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10] Dressings Flashcards

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1
Q

Functions of dressings (5)

A

 Act as a barrier to bacteria
 Provide cushioning and protection from shear and compression forces
 Decrease pain
 Provide for enzymatic or autolytic debridement
 Maintain moisture balance

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2
Q

If there is necrotic tissue you want to choose a dressing that promotes?

A

Autolytic debridement

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3
Q

Examples of autolytic debridement dressings (9)

A 
Hydrogel
Hydrocolloid
Alginate 
Foam
Silver
Silicone
Hydrofera blue
Unna boot
Medihoney
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4
Q

What does NICE stand for

A

Necrotic tissue
Infection/inflammation
Characteristics
Exudate

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5
Q

A type of dressing you can use in infected wounds

A

Antimicrobial (silver) dressing

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6
Q

What characteristics should you consider? (3)

A

Incontinence
Location
Amount of time dressing can be left in place

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7
Q

E- exudate

A

Match amount of absorbable to drainage

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8
Q

Primary dressings

A

In contact with the wound

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9
Q

Secondary dressings

A

Secure primary dressing in place or absorbs excess moisture

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10
Q

When packing wounds.. (3)

A

Fill it
Dont stuff it
Try to use just 1

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11
Q

Traps wound debris, absorbs exudate from wound

A

Gauze

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12
Q

Is gauze primary or secondary

A

Secondary

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13
Q

Advantages of gauze (2)

A

Good cost

Can be used on infected or non-infected

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14
Q 
 packing adheres to wound bed; 
 frequent dressing changes; 
 increased infection rate compared to 
occlusive dressings; 
 no barrier to bacteria
A

Disadvantages of gauzes

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15
Q

What is transparent film?

A

Thin membrane permeable to vapor and oxygen but not to bacteria and water

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16
Q

Is transparent film primary or secondary

A

Secondary

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17
Q

 Consider as secondary dressing for ulcers treated with wound fillers that will likely
remain in ulcer for an extended time period

A

Transparent film

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18
Q

Used for partial or shallow full-thickness wounds; granular or necrotic; minimal
exudate

A

Hydrocolloid

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19
Q

Consist of gel-forming polymers that absorb exudate

A

Hydrocolloid

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20
Q

Protect body areas at risk for friction injury orinjury from tape

A

Transparent film

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21
Q

Adhesive backing adheres to skin surrounding the wound

A

Hydrocolloid

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22
Q

Do not use as cover over enzymatic agents, gels or ointments

A

Transparent film

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23
Q

Remove carefully from fragile skin

A

Transparent film

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24
Q

Advantages of Hydrocolloid (3)

