Wound Healing Flashcards
What are the 4 stages of wound healing?
- haemostasis
- inflammation
- proliferative
- remodelling
What are the 4 stages of Haemostasis?
- vasoconstriction
- primary Haemostasis (platelet aggregation)
- secondary haemostasis (coagulation with fibrin)
- clot stabilisation
What does astringent mean?
contraction of skin cells -> skin dryness
What can be used for oozing wounds?
- potassium permanganate
- saline wash
What is suitable for infants and children as a disinfectant?
octenisept
Is it better for wounds to heal in a dry or moist environment? Why?
Moist: allows cells to migrate & stay hydrated, contains MMP to debride dead tissues & bacteria
What is the difference between primary and secondary dressing?
- primary: direct contact with wound surface
- secondary: secures primary dressing & absorbs wound exudate
Examples of primary dressings?
- melolin (low adherent absorbent pads)
- jelonet (paraffin gauze)
- bactigras (paraffin gauze with chlorhexidine)
Examples of secondary dressing?
- opsite flexigrid
- tegaderm
(waterproof film dressing)
Examples of chronic wounds?
- diabetic foot ulcers
- pressure ulcers
- venous leg ulcers
What is the TIME framework?
- tissue non-viable or deficient
- infection or inflammation
- moisture balance
- edge of wound
What wound products should be used for dry wounds?
- hydrogel: give moisture to wound
- hydrocolloid: absorb exudate, form gel over wound
- wound ointments
What wound products should be used for moist wounds?
- calcium alginate (e.g. kaltostat, algisite M)
- hydrofiber
- thin foams
What is special about calcium alginate?
- can pack sinuses and cavities
- absorbent, promote haemostasis
Is calcium alginate or hydrofibers more absorbent?
Hydrofibers
What is tulle gras and examples? Does it absorb exudate and why/why not?
- mesh / cloth impregnated with substances (e.g. paraffin, petrolatum, CMC) -> reduce adhesion & better removal
- does not absorb exudate -> promote moist wound env
- e.g. jelonet, bactigras
What is the purpose of silicone dressings?
- more comfortable adhesion & removal
- can conform to diff anatomical shapes
What is the purpose of silver and what products can it be found in?
- broad spectrum antimicrobial (even MRSA & VRE)
- foams, calcium alginate, hydrofibre
What is the purpose of iodine dressings and in which patients should they not be used in?
- broad spectrum antimicrobial
- CI hypersensitivity, hyperthyroid, pregnancy & lactation, children
What is special about Mepilex transfer?
transfers exudate to secondary dressing without causing maceration to periwound
How to manage skin tears?
- control bleeding (apply pressure, elevate limb, dressings that help with haemostasis)
- cleanse & debride
- manage infection / inflammation
- moisture balance & exudate control
- pain management
What dressings should be considered for skin tear? What should not be used?
- silicone dressing
- non-adhesive contact layer
- remover spray
- skin barrier spray
(do not use adhesives/gauze or those that dry wound)
How to manage incontinence associated dermatitis?
- skin protectants (creams, ointments, pastes, lotions, films)
- skin cleansers
What kind of ingredients do skin protectants contain?
- petrolatum
- zinc oxide
- dimethicone
- acrylate terpolymer
What percentage of zinc oxide is used to prevent or treat incontinence associated dermatitis?
- prevent: 10%, 20%
- treat: 20%, 30%, 40%
Is dimethicone used to prevent or treat incontinence associated dermatitis?
prevent
How often should you reposition patient to prevent pressure ulcer?
Q2h if lying down, Q1h if sitting up
