Wound Care Products, Dressings, & Drains

Question 1

What is the function of bandages?

Answer 1

• allow/absorb drainage
• mechanical debridement
• prevent contamination
• warmth increases the rate & strength of tissue repair
• apply pressure to decrease dead space, bleeding, & oedema
• immobilisation provides comfort
• protects the wound from the environment & the environment from the wound
• aesthetic function

Question 2

What two types of non-adherent primary layer can be used?

Answer 2

Occlusive - impermeable to air
Semi-occlusive - allows air to penetrate & exudates to escape

Question 3

What two types of adherent primary layer can be used?

Answer 3

Dry adherent - large vol, low viscosity exudate
Wet adherent - viscous exudate, adherent foreign/necrotic material

Question 4

Adherent primary ‘wet to dry’ bandages are…

Answer 4

very common

Question 5

How does a ‘wet to dry’ primary layer of bandage work?

Answer 5

Use saline-soaked gauze applied directly to a wound. Regular changes are required. Mechanical debridement occurs as the dried out gauze are removed from the wound

Question 6

When is a wet-to-dry primary layer used?

Answer 6

first 3-5 days of a wound

Question 7

Non-adherent dressings in a primary layer are used…

Answer 7

when granulation tissue is present

Question 8

Non-adherent dressings characteristics include:

Answer 8

• are non-traumatic
• absorbs exudates
• keeps wounds moist
• maintains adequate oxygen tension
• does not stick to the wound surface
• semi-occlusive to allow moist wound environment to promote epithelialization and allowing drainage preventing tissue maceration

Question 9

What are types of non-adherent dressings?

Answer 9

• mesh dressings w/ petroleum
• hydrogels
• hydrophilic foams
• cotton non-adherent film dressings

Question 10

Petroleum impregnated gauze dressings are contraindicated in…

Answer 10

draining wounds

Question 11

Petroleum gauze slows…

Answer 11

epithelialization

Question 12

Hydrogels maintain…

Answer 12

a moist wound environment

Question 13

Hydrogel characteristics:

Answer 13

• increase oxygenation to the wound
• debriding capacity
• preserve viable epithelial & deeper cells
• non-adherent/soothing
• not suitable for moderate to highly exuding wounds

Question 14

Hydrophilic foam characteristics:

Answer 14

• moist & warm wound environment
• can be left in place for longer than most dressings
• significant absorptive capacity
• reduced frequency of dressing changes
• minimal disruption to the healing process

Question 15

Characteristics of cotton non-adherent film dressings:

Answer 15

• film prevents dressing from adhering to wound surface
• perforations allow the passage of exudate from the wound to the pad
• can be used as a primary wound contact layer for more heavily exuding wounds if backed by a second absorbent dressing

Question 16

Cotton non-adherent film dressings can be used on…

Answer 16

dry sutured wounds, superficial cuts & abrasions, and other lightly exuding lesions

Question 17

Honey is…

Answer 17

antibacterial, deodorizing, debriding, anti-inflammatory, and wound-pain reducing

Question 18

Bandage layers consist of what layers?

Answer 18

primary - determined by the wound
secondary - cotton wool/cast padding
tertiary - cohesive or adhesive bandage

Question 19

Drains are used to…

Answer 19

direct fluid out of a wound or body cavity

Question 20

passive drainage uses

Answer 20

gravity or capillary action to draw fluid from the wound or cavity

Question 21

Penrose drains act by

Answer 21

gravity or capillary action

Question 22

Penrose drains are used in wounds with…

Answer 22

foreign material, contamination, non-viable tissue, or dead space

Question 23

Rigid/semi-rigid tube drain (fenestrated/non-fenestrated) drains are

Answer 23

more rigid than Penrose drains and therefore cause greater irritation and allows intermittent suction

Question 24

Active drains are more efficient due to

Answer 24

negative pressure applied continually or intermittently

Question 25

Closed suction drains decrease the likelihood of…

Answer 25

ascending infection that can be associated with passive drains

Question 26

Simple closed suction drains are small active drains made from…

Answer 26

a butterfly catheter and a vacutainer

Question 27

Thoracic cavities warrant what drain type?

Answer 27

• fenestrated semi-rigid tube drain
• 3 way tap & gate clamp (Heimlich valve)

Question 28

The abdominal cavity warrants what drain type?

Answer 28

open peritoneal drainage

Question 29

Wounds warrant what drain type?

Answer 29

Penrose drains

Question 30

Septic joints warrant what drain type?

Answer 30

Penrose or active drains

Question 31

What goes into drain management?

Answer 31

• drains need to be secured to avoid dislodgement
• drainage output should be measured & recorded
• changes in character or volume of fluid should be noted
• use measurements of fluid loss to assist IV replacement of fluids
• Drains should be left in place until fluid decreases in quantity and no longer appears purulent
• fluid can be evaluated by cytologic examination