wound dressings Flashcards by Zac Cooper

what are ideal treatment/dressing characteristics?

moist wound environment
thermal insulation
easy removal
removes drainage and debris
maintains a environment free of particulates and toxic products

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What is the TIME principle

Tissue non viable or deficient
Infection/inflammation
Moisture Imbalance
Epidermal margin

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Regarding the TIME principle, if the tissue is non viable or deficient then it needs ______ which ______

debridement

restores wound base and ECM proteins

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Regarding the TIME principle, if the has an infection/inflammation, it needs ______ which ______

antimicrobials

lowers bacterial counts and controlled inflammation

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Regarding the TIME principle, if the wound has moisture imbalance, it needs ______ which ______

dressings compression

restores cell migration, maceration is avoided

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Regarding the TIME principle, if the wound has impairment of epidermal margin then it needs ______ which ______

biological agents/cell therapy

stimulate keratinocyte migration

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What are the two categories of wound dressings?

Primary: come into contact with the wound
Secondary: placed over primary for increased protection, cushioning, absorption, or occlusion

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What are some dressing considerations?

anatomical site
drainage amount
bacterial load
periwound integrity
depth
edema
caregiver ability
aggressive vs conservative care
cost and reimbursement

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True or false

wet-to-dry gauze is considered debridement?

true

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What are advantages to gauzes?

various shape and sizes
can be used for packing
impregnated
non-adherent
can be used as primary or secondary
nonselective debridement

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what are disadvantages of gauzes?

painful removal
harm healthy tissue
can desiccate wound bed
little absorption capacity
no barrier to bacteria
not cost-effective due to frequent changes require money and nursing time

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Contact layers provide ____?
Can they be reused?
Are they absorptive?

wound bed with protection with fluid flow-through

yes

usually non-absorptive

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Contact layers require ______ and are sometimes _______.

secondary dressings

impregnated

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Examples of contact layers include:

N- terface
Mepitel
Profore Contact
Tegapore

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Polyurethane film over op-site and tegaderm are examples of?

transparent films

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Advantages of transparent films include?

WATERPROOF
wound is visible
promotes autolytic debridement
semi-occlusive
protection for friction or shear
can be used as primary or secondary

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what are disadvantages to transparent films?

Minimal absorptive capacity
can cause maceration
can promote skin irritation
can be traumatic on removal

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Transparent films SHOULD NOT be used on _____?

infected wounds

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Hydrocolloid otherwise known as ________ is ______ that interacts with wound fluid.

duoderm

thick fluid

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Advantages of Hydrocolloid are:

occlusive dressing
promote autolytic debridement
min to mod absb cacpacity
can be used under compression
can stay in place 5-7 days
can be used as a primary or secondary dressing

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Disadvantages to hydrocolloid are:

cause wound odor
risk of hyper hypergranulation
can macerate periwound
can cause skin irritation
can melt down or edges roll

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What type of wounds should hydrocolloid dressings NOT be used on?

infected wounds

wounds with undermining or tunneling

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What are advantages of Hyrdogel?

promote moist wound environment
soothes and assists with pain management
can assist with autolytic debridement
used only as primary dressing
used for viable and nonviable tissue

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Disadvantages to hydrogel include:

varies in viscosity
can cause maceration
Usually requires a secondary dressing

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Hydrogel should not be used on _______?

heavily draining wounds

Alginates and Hydrofibers are use to ______?

keep drainage from getting to periwound

examples of alginates and hydrofibers include?

seaweed derived dressing-Kalttostat curasorb aquacel sorbsan

Advantages or Alginates and Hydrofibers include?

``` mod to heavy drainage viable or nonviable tissue can reduce frequency of dressing changes can assist with debridement can be used with compression can be used with infected wounds may have hemostatic properties ```

What are disadvantages of Alginates?

Can desiccate wound | cause alginate scab

Advantages of Foams are:

``` mod to heavy drainage semi-occlusive adhesive and nonadhesive longer wear time wick away moisture can be used with compression protects wound insulator may retard hyper hypergranulation tissue ```

Disadvantages of foams include:

maceration may desiccate wound bed may require secondary dressings expensive

Collagen can contain ____ material so best to ask pt if they have allergies.

bovine

advantages to collagen include:

mod to heavy drainage multiple forms reduce MMPs

True or False | Collagen directly increases healing?

