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Practice topics Exam 3 > Wound Interventions: Wound Dressings > Flashcards

Wound Interventions: Wound Dressings Flashcards

1
Q

Dressing selections - in general you should consider

A

what it is you are trying to accomplish at this point in time with a particular wound

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2
Q

Objectives

A

Fluid control function
Compressive ability
Maintain a certain level of temp
Debridement capacity

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3
Q

Goals

A

Provide a healing environment
User friendly
Control infection
Cost effective

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4
Q

Goals - Provide a healing environment

A

Control moisture
Allow gas exchange to occur
Maintain thermal control
Debride, if needed

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5
Q

Goals - user friendly

A

Easy to apply and remove
Minimal dressing changes
Remains in place with limited trauma to surrounding area

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6
Q

Goals - control infection

A

Dec risk for infection

If infection is present, can it be used for the wound safely (occlusive is contraindicated for infected wound)

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7
Q

Two types of dressings

A

Primary dressing

Secondary dressing

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8
Q

Two types of dressings - primary

A

Direct contact with the wound bed
This is the one that will be meeting your goals most likely
May or may not require a secondary dressing

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9
Q

Two types of dressings - secondary

A

Used over the primary dressing

Purposes - hold the dressing on, protection, occlusion, absorption

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10
Q

Occlusive vs. Permeable dressing: Occlusive =

A

Allow no evaporation
Retain moisture
Ex - latex, rubber, saran wrap

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11
Q

Occlusive vs. Permeable dressing: Permeable =

A

Allow full evaporation
Dec moisture content
Air is most permeable
Ex - Gauze

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12
Q

Occlusive vs. Permeable dressing - In between the two extremes are

A

Semiocclusive and Semipermeable dressings

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13
Q

Most permeable non occlusive dressing

A

Air

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14
Q

Most impermeable occlusive dressing

A

Latex

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15
Q

Gauze - is what

A

Most common dressing material used
Two types - woven and non–woven
Variety of forms - squares, pads, rolls, Packing strips, Telfa dressings

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16
Q

Gauze - woven are made of

A

cotton fibers woven together

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17
Q

Gauze - non woven are made of

A

synthetic fibers pressed together

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18
Q

Gauze - absorption

A

Come in varying levels of absorption

Come in layers, known as plies

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19
Q

Gauze - primary or secondary

A

Either

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20
Q

Gauze - infected wounds

A

Can be used with infected wounds

Except for waterproof gauze - this tends to be more occlusive

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21
Q

Gauze - what is unique about it

A

It can be impregnated with medications or other substances

Can be packed into tunnels

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22
Q

Gauze - negative to it

A

It tends to traumatize tissue
Used for wet-to-dry dressings and when you take it off, it can lead to trauma
Soaking it in saline solution before taking it out can help

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23
Q

When do we use gauze - what wounds

A

Wound with heavy exudate
Infected wounds
When packing is required
Frequent dressing changes needed

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24
Q

Film dressings - permeability

A

Permeable to moisture vapor and air (gas)

