Wound Dressings Flashcards
What is the ideal wound environment?
MOIST --wounds heal twice as fast if moist then if exposed to air Free from exudate Warm Protected from trauma and infection Free from necrotic tissue
What are the advantages to a moist environment for wound healing?
- Decreases intensity and length of inflammatory phase
- Traps endogenously produced enzymes w/in wound bed facilitating autolytic debridement
- Inc fibroblast proliferation and collagen synthesis
- Inc keratinocyte proliferation and migration
Dressings should mimic the functions of skin by doing what….
- Maintain moist wound healing env
- Provide thermal insulation (enhances tissue perfusion)
- Provide barrier to organisms
This type of dressing used as a secondary dressing to hold things in place. It is inexpensive, made from woven cotton thread/ non-woven synthetic fibers and provides cushioning.
Gauze
Why would you not put gauze directly onto a wound?
Adheres to wound, leaves particulate matter in wound bed, dries out wound. It also is permeable so allows air/other stuff into wound, requires frequent dressing changes which is costly over time.
This dressing contains petrolatum to protect wounds from contamination, allows exudate to escape, is inexpensive but it dries out quickly and requires a secondary dressing
Impregnated Gauze Dressings
*Use w/ granular, non-draining or necrotic non-draining
This dressing is thin, transparent and flexible. It encourages autolytic debridement, Allows for visualization of wound bed and is waterproof.
Film Dressing
*Use w/ granular, non-draining
What dressing would you NOT use for highly exudating or infected wounds?
Film Dressing and Hydrogels
*Hydrocolloids can’t be used w/ infected wounds
This type of dressing puts moisture back into wounds and doesn’t adhere to wounds. It can help reduce pain in wounds. It may dehydrate and requires a secondary dressing/
Hydrogels
*Use w/granular non-draining or necrotic non-draining wounds
This dressing is moisture retentive, encourage autolytic debridement, provides thermal insulation, is waterproof and does moderate absorption. It leaves residue in wound bed and can cause trauma to fragile periwound skin.
Hydrocolloids
Used with necrotic, non-draining
Used with Granular and Necrotic w/ draining
This dressing is very absorbent, the outer layer acts as a barrier, provides thermal insulation, absorbs moderate amount of exudate, bottom layer has silicone to allow adherence (but not to wound) and provides cushioning.
Foam Dressing
Use with granular and necrotic draining wounds
What type of dressing would you use if your patient had a pressure ulcer?
Foam-provides cushioning
When would you choose a silver foam dressing?
If your patient has or you suspect on infection
This dressing is made from calcium salts of alginic acid, form a gel when combined with wound exudate, highly absorbable, painless to remove, hemostatic properties. Requires a secondary dressing and must cut it to the shape of the wound.
Alginates
Use w/necrotic or granular draining wounds
What dressings would you use for a high exudate wound?
Alginates, foam
This dressing is porous, semi-transparent, low adherent wound contact layer, coated w/ silcone and adhere to peri-wound area
Silicone Mesh
Use on draining and non draining necrotic wounds
The dressing is made from sodium carboxymethycellulose containing 1.2% silver in ionic form, silver provides antimicrobial properties, dressing absorbs wound exudate to form a gel that traps bacteria and conforms to the contours of the wound
Hydrofiber/silver
This acts as an absorbent core between layers of silver coated plolyethylene, antibacterial activity, effective against yeasts and fungi, allows dressing to be left in place but must be kept moist to work
Silver (Anticoat)
This dressings are bioactive-may play a role in healing process, provides a matrix that enhances cell migration, absorb wound exudate and form a biodegradeable gel, most effective when changed infrequently, requires secondary dressing
Collagen Dresing
This is a collagenase ointment, digests the collagen in necrotic tissue, not an antibiotic ointment
Enzymatic Debridement
What is medical grade honey used?
May kill bacteria due to low pH, high sugar with lower water content
Why use a topical cream?
Helps with bacteria
What do you do if there is significant pain upon application of a dressing?
Remove it!
What amount of external pressure is necessary to prevent capillary exudation?
35-40 mmHg
What is an unna boot?
Zinc Oxide impregnated gauze wrapped with elastic bandage
What should you do with your patient prior to compression?
Assess arterial supply through peripheral pulses and ABI
*Pt’s w/critical limb ischemia or ischemic pain should have a thorough vascular evaluation prior to using compression bandage
What defines someone as having critical limb ischemia?
- Recurring ischemic rest pain that requires regular use of analgesics > 2 weeks w/ an ankle systolic pressure < 50
- Ulceration or gangrene involving the toes or foot w/ ankle systolic pressure < 50 mmHg
Name the STG for granular, non-draining
- Obtain moist environment
- Protect tissue
Dressing options: Impregnated gauze, transparent film, hydrogel
Name STG for granular, draining
- Observe for infection
- Absorb exudate
- Protect surrounding tissue
Dressing options: Alginate, foam, hydrocolloid
Name STG for necrotic, non-draining
- Soften eschar
- Remove eschar
- Obtain moist env
- Protect surrounding tissue
Dressings: Impregnated gauze, hydrogel, hydrocolloid, silver
Name STG for necrotic, draining
- Observe for infection
- Absorb exudate
- Remove eschar
- Protect surrounding area
Dressings: Alginate, foam, hydrocolloid, silver