False, | Reduction of MMPs may attracts components for healing

Composites are ? Examples?

``` Two in one dressings telfa island foam with adhesive tielle combiderm ```

Advantages of composites include?

multiple features or function in one dressing easy to use various forms and sizes

Combination advantages?

multiple activities in one dressing | example: collagen and alginate, silver and alginate

Disadvantages of combination include?

confusing for caregiver | must clarify primary function for reimbursement

When are silicone gel sheets used? who uses them a lot?

in the maturation phase | plastic surgeons

advantages of silicone gel sheets include:

assists with scar management may reduce or prevent hypertrophic and keloid scars increases scar mobility and elasticity to reduce contractors reduce discoloration of scars

Bacitracin, an antibiotic ointment, is ______ and good for the ____ and _____

water-based | hands and face

Bactroban, an antibiotic ointment, is effective against _____

MRSA

What should one look out for when using neosporin?

allergies to the neomycin

What is the primary ingredients to silvadende?

sulf and silver

What should one know before taking Silvadene?

if allergic to sulfa

After application of Silvadene , the wound can look _____ when read to move and can turn wound _____

purulent | dull or grey from the silver

what are silver dressings effective against?

Pseudomonus, MRSA, staph, strep, enterococcus

Some silver dressings require ____ for activation

sterile water

True or false | silver dressings can only be used one

false | some can be rinsed and re-applied

What are the ingredients to Hydrofera Blue?

Bacteriostatic foam containing methane blue and crystal violet

Hydrofera blue is effective against?

MRSA, VRE, Stap, Seratia, E-coli, Bacillus subtilis, yersina enterocolitica

What color does hydrofera blue turn when its ready to be replaced?

light or white on either side

What does Hydrofera blue need for daily and when to be removed in dried out wounds?

requires rehydration

Hydrofera blue is the only dressing that ____?

can be used in connection with enzymatic debriding ointment

Cadexamer Iodine is effective against

``` psudomonus MRSA staph strep enterococcus etc ```

True or False | Cadexamer Iodine is cytotoxic due to being time-released.

False | antimicrobial

Cadexamer is good for _____ | draining wounds and can assist with ________.

mod to heavy draining wounds debridement

Cadexamer Iodine looks like ______ when applied and ______ when ready to remove.

rust colored play dough yellow applesauce

Cadexamer Iodine is indicated for?

slough, draining wounds

What are benefits of using Honey?

Promotes a moist environment high absorptive cleanses and derides due to its high osmolarity helps to lower the wound pH for optimal environment nontoxic, natural, safe antibacterial effects

Indications for the use of honey include:

``` diabetic foot ulcer venous leg ulcer arterial leg ulcers leg ulcers of mixed etiology pressure ulcers burns(not full thickness) donor sites traumatic and surgical wounds ```

Growth factors utilize ___________ to stimulate the ______ phase of wound healing

platelet derived growth factor ( PDGF ) | proliferative

Oasis is an _______ made from ?

acellular xenograft made from the submucosal lining of a small intestine of porcine

Regranex is a ? and indicated for?

recombinant human platelet-derived growth factor for topical application indicated for LE diabetic neuropathic ulcers

Oasis is an acellular xenograft containing a _______ with _____ and _____ that support tissue repair

collagenous, extracellular matrix | cytokines and cell adhesion molecules

what are skin sealants?

provide additional protection and stickiness to skin for dressing retention

examples of barrier ointments include ? and there function?

petrolatum dimethicone zinc oxide protect skin from moisture and possibly friction

what are some periwound considerations?

``` maceration dryness irritation incontinence trauma dermatitis skin prep moisturizer antibiotic ointment moisture barriers protective dressings steroid ointments ```

true or false | when bandaging fingers, each finger should be wrapped individually

true

when bandaging a large or infected wound on the hand, ______ is required and applied with _______ focusing on _________ to allow use of extremity

roll gauze figure 8 wrapping minimizing bandage bulk

wounds on the trunk requiring a secondary dressing may be secured with?

roll gauze elastic netting vest both

trunk wounds covering a large wound may best be manage with?

a burn vest

What are montgomery straps?

minimally adhesive strips with ties on one side used to create an external suture

What are three bandages that can be used on plantar wounds?

thick gauze pads sheet hydrogels thick foams

when to change treatment course?

``` no chnage in 2-4 weeks wound worsening necrosis debrided and viable tissue present new odor or change in drainage new erthema/ or pain bleeding present wound bed dry or too moist ```

when to stop treatment?

suspicious of osteomyelitis recurrent or unresolved erythema persistant purulent drainage or fluctuance necrosis with muscle, tendon, bone involvement unexplained persistent pain new ulcers