Wound Dressings

Question 1

What is the ideal wound environment?

Answer 1

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

Question 2

What are the advantages to a moist environment for wound healing?

Answer 2

• 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

Question 3

Dressings should mimic the functions of skin by doing what….

Answer 3

• Maintain moist wound healing env
• Provide thermal insulation (enhances tissue perfusion)
• Provide barrier to organisms

Question 4

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.

Answer 4

Gauze

Question 5

Why would you not put gauze directly onto a wound?

Answer 5

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.

Question 6

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

Answer 6

Impregnated Gauze Dressings

*Use w/ granular, non-draining or necrotic non-draining

Question 7

This dressing is thin, transparent and flexible. It encourages autolytic debridement, Allows for visualization of wound bed and is waterproof.

Answer 7

Film Dressing

*Use w/ granular, non-draining

Question 8

What dressing would you NOT use for highly exudating or infected wounds?

Answer 8

Film Dressing and Hydrogels

*Hydrocolloids can’t be used w/ infected wounds

Question 9

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/

Answer 9

Hydrogels

*Use w/granular non-draining or necrotic non-draining wounds

Question 10

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.

Answer 10

Hydrocolloids

Used with necrotic, non-draining
Used with Granular and Necrotic w/ draining

Question 11

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.

Answer 11

Foam Dressing

Use with granular and necrotic draining wounds

Question 12

What type of dressing would you use if your patient had a pressure ulcer?

Answer 12

Foam-provides cushioning

Question 13

When would you choose a silver foam dressing?

Answer 13

If your patient has or you suspect on infection

Question 14

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.

Answer 14

Alginates

Use w/necrotic or granular draining wounds

Question 15

What dressings would you use for a high exudate wound?

Answer 15

Alginates, foam

Question 16

This dressing is porous, semi-transparent, low adherent wound contact layer, coated w/ silcone and adhere to peri-wound area

Answer 16

Silicone Mesh

Use on draining and non draining necrotic wounds

Question 17

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

Answer 17

Hydrofiber/silver

Question 18

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

Answer 18

Silver (Anticoat)

Question 19

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

Answer 19

Collagen Dresing

Question 20

This is a collagenase ointment, digests the collagen in necrotic tissue, not an antibiotic ointment

Answer 20

Enzymatic Debridement

Question 21

What is medical grade honey used?

Answer 21

May kill bacteria due to low pH, high sugar with lower water content

Question 22

Why use a topical cream?

Answer 22

Helps with bacteria

Question 23

What do you do if there is significant pain upon application of a dressing?

Answer 23

Remove it!

Question 24

What amount of external pressure is necessary to prevent capillary exudation?

Answer 24

35-40 mmHg

Question 25

What is an unna boot?

Answer 25

Zinc Oxide impregnated gauze wrapped with elastic bandage

Question 26

What should you do with your patient prior to compression?

Answer 26

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

Question 27

What defines someone as having critical limb ischemia?

Answer 27

• 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

Question 28

Name the STG for granular, non-draining

Answer 28

• Obtain moist environment
• Protect tissue

Dressing options: Impregnated gauze, transparent film, hydrogel

Question 29

Name STG for granular, draining

Answer 29

• Observe for infection
• Absorb exudate
• Protect surrounding tissue

Dressing options: Alginate, foam, hydrocolloid

Question 30

Name STG for necrotic, non-draining

Answer 30

• Soften eschar
• Remove eschar
• Obtain moist env
• Protect surrounding tissue

Dressings: Impregnated gauze, hydrogel, hydrocolloid, silver

Question 31

Name STG for necrotic, draining

Answer 31

• Observe for infection
• Absorb exudate
• Remove eschar
• Protect surrounding area

Dressings: Alginate, foam, hydrocolloid, silver