wound dressing Flashcards
purpose of dressings
provide optimal environment
Moisture, neutral warmth, protection, barrier odor delivery of topicals, reduced pain
Not static applied in response to changing wound status
changes with drainage amount to type healing phase activity level, temperature, tissue bioburden
Re-eval dressing every visit
when to change dressing
when saturated strike through
Maintain moist environment
Timeline for topicals or combo dressings
Become soiled, contaminated or wet
Disrupted
Bathing
Odor
regular gauze offers
available various sizes inexpensive
non-occlusive and absorptive
mechanical debridement
Padding primary with hydrogel or secondary dressing, wet to dry
Cut to size
Telfa - non-adherent little absorption
Change daily as primary dressing
regular gauze cautions
drying
Absorbed topicals quickly
Fiber
Roll gauze applied at an angle
impregnated gauze
aTraumatic removal- contact layer
Multiple sizes cut to fit
mild occlusiveness, promotes moist wound healing
Less permeable than regular gauze
Can be combined with topicals
Can be primary or secondary
Some can be left in place several days
Typically used on wounds without a lot of depth
Adaptic, xeroform
cautions with impregnated gauze
maceration
Adherent if allowed to dry
Semi permeable film
thin flexible, multiple sizes cut to size
Transparent occlusive
Barrier to outside world can stay in place up to seven days
Little absorption, if used alone can be combined with other dressings
Primary or secondary
Usually for superficial wounds
Highly conformable adherent to Periwounds
cautions for semi permeable film
Limit wrinkles
Applied without tension
Difficult to apply
Specific removal technique
Can damage skin with removal
Poor choice for skin tears
hydrogel
Donate moisture
Can absorb a small amount of drainage
Decrease pain
Promote autolytic debridement
Gel and sheet forms
Can be combined with other dressings
Require secondary dressing
Silver gel
Silver powder plus Hydro gel
Moist dressing
regular gauze
Sailine
Hydrogel
cautions for Hydrogels
maceration
Sheets not used on infected wounds
foam
Absorptive
Flexible, variety of sizes
non-adherent, thick or thin
Primary or secondary
Insulating
Can be left in place up to seven days
foam cautions
Maceration
Can roll with friction
hydrocolloids
highly occlusive
Promotes autolytic debridement
highly Adhesive
sheets or pastes
Primary or secondary
cautions for hydrocolloids
maceration
Not as absorbent as claimed
Skin damage with removal
Sheet forms not for deep wound
Paste expand in deeper wounds
edges can roll with friction
alginate
highly absorptive
Holds drainage in dressing
absorbs vertically and laterally
gel with absorption for a traumatic removal may trap bacteria within dressing
Some assistance with clotting
Can be left in place up to seven days
Non-occlusive
Contours easily to wound surfaces and can be layered into deeper wounds
cautions for alignate
Maceration if placed outside of wound margins for highly draining wounds wound desiccation
contraindications for alginate
Not to be used over bone tendon, or on neonates
hydrofibers
highly absorptive
More than alginate
Absorb is only vertically so there’s less risk of maceration
not hemostatic
Sheets
up to 7 days
aquacel
Wound ribbon dressing
May have stitch bonding to increase strength
antimicrobials usage
when there is
critical colonization
Active infection
High risk of infection
discontinue antimicrobials when
wound is clean
risk is removed
short term dressing
three types of antimicrobials
silver
honey
cadexomer
silver
Broad spectrum, various forms
powder gel, alginate, hydrocolloid foam sheets creams
various wear times- daily- 7 days
Cream must be removed daily
Some required pre-moistening
Cannot combine with collagenase
