Wound dressings Flashcards
What is the benefit of a moist wound bed?
Wounds heal faster with a moist wound bed.
A moist wound environment decreases the intensity and length of the inflammatory phase, facilitates autolytic debridement, speeds up the proliferative phase, preserves endogenous growth factors, and facilitates fibroblastic activity and collagen synthesis.
What happens if a wound is too dry?
It will desiccate and stall healing.
What happens if a wound is too wet?
It will cause maceration, stall healing in the wound bed, and damage the periwound tissue.
What are the components of an optimum wound healing environment?
- A warm moist wound bed
- absence of necrotic tissue and/or infection
- moisture control
- dead space eliminated
- protected granulation and epithelial tissue.
What should ideal wound dressings maintain?
- Balanced moisture in the wound bed.
- Provide thermal insulation
- Protect against infection
- Assist with debridement
May also:
* control bleeding
* decrease edema
* eliminate dead space
What are the two types of wound dressings?
- Primary dressings - contact the wound bed
- Secondary dressings - placed over the primary for added protection, absorption
What are moisture-retentive dressings?
- Dressings that have a low moisture evaporation rate and facilitate autolytic debridement.
What are key advantages of moisture-retentive dressings?
- stimulate granulation tissue
- facilitate epithelialization
- serve as barrier to infection
- impermable to body fluids
- require less frequent dressing changes
- pull excess moisture out of the wound bed
What is the primary use of gauze dressings?
- To fill dead space and absorb exudate.
- good secondary dressing
- highly permeable and non-occlusive
Contraindications for the use of gauze dressings
- dry wound
- granulation tissue
What are impregnated gauze dressings?
Gauze in which compounds or solutions have been added, such as petroleum or hydrogels.
Can be primary or secondary
Semi occlusive - holds in some moisture
Advantages and disadvantages of impregnated gauze
- Advantage: non-adherence prevents trauma
- Disadvantage: possible residue in wound
What are semipermeable transparent films?
Adhesive polyurethane membrane which mimics the skin and maintains a moist environment and facilitates autolytic debridement.
What are the indications for semipermeable transparent films?
- Non-infected partial thickness wounds
- Protection against friction
- Blister protection
Advantages of semipermeable transparent films
- Can be primary or secondary
- repels water and bacteria
- can remain in place up to 7 days
- cost effective
- wound is visible when primary
- resists friction
What is a key contraindication for transparent films?
- Moderate or large amount of exudate.
- Cavity wounds (except as secondary)
- Undermining (except as secondary)
- Tracts (except as secondary)
- Infection (except as secondary)
What are hydrocolloids composed of?
Pectin, gelatin, and carboxymethylcellulose combined with elastomers and adhesives.
Normal “melting” causes odor and “puslike appearance
Most are occlusive, some are semi occlusive
What are the indications for hydrocolloids?
- Absorb moderate exudate
- Fill uneven and deep craters
- Control bacteria
- Protect wound
- Autolytic debridement
Contraindications of hydrocolloids
- infection
- bleeding wounds
- fragile or damaged periwound tissue
- heavy drainage
- dry wounds
- packing of tunneling or undermining
What are amorphous hydrogels?
- Hydrogels with no fixed structure
- Mixture of water and gel forming glycerin which is O2 permeable, conforms to shape of the wound, and maintains moisture
What are the advantages of amorphous hydrogels?
- Maintains moist environment
- Good thermal regulator
- Comfortable and decreases pain
- Facilitates autolytic debridement
- Easily removed
Indications of amorphous hydrogels?
- Increase and/or maintain moisture
- fill undermining and tunnels
Contraindications of amorphous hydrogels?
Excess moisture
What are hydrogel sheets?
- Water and glycerin mixture in sheet form with polymer film backing
- Can be semi-permeable or impermeable
