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Flashcards in Dressings Deck (36):
1

TIME prinicple

Tissue viable or deficient: debride wound and restore base.

Infection or inflammation: high microbial: antibiotics

Moisture imbalance

Epidermal margin: stimulate migration

2

Primary vs Secondary Dressings

Primary: comes into contact with wound

Secondary: placed over primary for increased protection, cushioning, absorption, or occlusion

3

Dressing Considerations

anatomical site
bacterial load
drainage amount
depth
edema
aggressive vs conservative

4

Gauze advantages

Various shapes/sizes.
Can be used for packing.
Can be impregnated.
Nonadherent.
Primary or secondary
Non-selective debridement

5

Gauze disadvantages

Pain with removal.
Can harm healthy tissue.
Can dessicate wound bed.
Little absorption.
No barrier to bacteria.

Not cost effective due to frequency of changes.

6

Contact layers

Provide wound bed protection with fluid flow through.

May be able to be reused

Usually non-absorptive

Requires secondary dressing

May be impregnated

7

Transparent films advantages

examples: tegaderm, op-site

Wound visible.
3-5 days.
Autolytic debridement
Semi-occlusive
Waterproof
Protect from friction/shear
Can be 1* or 2*

8

Transparent films disadvantages

Minimal absoprtive.
Maceration.
Skin irritation.
Trauma upon removal.
Not to use on infection.

9

Hydrocolloid advantages

"duoderm", "second skin"

Occlusive
Autolytic debridement
Minimal-moderate absorbance
Can be used with compression
5-7 days
1* or 2*

10

Hydrocolloid disadvantages

Odor
Hypergranulation
Maceration
Skin irritation
Edges roll/melt
Not to use with infection, undermining, or tunneling

11

Hydrogel advantages

Waterbased gel

Moist wound environment
Pain management
Autolytic debridement
Primary dressing
Can be used on viable and nonviable tissue.

12

Hydrogel disadvantage

Variable viscosity
Maceration
Not for heavily draining wounds
Usually requires 2*

13

Alginates and Hydrofibers advantage

Moderate-heavy draining wound
Viable or non-vaible tissue
Can assist with debridement
Can use compression
Can use on infected
Can pack wounds
Hemostatic

14

Alginate disadvantages

Dessication
Alginate scab

15

Foam advantages

Moderate to heavy drainage
Semi-occlusive
Adhesive or non-adhesive
Longer wear time
Wick away moisture
Protects/insulates
Retard hypergranulation

16

Foam disadvantages

Maceration
Dessication
May require 2* dressing
Expensive

17

Collagen Dressing advantages

Moderate to heavy drainage
Multiple forms
Reduces MMP

18

Collagen disadvantages

Bovine ingredients (allergies)

19

Composites

Two in one dressing: foam with other

Multiple features in one dressing

Various forms/sizes

20

Combination

Two in one with antimicrobial

Multiple activities with one dressing

May be confusing for caregiver

21

Silicone gel sheets

Used in maturation phase

Assists with scar management
May reduce hypertrophic scarring
Increase scar mobility
Reduce discoloration

22

Antimicrobial dressings

Ointments
Silvadene
Silver dressings
Cadexamer
Wound cleanser
Dakin's
Acetic Acid
Betadine

23

Antibiotic ointments

Bacitracin: water based, good for hands and face

Bactroban: effective against MRSA

Neosporin: allergies to neomycin

24

Silvadene

Sulfa and silver

May look purulent when ready to remove

Can turn wounds dull/gray 2* silver

25

Silver dressings

Effective against Pseudomonus, MRSA, staph, strep, eterococcus

Can stain

May require activation c sterile water

Change twice for effectiveness against bacteria

26

Hydrofera blue

Bacteriostatic against MRSA, VRE, staph, ecoli, more

Methylene blue and crystal violet

Requires rehydration

Light/White when ready to be replaced

Only antimicrobial that can be used in conjunction with enzymatic debriding

27

Cadexamer

Iodoflex and iodosorb: pseudomous, MRSA, strep, staph

Time release
Moderate to heavy drainage
Assist with debridement
Rust colored playdoh on application
Yellow applesauce=ready to remove
Indicated for sloughy, draining wounds

28

Honey

Promotes moist wound environment
Highly absorptive
Cleanses and debrides
Lowers pH
Non-toxic, natural, safe

29

Honey indications

DFU
VLU
ALU
Pressure ulcer
Superficial burns
Donor sights
Traumatic wounds

30

Growth factors

Utilize platelet derived growth factor to stimulate proliferative phase.

Regranex: recombinant.

Indicated for DFU.

31

Oasis

Biologic: from porcine small intestine

Collagenous ECM c cytokines

Temporary dressing for partial/full thickness loss.

Hydrated on application

32

Packing wounds

Fill, dont stuff, dead space
Do not traumatize
Use 1 piece if possible

33

Changes if macerated

Increase dressing change freuqency

Use skin barrier

Use more absorbent dressing

34

Hand bandaging

Keep bandaging minimal

Each finger individually.
Tubular if sterility not required

Occlusive for small wounds

35

When to change treatment

No sig change in 2-4 wks
Wound worsening
New odor or drainage
Bleeding

36

When to stop treatment

Osteomyelitis
Recurrent, unresolved erythema
Persistent purulent drainage
New ulcers
Necrosis of muscle, tendon, bone.