Wound Dressing Flashcards
How often should you re-eval wound dressings for a patient?
Every single visit
What considerations need to be made when choosing wound dressings for a patient?
type and amount of exudate bioburden of wound tissues present in wound location size and depth of wound peri-wound health etiology of wound allergies patient comfort supplies available and cost of supplies
When should you change wound dressing?
- when saturated
- when moist environment is compromised
- when new topicals need to be given
- when wound becomes soiled or contaminated
- when bathing
- when odor is present
- Caregiver discretion
What is Telfa?
a type of gauze that is non-adherent and offers little absorption making it useful for using topicals
What cautions are there for using gauze pads?
can absorb topicals very quickly, fibers can become stuck in wound, must be applied at angle to the wound
What is impregnated gauze?
What precautions are there for this gauze?
gauze that has mild occlusiveness and promotes a moist wound bed and since it is wet it has an atraumatic removal.
It can be combined with topicals and can be either primary or secondary dressing but is usually not used often with deeper wound beds
Precautions:
-maceration and it can be adherent if allowed to dry
What type of wounds are semipermeable films typically used for?
What cautions are there for semipermeable films?
superficial wounds
need to limit wrinkles and applied without tension, it is difficult to apply properly and is not water proof, there is a specific wound removal technique and it can be harmful when removed if not done well
What is the benefit of using hydrogels for wound dressings?
What are the cautions?
- can absorb small amounts of drainage
- decreases pain
- promotes autolytic debridement
- donates moisture
cautions:
- maceration
- sheets not used on infected wounds
- needs a secondary dressing
What are the benefits of hydrocolloids?
Cautions for hydrocolloids?
they are highly occlusive and adhesive and the paste can be used for deeper wounds, can also be used as primary or secondary dressing
Cautions:
- maceration
- skin damage w/ removal
- sheets aren’t for deep wounds
- paste expands in deeper wounds
- edges can roll with friction
- linked with hypergranulation
What are the benefits of alginate dressings?
What are the cautions and contraindications for this dressing?
- highly absorptive and since it’s mixed with gel it has atraumatic removal
- some assist w/ clotting
- can be left on for 7 days
- non-occlusive
- contours easily w/ wound surfaces and can be layered into deeper wounds
Cautions:
- maceration if placed outside of wound margins
- “looks bad” when wet
- wound dessication
contraindications:
-not to be used over bone/tendon/etc. or on neonates
What dressing type is more absorptive than alginate and only absorbs vertically so there is less risk of maceration?
Hydrofiber
When should antimicrobials be used?
When should they be discontinued?
- critical colonization
- active infection
- high risk of infection
- when wound is clean with good epithelialization and granulation
- when risk is removed
- only use in the short term
What are the benefits of a cadexomer iodine antimicrobial?
What cautions should be followed? Contraindications?
- broad spectrum
- absorptive (turns white as it absorbs)
- can be a cheaper option
Cautions: allergies to iodine/shellfish, pregnancy/breast feeding, less than 6 months old, prolonged use, can stain skin and can’t be combined with collagenase
Contraindications: thyroid disease, deep cavity wounds
What are the benefits of silver antimicrobials?
Cautions for silver?
- broad spectrum
- various forms that can be combined with other dressings
- various wear times
- some require pre-moistening
Cautions- cannot combine w/ collagenase, toxicity risk w/ prolonged use, allergies, irrigate w/ sterile water, use on newborns/infants/new children
What are the benefits of honey antimicrobials?
Cautions?
Contraindications?
can reduce odor and pain
anti-inflammatory and non-toxic
promtoes autolytic debridement (assists w/ breakdown of nonviable tissue)
cautions: initial stinging
Contraindications: allergy to bees or honey
