Wound products

Question 1

What to consider?

Answer 1

wound and skin factors - severity, size, location, exudate infection

pt factors - nutrition, medical status, odor, and cost-benefit ratio

Dressing factors- availability, durability, adaptability of the products

Question 2

Ideal dressing characteristics

Answer 2

manages exudate

allows gas exchange

insulates

protect from bacteria

can use on infected wounds

user friendly

minimal pain

does it stay in place?

cost-effective

Question 3

Does a wound product heal you?

Answer 3

NO, the product may promote a healing environment but it is your body that does it

Question 4

Skin info

Answer 4

largest organ = 9-13 lbs

slightly acidic

protection

secretion

absorption

tactile communication

Question 5

Gauze gen info

Answer 5

Woven or non woven

100% cotton or mix of fibers

available in rolls or sponges, strips

may be impregnated with a compound - NaCl, Iodoform, Gel, Petrolatum

Question 6

Gauze indications

Answer 6

Scrubbing, prepping, wiping

absorption and protection

infected wounds

good space filler - cavities and tracts

can apply solutions for delivery into wound bed

can soften eschar if applied wet

used for wet to dry

Question 7

Gauze advantages

Answer 7

Absorption
packing
easy to use
cheap
mechanical debridment

Question 8

Gauze disadvantages

Answer 8

Traumatic when removed
may dry out
frequent changes (min 1x per day)
require secondary dressing to top it
may lint or shed

Question 9

Antifungal / antimicrobial products

Answer 9

nystatin powder, clotrimazole cream, elta silver gel

Question 10

liquid skin protectants

Answer 10

no sting barrier spray

3M cavilon, smith and nephew, Medline

Question 11

Moisture barriers

Answer 11

common ingredients - dimethicone, petrolatum, zinc oxide

may be combo of all 3

Question 12

skin cleansers

Answer 12

remove bacteria and or feces while maintaining the skin barrier function and providing comfort

convatec, smith and nephew, medline

Question 13

therapeutic moisturizers

Answer 13

assist with maintaining moisture and skin hydration, and replace skin lipids

Question 14

Alginates

Answer 14

composites of fibers made from seaweed or calcium alginate fibers

absorb 20x its own weight

exchange Na and Ca ions to form a gel

product manufacturing will determine wicking ability

newer hydrofibers are 30% more absorptive

Question 15

alginate indications

Answer 15

pressure ulcers or partial / full thickness wounds

fill in the dead space

for mod to heavy drain sites

infected wounds

minimal hemostasis

Question 16

how often to change alginates

Answer 16

every 1-3 days

Question 17

alginate advantages

Answer 17

highly absorbtive
used with infection
good for tunneling/ sinus tracts
atraumatic if fully hydrated
comes in multiples applications 
can get in Ag

Question 18

alginate disadvantage

Answer 18

requires Sec. dressing
can dry out or stick
may macerate intact skin if not applied correctly

Question 19

Antimicrobial dressing

Answer 19

derived from silver, Iodine

can be integrated into other dressings

used on draining or non draining sites

left in place multiple days

Question 20

Honey can be

Answer 20

Antibacterial

antifungal

sterile

gamma irradiated

Question 21

collagens

Answer 21

stimulate granulation tissue formation

tissue development

create environment to heal

partial to full thickness wounds

Question 22

pros / cons of collagen

Answer 22

pro - absorbent, maintain a moist wound environment, nonadherent, easy to use

cons- require secondary dressing, not for use on black eschar, or 3rd degree burns, VERY EXPENSIVE AND LAST RESORT, cannot have infections

Question 23

Composites

Answer 23

combine 2 or more physically distinct products into 1

may include physical barrier, absorptive layer, foam hydrocolloid, adhesive border

Question 24

composite pros and cons

Answer 24

pros- allow moisture vapor, mold well, facilitate debridement, easy to use, include adhesive border

cons - have to have good skin to secure dressing

Question 25

contact layer

Answer 25

single layers of some woven material with low adherence may use this to prevent foam from sticking into wound bed

Question 26

contact layer pros vs cons

Answer 26

pros- protect wound, allow drainage to pass through, used with topical meds or fillers cons - require secondary dressing, will not handle a viscous drainage

Question 27

foams

Answer 27

polyurethane, open-cell sheets, single or multi-layered multiple varieties and thicknesses may have incorporated charcoal or Ag FOAM IS YOUR FRIEND

Question 28

foam indications

Answer 28

``` pressure ulcers - all stages partial - full thickness wounds minor burns surgical sites minimal to heavy exudate infected or non infected wounds ``` change 1-7 days depending on manufacturing can be re- placed after checking/ cleaning wounds

Question 29

foam advantages

Answer 29

``` highly absorbent can be used in infection available with or without border facilitates AUTOLYSIS atraumatic removal if non adherent multiple applications comes in Ag ```

Question 30

disadvantages of foam

Answer 30

may require additional securement may macerate if over saturated not recommended on dry eschar may lint, dependent on quality

Question 31

hydrocolloids

Answer 31

semi occlusive dressings like gelatin, pectin, and other products - not used often anymore maintain moist environment and help granulate or debride a wound CANNOT BE ON INFECTED WOUND

Question 32

hydrocolloids pros

Answer 32

can handle light to mod drainage, minimize skin trauma, impermeable to bacteria, mold well to site

Question 33

hydrocolloids cons

Answer 33

not for infections, not for fragile periwound skin, may curl at the edges, has occlusive properties, cant see under MUST BE ON FOR MULTIPLE DAYS IT IS VERY STICKY not a first choice tx

Question 34

hydrogels

Answer 34

water or glycerin based gels maintain moist environment, facilitate autolytic debridement

Question 35

hydrogel pros vs cons

Answer 35

pro- soothing and reduce pain, fill in dead space, absorb min to mod drainage, easy to apply, use to keep tendons and tissues moist con- not for heavy exudate, dehydrate if not covered, may be difficult to secure, may cause maceration

Question 36

Hypertonic sodium additive

Answer 36

heps promote autolysis

Question 37

hydrogel indications

Answer 37

``` pressure ulcers - stage 2-4 partial and full thickness wounds radiation burns skin tears wounds with necrosis ``` must change 1-3 days

Question 38

transparent films

Answer 38

waterproof and impermeable to bacteria but allow water vapor to pass, promote moist environment

Question 39

pros and cons to transparent films

Answer 39

pro- allow wound observation, dont require a secondary dressing con- not for infection, doesn't absorb, not for frail skin, difficult to handle, dislodge with friction

Question 40

disadvantages to transparent films

Answer 40

nonabsorbant may cause maceration may cause dermal stripping

Question 41

wound fillers

Answer 41

come as paste, beads, and gels provide moist environment, absorb exudate, debride and soften eschar

Question 42

pros and cons of wound fillers

Answer 42

-pro- fill dead space, may absorb, easy to use, use with other products cons- not for dry wounds, need secondary dressing - usually for smaller wounds like drain sites

Question 43

drugs

Answer 43

enzymatic debriders - generally attack a specific protein in collagen to denature will have to get from pharmacy and require MD's order

Question 44

One product that will crack biofilm

Answer 44

Iodoform