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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
Q

Film dressings - Characteristics

A

Flexible

Unable to absorb exudate

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26
Q

Film dressings - primary or secondary

A

Either

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27
Q

Film dressings - often used over

A

minor burns
surgical repair
simple abrasions/lacerations

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28
Q

Film dressings - Negative

A

Adhesive may cause problems in the wound area

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29
Q

Film dressings - can be used for what

A

Autolytic debridement

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30
Q

Film dressings - Do not use with what wounds

A

infected wounds!

Is impermeable to microorganisms

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31
Q

Film dressings - can remain in place how long

A

up to a week

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32
Q

Foam dressings - permeability

A

Semi permeable

33
Q

Foam dressings - descriptions

A

typically composites
Easy to apply and remove
Provide a warm environment

34
Q

Foam dressings - hydrophobic or philic?

A

Can be either

35
Q

Foam dressings - should not be used in what wounds

A

Tunneling

Dry/Non draining wounds

36
Q

Foam dressings - adherent?

A

Typically nonadherent

Some have adhesive component though to connect to wound margins

37
Q

Foam dressings - Primary or Secondary?

A

Can be either

IF primary though, need the kind that adheres to wound margins

38
Q

Foam dressings - can be used with

A

Autolytic debridement

They are semipermeable, but they do tend to keep moisture in

39
Q

Foam dressings - if used on infected wound - how long can you leave it on

A

Need to change it on a daily basis

40
Q

Foam dressings - how long can it be left on

A

up to 4 days

41
Q

Hydrogel dressings - content

A

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
Q

Hydrogel dressings can be used for what (5)

A

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
Q

Hydrogel dressings - do what

A

can dec friction and pressure

44
Q

Hydrogel dressings - do not use with

A

infected wounds

45
Q

Hydrogel dressigns - can remain on wound how long

A

up to 3 days

46
Q

Hydrocolloid dressings - properties

A

Generally occlusive, some are semiocclusive to semipermeable
Has adhesive properties

47
Q

Hydrocolloid dressings - come in what form

A

Paste or powder

Or Sheets as well

48
Q

Hydrocolloid dressings - primary or secondary

A

May require secondary sheets when used as primary?

49
Q

Hydrocolloid dressings are primarily used for

A

autolytic debridement capabilities

50
Q

Hydrocolloid dressings - absorption

A

Limited absorption

51
Q

Hydrocolloid dressings - Not recommended for what wounds

A

With tunnels or undermining

Infected wounds

52
Q

Hydrcocolloid dressings - removal may cause what

A

damage to surroudning skin

53
Q

Hydrocolloid dressings - permeability

A

Impermeable to urine, stool, bacteria

54
Q

Hydrocolloid dressings - 2 random facts

A

1) will leave residue in the wound

2) When they absorb exudate, they spread it out in the sheet

55
Q

Hydrocolloid dressings - can be left on for how long

A

up to 4 days

56
Q

In general, what are signs that dressing needs to be changed

A

The edges are coming up - this means that the dressing has lost its occlusive properties and is also no longer impermeable to thing

57
Q

Calcium Alginate dressings (CAD) - made from what?

A

Calcium salts extracted from seaweed

Many different shapes and sizes

58
Q

Calcium Alginate dressings (CAD) - properties

A

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
Q

Calcium Alginate dressings (CAD) - Primary or secondary

A

Requires a secondary dressing

60
Q

Calcium Alginate dressings (CAD) - is often used with

A

autolytic debridement

61
Q

Calcium Alginate dressings (CAD) - dressing changes occur how often

A

If on infected wound = daily

Otherwise = no longer than 7 days

62
Q

Calcium Alginate dressings (CAD) - caution with

A

exposed structures - it is meant to absorb, it is not contributing moisture!

63
Q

Composite dressings are what

A

Combination dressings

Multiple layers with each layer having different qualities

64
Q

Wound cavities - what is it and what do you do

A

Substantial loss of tissue structure

Packing or filling may be required

65
Q

Wound cavities - packing is what

A

Typically the application of a dressing to delay healing

Infection, draining an abscess

66
Q

Wound cavities - filling is what

A

the application of a dressing to promote healing from the inside out and to control exudate
Undermining, tunneling, large cavities

67
Q

Wound cavities - how to pack

A

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
Q

Antimicrobial Dressings are what

A

Slow and sustained release of antimicrobial agent

69
Q

Antimicrobial dressings - most popular is what?

Others?

A 
Popular = Silver
Others = iodine, methylene blue, gentian violet, polyhexamethylene biguanide
70
Q

Antimicrobial dressings - need to address for what

A

Adverse rxns - ALLERGIES!

71
Q

Collagen - properties

A 
Hemostatic, mitogenic, chemotaxis effect
Highly absorbent 
Hydrophilic 
Animal product (sens issue)
Need Rx
72
Q

Collagen - product forms

A

Variety

Gels, paste, powders, freeze dried sheets

73
Q

Collagen - should not be used un

A

dry wounds! Highly absorbent!

74
Q

Growth factors - are what

A

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
Q

Growth factors

A

Applied topically

Rx needed

76
Q

Types of growth factors used

A 
Platelet derived GF (1st to be approved)
FIbroblast GF (clinical trial)
Epidermal GF (clinical trial)
77
Q

Collagen and GF - most common

A

OASIS
made of pork submucosa, collagen matrix and some growth factors
Requires physician application!!!

78
Q

Biosynthetic or Biological Dressings

A

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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