A

Moist environment- autolytic debridement
Protection
Moderate absorption

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25
``` May roll in areas of friction;  damage to skin of periwound;  cannot be used on infected or deep wounds;  should not be used on skin tears! ```
Disadvantages of Hydrocolloid
26
Two sides of foam
Wound side is hydrophilic and outer surface is hydrophobic
27
What two types of foams are available
Adhesive and no adhesive
28
Foam can be left on for
3-4 days
29
5 advantages of foam
``` Moist environment Cushions Autolytic debride-mod to heavy absorb Thermal insulation Protects from periwound maceration ```
30
Disadvantages of foam (3)
May roll in friction areas Damage to periwound Not transparent
31
What are alginates
Highly permeable, non-occlusive
32
Alginates are used on what kinds of wound
Partial and full thickness
33
Contraindications for alginates (4)
Vasculitis 3rd degree burns Dry wounds Escher
34
``` Advantages:  absorb heavy drainage;  use on infected or non-infected wounds;  can promote autolytic debridement;  Can pack  Can do hemostasis ```
Advantages of alginates
35
2 disadvantages of alginates
Needs secondary dressing | Frequent changes
36
What is hydro fiber made from and what does it interact with
Made from Na carboxymethylcellulose and interacts with exudate and forms a gel
37
Advantages of hydro fiber (3)
Highly absorptive, can be placed over or in wounds, hemostasis
38
Disadvantage of hydrofiber
Needs secondary dressing
39
What is hydrogel
Sheet or amorphous form
40
Hydrogel assists
Autolytic debride
41
Hydrogel is contraindicated for
3rd degree burns
42
``` Indications: minor burns, skin tears, venous ulcers, surgical incisions, diabetic foot ulcers, pressure ulcers ```
Hydrogel
43
Disadvantage of hydrogel (2)
Can’t be used with mod/heavy drainage | Dressing Might dehydrate
44
Non-adherent dressings help to
Retain moisture
45
Non-adherent dressings can be placed ?
Directly over the wound/hydrogel/skin graft
46
Examples of non-adherent dressings (3)
Oil emulsion Petroleum based Vaseline gauze
47
Immediate and sustained release of ionic silver
Silver dressing
48
Silver dressings is an effective barrier to?
Penetrating bacteria
49
Silver dressings is used for?
Infected or highly colonized wounds
50
Advantage of silver dressing
Stops pathogen growth
51
3 disadvantages of Silver dressings
Can’t use with enzymatic debriders, topical meds or oil Secondary needed Dont use with cellulitis
52
Bacteriostatic dressing  Methylene Blue and Gentian Violet  Effective against MRSA and VRE
Hydrofera blue
53
Hydrofera blue must be?
Changed every 3 days or when dressing turns white
54
Absorbency of hydrofera blue
High
55
Wound types for hydrofera blue
All types EXCEPT 3rd degree burns
56
Reduces bacterial load in wound environment, i.e. MRSA
Cadexomer iodine dressing
57
Removes loose slough and debris
Cadexomer iodine dressings
58
Manages excess exudate in highly exudate wounds
Cadexomer iodine dressings
59
Avoid iodine in
Large cavity ulcers that need daily changes
60
Can you pack iodine in wounds?
Yes
61
Consider as would contact layer to promote atraumatic dressing changes
Silicone
62
When would you use silicone?
To prevent tissue injury when ulcer/periwound is fragile
63
Enzymatic debride aka
Santyl
64
EzD santyl is what?
Chemical agent that breaks down devitalized tissue
65
Santyl is used for
Wounds with necrotic tissue- infected or non
66
What do you need a prescription for?
EzD- santyl | Silver nitrate
67
Advantage of santyl
Surgery alternative
68
3 disadvantages of santyl
Daily dressing change Inactivated by wound cleanser Needs secondary
69
% of silver nitrate
75% silver nitrate | 25% K nitrate
70
Silver nitrate is used on
Hypergranulation tissue
71
How do you do silver nitrate
Apply tip to moist wound and drag around until grey
72
Antimicrobial; keeps wound bed moist, allowing for autolysis of eschar
Silvadene
73
Changes for silvadene
Daily to BID
74
Silvadene indicated for
Burns, road rash
75
Does silvadene need a Rx?
YES
76
What to remember with silvadene?
allergies!!
77
4 types of tape from most to least harsh
Silk Plastic Paper Foam
78
Silk aka
Durapore
79
Plastic aka
Transpore
80
Paper aka
Micropore
81
Foam aka
Micro foam
82
Lowers pH to decrease inflammation, inhibit | bacteria growth, and increase oxygen diffusion
Honey
83
Honey impregnated dressings can be used on
All types of wounds | 1st and 2nd degree burns
84
Typical wear time of honey
3 days
85
Indications for honey (4)
Necrotic tissue Foreign bodies Wound infection/biofilm Autolytic debride
86
Most occlusive to least occlusive
``` Hydrocolloid Hydrogel Foam Film Impregnated gauze Alginate Normal gauze ```
87
Moisture retention from most to least
``` Alginate Foam Hydrocolloid Hydrogel Film ```
88
High adherence to low to skin
Silk Plastic Paper Foam
89
Dressings you CANT use with infected wounds (3)
Transparent film (not as primary) Hydrocolloid ( no pus!) Silicone

Integumentary (15 decks)

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