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Wound Dressing

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by

Dakdok AJ

on 13 February 2014

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Transcript of Wound Dressing

Wound Dressing
Types of Dressing;
When to use which?
Different dressings are indicated by type of wound, purpose of dressing, wound color, and the presence of exudate or infection.

Dressing choices indicated by wound color
Objectives;
-Definition
-Purpose
-Types of dressing
-When to use which?
Purpose;
Stop bleeding
Absorb exudate
Ease pain
Debride wound
Protect from infection
Promote healing
Reduce psychological stress
Hydrogel dressings

Requires secondary dressing
Semiocclusive dressing or filler for deep or extensive wounds
Water or glycerin-based gels, impregnated gauzes, or sheet dressings
Maintains moist healing environment, promoting granulation and autolysis of necrotic tissue
Done by ; Dr.Isra Ali Al-Jazeeri
Red or pink
(granulation tissue or epithelization):

Keep wound clean and moist
Transparent film dressing, hydrogel, hydrocolloid, foam (moist wound), alginate, collagens
Consider topical, such as thin layer of bacitracin
Wet-to-dry dressing with gauze and normal saline changed three times a day is often sufficient
Yellow (soft, creamy slough):

Debride nonviable tissue
Absorb excess exudate
Hydrocolloid dressing, collagens
Depending on the size of the wound, iodoform gauze or wet-to-dry dressings with normal saline is usually used to pack/cover wound
Black (hard, dehydrated, necrotic):

Debride nonviable tissue first
Hydrogel
Then follow yellow or red recommendations, depending on condition of viable tissue
Other circumstances;
Reduction of skin maceration

Carefully apply stomal adhesive wafer to wound margins; dressing adheres to wafer instead of at-risk skin
Cover skin at wound margins with zinc oxide or petroleum jelly

Exudate

Minimal to mild: hydrocolloid dressing, transparent film, saline gauze dressing, collagens, foam, hydrogel
Moderate to heavy: alginate dressing, collagens, foam, consider collection device such as that used for ostomy care

Infected wounds

Topical antiseptic
Saline wet-to-dry gauze with saline
Hydrogels (if exudate is not great)
Foam, nonadherent dressings
Alginate to absorb excess exudate

Cavitation

Alginate packing to absorb excess exudate
Hydrocolloid paste
Foam dressing filler
Pack with wet-to-dry saline dressings once hemostasis is not an issue. Can also loosely pack cavity

Wound protection

Nonadhering dressing or Adaptec or vaseline gauze
Foam
Transparent film
Definition;
A dressing is an adjunct applied to a wound to promote healing and to prevent from further harm.
Foam dressings



Semiocclusive, absorbant dressing or wound filler
Retains moisture, insulates wound
Nonadherent layer allows for atraumatic removal
Film (transparent) dressings

Used for wounds with little or no exudate, necrotic tissue, or slough
NOT used for wounds with moderate to heavy drainage, infected wounds, or on fragile skin
Impermeable to bacteria and contaminants, but permeable to water vapor
Maintains moist healing environment, promoting granulation and autolysis of necrotic tissue
Allows visualization of wound
Semipermeable polyurethane membrane, creates occlusive dressing
Alginate dressings


Require a secondary dressing
Absorbant, conform to wound shape
Forms a gel within the wound to maintain moist environment
Made from brown seaweed ropes, twisted fibers, or pads
Gauze ( wet to dry )

Used for rough debridment
Is Painful
Predisposes Wound to Infection
Becomes a Foreign Body
Delays Healing Time

Negative Pressure Dressing;


Promotes healing by moisturizing ,
reducing edema and dead space,
increasing blood flow and mechanotransduction.
WAZ UP!!
Evidence-based surgical wound care algorithm
List of Clinical Practice Guidelines (CPG)
Hydrocolloid dressings


Occlusive or semipermeable adhesive dressing
Impermeable to bacteria
Provides moist healing environment, promoting granulation and autolysis of necrotic tissue
Opaque nature limits visualization of wound
References;
Gab Smith's Plastic surgery textbook 6th ed.
Adaptation of Evidence-based Surgical Wound Care Algorithm Korean Journal
First Consult; Acute wound care Article
BMJ Best Practice Wound dressing
Full transcript