wound packing:

Question 1

indications:

Answer 1

cavity wounds
wounds with undermining
sinus tract
tunneling wounds
depth greater than 1cm

Question 2

contraindications:

Answer 2

fistulas

wounds with tunneling, undermining. or sinuses where endpoint cannot be reached using a sterile metal probe or cotton tipped applicator

Question 3

purpose of packing:

Answer 3

a) loosely fill dead spaces

b) facilitate removal of debris

c) encourage growth of granulation tissue from base of wound to prevent premature closure and abscess formation

Question 4

packing materials:

Answer 4

a) gauze which may be dry or moistened with normal saline, ointment, or hydrogel

b) impregnated ribbon dressing

c) hydrofiber dressings

d) alginate dressings

e) antimicrobial dressings

f) negative pressure wound therapy

Question 5

chosen packing material depends on:

Answer 5

wound assessment
treatment objectives
goal of care

Question 6

over-filling:

Answer 6

over-filling dead space(s) too tightly will cause pressure on the wound tissue which cause pain, impair blood flow and potentially cause further tissue damage

Question 7

under-filling:

Answer 7

under-filling dead space(s) does not provide enough packing material to be in contact with the base and sides of the cavity, undermining or sinus/tunnel

can lead to rolled wound edges and/or abscess formation

Question 8

tail of packing material:

Answer 8

always leave a tail or tails of packing material clearly visible in wound cavity or on peri-wound skin (can be secured with steri-strips to periwound skin)

if 2 or more pieces of packing are knotted together, ensure the knots are placed in the wound cavity and not exerting pressure within the wound

Question 9

any wound that has a depth greater than ___ requires packing and all packing is counted and charted # of pieces out/# of pieces in

Answer 9

1cm