Dressing Selection

Question 1

What to do if a wound is infected

Answer 1

• do not occlude
• a moist, dark, warm environment can assist in bacterial/fungal growth
• if not already performed, request a culture

Question 2

When to not use topical antibacterials for infected wounds

Answer 2

• don’t use topical agents that are also administered systemically to avoid development of resistant-strain organisms
• don’t use topical agents that are known allergens
• don’t use topical agents that have a high cellular toxicity

Question 3

What to do for noninflected wounds

Answer 3

• debridement (autolytic or enzymatic)
• moist wound healing (granulation & epithelial cell migration)

Question 4

When to use and when not to use autolytic debridement

Answer 4

• to use the wound must demonstrate signs & symptoms of inflammation suggesting WBC present
• can not be performed infected

Question 5

When should you not do enzymatic debridement

Answer 5

• do not use if granulation tissue is present

Question 6

Describe moist wound dressings

Answer 6

• wound dressings need to maintain a moist wound environment but not stick to the wound during removal
• exudate must be contained
• a dry wound needs a hydrating agent to prevent the exudates from becoming a glue-like substance

Question 7

What dressings can be used for non-infected wounds

Answer 7

• hydrogels
• transparent films
• hydrocolloids
• hydrocellular foams

Question 8

What dressings can be used for infected wounds

Answer 8

• alginates
• hydrofibers
• composite border dressings/island dressings

Question 9

Hydrogels

Answer 9

• dry or minimal draining wounds - add moisture to the wound bed
• change every 1-3 days
• sheet or gel
• should not be used with infections

Question 10

Transparent films

Answer 10

• adhesive, semipermeable polyurethane dressings that are clear, waterproof, & impermeable to bacteria & other contaminants
• no absorbent ability but maintain a moist wound environment to promote autolytic debridement
• can be used as a primary (shallow wounds) or secondary (deeper wounds) dressing
• should not be used with infections

Question 11

Hydrocolliods

Answer 11

• provide a moist wound environment in wounds with small to moderate exudate & promotes autolytic debridement
• can lead to an unpleasant odor
• should not be used with infections

Question 12

Hydrocellular foam

Answer 12

• intended for absorption of moderate to heavy exudate
• foams have also been used for padding in areas of constant trauma
• should not be used with infections

Question 13

Alginates & hydrofibers

Answer 13

• used as primary dressings, can fill dead space, & require a secondary dressing
• used for moderate to heavy exudate & promotes autolytic debridement

Question 14

Composite border dressing/Island dressing

Answer 14

• made of non adherent gauze with border tape & covered by a transparent film to protect the wound from outside contaminants
• may be used in combination with enzymatic debridement agents or with alginates

Question 15

Tissue engineered therapies

Answer 15

• Dermagraft & Apligraf
• provide living fibroblasts, which produce necessary growth factors & collagen to the wound base

Question 16

Dressing considerations for inflammation phase

Answer 16

• maintain moist wound environment
• protect wound from infection
• promote debridement of dead tissue (autolytic, enzymatic, & mechanical)

Question 17

resting considerations for repair/proliferation phase

Answer 17

• maintain moist wound environment
• protect wound from infection
• manage exudate
• limit disruption of wound bed
• pressure management