Integumentary: Dressings Flashcards

1
Q

Films: What it is

A
  • Clear adhesive, semipermeable membrane
  • Permeable to air and moisture
  • Non permeable to Water, bacteria, and environmental contamination
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2
Q

Films: What they do

A
  • Cover shallow wound beds

- Autolytic Debridement

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3
Q

Films: What types of wounds to use them on

A
  • Stage 1 and II pressure ulcers (shallow wound beds)
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4
Q

Films: What types of wounds NOT to use them on

A
  • Wounds with fragile surrounding skin or infected wounds
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5
Q

Films: Wet/Dry Wounds

A
  • N/A
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6
Q

Films: Main Advantages

A
  • Visual examination possible
  • Protects against external fluids and bacteria.
  • Promotes autolytic debridement
  • Minimize friction
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7
Q

Films: Main Disadvantages

A
  • Non absorptive
  • May cause maceration
  • Not to be used on wounds with depth, undermining, or tunneling.
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8
Q

Films: Considerations

A
  • Secondary dressing not required
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9
Q

Hydrocolloids: What it is

A
  • Adhesive wafers that contain hydro active absorptive particles that interact with wound fluid to form a gelatinous mass over wound bed.
  • Occlusive or semi-occlusive
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10
Q

Hydrocolloids: What they do

A
  • Cover shallow wounds with scant /small exudate
  • As secondary dressing with alginate or hydrofiber.
  • ## PROVIDE A MOIST ENVIRONMENT FOR FIBRINOLYSIS
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11
Q

Hydrocolloids: What types of wounds to use them on

A
  • Partial thickness wounds
  • Autolytic debridement
  • Wounds with mild exudate
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12
Q

Hydrocolloids: What types of wounds NOT to use them on

A
  • Not recommended for wounds with heavy exudate, sinus tracts, infections.
    No recommended for wounds that expose bones or tendons.
  • Not recommended for words with fragile surrounding skin
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13
Q

Hydrocolloids: Wet/Dry Wounds

A
  • Hydrocolloids should be used to moisten dry wounds or maintain moist environments in wounds that are already moist.
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14
Q

Hydrocolloids: Main Advantages

A
  • Maintains a moist environment

- Autolytic debridement

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15
Q

Hydrocolloids: Main Disadvantages

A
  • Yellow drainage on removal

- Odor on removal

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16
Q

Hydrocolloids: Considerations

A
  • Characteristic Odor+Yellow exudate on removal normal.
  • Change every 3-7 days based on leakage
  • Avoid in wounds that are infected or have tracts
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17
Q

Hydrogels: What it is

A
  • Water or glycerine based gels.
  • Insoluble in water
  • Absorptive capacity varies
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18
Q

Hydrogels: What they do

A
  • Hydrate
  • Insulate
  • No residue left behind
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19
Q

Hydrogels: What types of wounds to use them on

A
  • Partial and full thickness wounds (Full thickness is distinguishing factor between hydrocolloids and hydrogels)
  • Wounds with necrosis and slough
  • Burns and tissue damaged by radiation
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20
Q

Hydrogels: What types of wounds NOT to use them on

A
  • Do not use Hydrogels on wounds with heavy exudate.

- Do not use sheet form on infected ulcers.

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21
Q

Hydrogels: Wet/Dry Wounds

A
  • Used to rehydrate/moisten dry wounds.
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22
Q

Hydrogels: Main Advantages

A
  • Rehydrate dry wounds
  • Autolytic debridement
  • Some absorption
  • Amorphous form can be used with present infection
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23
Q

Hydrogels: Main Disadvantages

A
  • Require a secondary dressing
  • May adhere to surrounding wound bed
  • May macerate surrounding skin
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24
Q

Hydrogels: Considerations

A
  • Sheet form works well for partial thickness ulcers.
  • Sheet form can promote growth of yeast
  • Dressing change every 8-48 hours
  • Skin barrier wipes on surrounding skin can decrease the chance of maceration.
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25
Q

Foams: What they are

A
  • Semi permeable membranes that are either hydrophilic or hydrophobic
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26
Q

Foams: What they do

A
  • Insulate+protect wounds
  • Manage minimal to heavy exudate
  • Can be used primary or secondary
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27
Q

Foams: What types of wounds to use them on

A
  • Partial and full thickness wounds with minimal to moderate exudate (Exudate being what distinguishes them from Hydrocolloids and Hydrogels).
  • ## Secondary dressing with packing to provide additional absorption.
28
Q

Foams: What types of wounds to NOT use them on

A
  • No to be used with wounds with dry eschar or wounds with no exudate
  • Poor conformability with wounds that are deep
29
Q

Foams: Wet/Dry Wounds

A
  • Foam should be used on wound that are wet or very wet.

- Foams should NOT be used on wounds that are dry.

