antimicrobials work?
the active ingredients are incorporated into a dressing to deliver an antimicrobial/antibacterial action to the wound
what things are typically used for odor control in a wound?
charcoal or hydrophilic powders
what is the only time we use hydrophilic powders for wound odor control?
when it is an open, infected wound
t/f: open arterial wounds are covered based on their location and exudate
true
what are the three actions we can use for moisture control?
absorb, maintain, or add moisture
what are the 3 levels of occlusiveness?
occlusive, semi-occlusive, and non-occlusive
what are the abdorptives?
Alginates
Collagen
Composite
Foams
Hydrophilic powders
Superabsorbants
what are the products that maintain moisture?
Films
Hydrocolloid (Duaderm)
Hydrogel sheets
Hydropolymers
what are the products that add moisture to a wound?
amorphous gels (90% water in a gel)
what are the occlusives?
Composite
Films
Foams
Hydrocolloids
Hydropolymers
what is the semi-occlusive we use for wounds?
superabsorbents
what are the non-occlusives?
Alginates
Amorphous gels
Collagen
Contact layers
Foams
Hydrogels
Hydrophilic powders
if there is an infection present or a new wound, can we use an occlusive dressing?
NO!
why can’t we use an occlusive with an infection present?
bc it will create a breeding ground for bacterial growth
t/f: pts with a bad immune system are at risk of infection with use of an occlusive dressing
true
what is cellular tissue therapy?
live cell graft used for wounds that haven’t responded to 30 days of standard care
used to facilitate the pt’s regenerative process for re-epithelialization and healing
what are the 2 types of cellular tissue therapy?
bioengineered skin products
human amniotic membrane allograft
what are bioengineered skin products?
living cells, growth factors, other proteins, and a collagen matrix taken from fetal foreskin cells
what are human amniotic membrane allografts?
decellularized, dehydrated graft with a preserved basement membrane and an intact ECM and structure
although cellular tissue therapy can be extremely useful, it hasn’t shown great workplace success, why is this?
bc the wound bed is not prepared properly to accept the graft
what is the first thing we need to do to create an environment to healing?
cleanse the wound bed!!!