Impermeable to fluid/ pathogens

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25
Film dressings - Characteristics
Flexible | Unable to absorb exudate
26
Film dressings - primary or secondary
Either
27
Film dressings - often used over
minor burns surgical repair simple abrasions/lacerations
28
Film dressings - Negative
Adhesive may cause problems in the wound area
29
Film dressings - can be used for what
Autolytic debridement
30
Film dressings - Do not use with what wounds
infected wounds! | Is impermeable to microorganisms
31
Film dressings - can remain in place how long
up to a week
32
Foam dressings - permeability
Semi permeable
33
Foam dressings - descriptions
typically composites Easy to apply and remove Provide a warm environment
34
Foam dressings - hydrophobic or philic?
Can be either
35
Foam dressings - should not be used in what wounds
Tunneling | Dry/Non draining wounds
36
Foam dressings - adherent?
Typically nonadherent | Some have adhesive component though to connect to wound margins
37
Foam dressings - Primary or Secondary?
Can be either | IF primary though, need the kind that adheres to wound margins
38
Foam dressings - can be used with
Autolytic debridement | They are semipermeable, but they do tend to keep moisture in
39
Foam dressings - if used on infected wound - how long can you leave it on
Need to change it on a daily basis
40
Foam dressings - how long can it be left on
up to 4 days
41
Hydrogel dressings - content
High level of water content so can't absorb a lot of exudate Because of high water content, they can become moisture donors to the wound site
42
Hydrogel dressings can be used for what (5)
1 for its autolytic properties 2 And can be used to fill in dead space 3 Can also be used to prevent drying of anatomical structures 4 As carriers for topcal meds (would require a secondary dressing) 5 Coupling agent for US
43
Hydrogel dressings - do what
can dec friction and pressure
44
Hydrogel dressings - do not use with
infected wounds
45
Hydrogel dressigns - can remain on wound how long
up to 3 days
46
Hydrocolloid dressings - properties
Generally occlusive, some are semiocclusive to semipermeable Has adhesive properties
47
Hydrocolloid dressings - come in what form
Paste or powder | Or Sheets as well
48
Hydrocolloid dressings - primary or secondary
May require secondary sheets when used as primary?
49
Hydrocolloid dressings are primarily used for
autolytic debridement capabilities
50
Hydrocolloid dressings - absorption
Limited absorption
51
Hydrocolloid dressings - Not recommended for what wounds
With tunnels or undermining | Infected wounds
52
Hydrcocolloid dressings - removal may cause what
damage to surroudning skin
53
Hydrocolloid dressings - permeability
Impermeable to urine, stool, bacteria
54
Hydrocolloid dressings - 2 random facts
1) will leave residue in the wound | 2) When they absorb exudate, they spread it out in the sheet
55
Hydrocolloid dressings - can be left on for how long
up to 4 days
56
In general, what are signs that dressing needs to be changed
The edges are coming up - this means that the dressing has lost its occlusive properties and is also no longer impermeable to thing
57
Calcium Alginate dressings (CAD) - made from what?
Calcium salts extracted from seaweed | Many different shapes and sizes
58
Calcium Alginate dressings (CAD) - properties
Highly absorbent, good in wounds with moderate to heavy exudate Reacts with exudate to form a hydrophillic gel Conforms to the shape of the wound - good for tunnels and undermining Easy to apply and remove
59
Calcium Alginate dressings (CAD) - Primary or secondary
Requires a secondary dressing
60
Calcium Alginate dressings (CAD) - is often used with
autolytic debridement
61
Calcium Alginate dressings (CAD) - dressing changes occur how often
If on infected wound = daily | Otherwise = no longer than 7 days
62
Calcium Alginate dressings (CAD) - caution with
exposed structures - it is meant to absorb, it is not contributing moisture!
63
Composite dressings are what
Combination dressings | Multiple layers with each layer having different qualities
64
Wound cavities - what is it and what do you do
Substantial loss of tissue structure | Packing or filling may be required
65
Wound cavities - packing is what
Typically the application of a dressing to delay healing | Infection, draining an abscess
66
Wound cavities - filling is what
the application of a dressing to promote healing from the inside out and to control exudate Undermining, tunneling, large cavities
67
Wound cavities - how to pack
Pack loose at the narrow end of the tunnel (the part you can't see) and tighter at the wider area of it (the exposed part you see)
68
Antimicrobial Dressings are what
Slow and sustained release of antimicrobial agent
69
Antimicrobial dressings - most popular is what? | Others?
``` Popular = Silver Others = iodine, methylene blue, gentian violet, polyhexamethylene biguanide ```
70
Antimicrobial dressings - need to address for what
Adverse rxns - ALLERGIES!
71
Collagen - properties
``` Hemostatic, mitogenic, chemotaxis effect Highly absorbent Hydrophilic Animal product (sens issue) Need Rx ```
72
Collagen - product forms
Variety | Gels, paste, powders, freeze dried sheets
73
Collagen - should not be used un
dry wounds! Highly absorbent!
74
Growth factors - are what
products that enhace cell growth and proliferation Multiple growth factors are being used and researched Not all are approved for use in all wounds
75
Growth factors
Applied topically | Rx needed
76
Types of growth factors used
``` Platelet derived GF (1st to be approved) FIbroblast GF (clinical trial) Epidermal GF (clinical trial) ```
77
Collagen and GF - most common
OASIS made of pork submucosa, collagen matrix and some growth factors Requires physician application!!!
78
Biosynthetic or Biological Dressings
Developed from human or animal sources Can include autografts, allografts, xenografts They are composite dressings that serve as skin substitutes

Practice topics Exam 3 (9 decks)

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