30
Q

Foams: Main Advantages

A
  • Insulate+protect wounds
  • Manage minimal to heavy exudate
  • Can be used primary or secondary
31
Q

Foams: Main Disadvantages

A
  • Non transparent
  • Non adherent
  • May cause desiccation and maceration
32
Q

Foams: Considerations

A
  • Change every 1-5 days as needed for leakage

- Protect intact surrounding skin to prevent maceration

33
Q

Alginates and Hydrofibers: What it is

A
  • Alginates: Soft, absorbent, non woven dressings, derived from seaweed that react with wound exudate to to form a viscous hydrophilic gel mass over the wound area.
    Hydrofibers: Same as alginates by composed of polymer
34
Q

Alginates and Hydrofibers: What they do

A
  • Absorbs from wounds with HEAVY exudate.

- Support debridement

35
Q

Alginates and Hydrofibers: What types of wounds to use them on

A
  • Wounds with moderate to large amounts of exudate
  • Wounds with combined exudate and necrosis
  • Wounds that require packing and absorption
  • Infected and non-infected exuding wounds.
36
Q

Alginates and Hydrofibers: What types of wounds NOT to use them on

A
  • Not recommended for dry or LIGHTLY exuding wounds.

- Can dry wound bed

37
Q

Alginates and Hydrofibers: Wet/dry wounds

A
  • Should be used on very wet wounds for purposes of drying exudate.
  • Should not be used on dry wounds as it may over dry.
  • Can be combined with alginate in wet wounds to create balance between drying and hydration
38
Q

Alginates and Hydrofibers: Main Advantages

A
  • Absorbs from wounds with HEAVY exudate.
  • Support debridement
  • Can be used in infected wounds
39
Q

Alginates and Hydrofibers: Main Disadvantages

A
  • Require secondary dressing
  • Can dry wound bed
  • May desiccate wound
  • Can macerate
40
Q

Alginates and Hydrofibers: Considerations

A
  • May use gauze or transparent film as secondary dressing

- Change schedule varies from every 8 hours to every 2-3 days.

41
Q

Gauze: What it is

A
  • Made of cotton or synthetic fabric that is absorptive and permeable to water and oxygen
  • Can be used with several other agents.
42
Q

Gauze: What it does

A
  • Several tasks
43
Q

Gauze: What types of wounds to use them on

A
  • Exudative wounds
  • Wounds with dead space, tunneling, or sinus tracts
  • Wounds with a combination exudate or necrotic tissue
44
Q

Gauze: What types of wounds to use them on: Wet to Dry

A
  • Mechanical debridement of necrotic tissue and slough
45
Q

Gauze: What types of wounds to use them on: Continuous Dry

A
  • Heavily exudating wounds
46
Q

Gauze: What types of wounds to use them on: Continuous Most

A
  • Protection of clean wounds
  • Autolytic debridement of slough or eschar
  • Delivery of topical needs
47
Q

Gauze: What types of wounds to NOT use them on

A
  • Avoid direct contact with granulating tissue.
48
Q

Gauze: Wet/dry wounds

A
  • Can be used on varying wet/dry wounds

- Can be combined with moistening agents to keep wounds moist

49
Q

Gauze: Main Advantages

A
  • Can be used on infected wounds
  • Good mechanical debridement if properly used
  • Filler for large wounds
  • Effective delivery of topicals if kept moist
50
Q

Gauze: Main Disadvantages

A
  • Delay healing if used improperly
  • Require secondary dressing
  • Increased infection rates when compared to semi occlusive.
  • Leaves behind microfibers creating a chronic inflammatory state
51
Q

Gauze: Considerations

A
  • Pack loosely. Tight packing compromises blood flow
  • Continuous roll for packing large wounds to insure complete removal.
  • Can macerate
  • Wide mesh=Debridement
  • Fine Mesh=protection
52
Q

Specialty Dressings: When to use

A
  • When conventional dressings do not show signs of aiding healing of wound.
  • Partial thickness should heal 1-2 weeks
  • Full thickness should heal 2-4 weeks
53
Q

Specialty Dressings: Main Advantages

A
  • Reduced abnormal biological activity in wounds.
54
Q

Specialty Dressings: Main Disadvantages

A
  • Expensive

- May not be readily available

55
Q

Specialty Dressings: Considerations

A
  • Application precautions specific to product
56
Q

Collagen: What it is

A
  • Protein found in connective tissues that comes in various dressings.
57
Q

Collagen: What it does

A
  • Stimulates fibroblasts
58
Q

Collagen: What types of sounds to use them on

A
  • Recalcitrant wounds
59
Q

Collagen: What types of wounds NOT to use them on

A
  • Do not use on necrotic wounds
60
Q

Collagen: Wet/dry Wounds

A
  • Dry wounds=Pre- moistened collagen

- Wet wounds=Collagen of granulated

61
Q

Collagen: Main Advantages

A
  • Low risk of allergic reaction
62
Q

Collagen: Main Disadvantages

A
  • Requires secondary dressing
63
Q

Collagen: Considerations

A
  • May require moisture additive
64
Q

Antimicrobial Dressings

A
  • Silver

- Iodine

65
Q

Antiseptics

A
  • Dakins solution
  • Acetic Acid
  • Povidone Iodine
  • Chlorhexadine
66
Q

Peri-wound Protection

A
  • ZInc Oxide

- Petroleum