SA Wound Treatment Options Flashcards
What is wound debridement?
Real of dead, necrotic, contaminated particulate material from a wound
What is the purpose of wound debridement?
To get wound into a fitter and healthier state
To allow wound to move onto next stage of healing
What methods are there of debridement?
Surgical
Mechanical
Autolytic
enzymatic
Biological
Surgical debridement examples
Remove biofilm and devitalised tissue
Use scalpel blade to remove devitalised tissue
When stuck in chronic granulation
HEALTHY GRANULATION BED
Mechanical debride examples
Lavage - warm isotonic crystalloid saline (Hartmann’s) (0/9% saline also acceptable)
Wet-to-dry dressing
* Good at converting chronic granulation bed to healthy granulation bed
○ May have previously scraped then lavage
Negative pressure wound therapy (NPWT)
Autolytic debridement examples
Body’s own enzymes beneath a dressing to liquefy tissues
Hydrocolloids
Hydrogels
Honey
Foam
Enzymatic debridement examples
Prescribed topical agent that chemical liquifies necrotic tissues with enzymes
Biological debridement examples
Maggots
Devitalised definiton
Dead
Describe wet-to-dry debridement
- Sterile swabs
○ Soak in isotonic crystalloid solution (Hartmann’s)- Squeeze out so not dripping wet
- Place over chronic granulation bed
- Place dry swabs on top
- Conforming layer
- Elasticated bandage on top
- Changed every 24 hours
What is NPTW
Topical Negative Pressure Wound Therapy
* Mechanical pumps connected to wound
* Provide partial vacuum at site of wound
○ Draws fluid out
○ Reduced oedema
○ Draws edges of wound together
§ Stimulates migration of epithelial cells
○ Increases blood flow
○ Stimulates granulation tissue
○ Reduces bacterial colonisation
○ Increases rate of mitosis
Why is honey used as autolytic debridement?
- Antimicrobial effect
○ Reduction or eradication of bacteria- Healing stimulating properties
○ Reduction in wound size
○ Healing time
○ Complete healing
○ Stimulation of granulation tissue
○ Epithelialisation - Debriding effect
- Anti-inflammatory effect
- Odour reducing capacity
- Reduction in wound pain
low pH
osmotic effect (don’t use on granulation stage)
- Healing stimulating properties
Wound closure Techniques
Primary closure - immediate suture
Delayed primary / third intention- closure after 3-5 days of wound management
Second intention healing - leave it alone
Foam dressings
- Absorbent
- Sponge-like polymer
- Outer-surface is waterproof but gas permeable
- Absorbs fluid from wound and saturates foam
○ Allows fluid to evaporate
Moist wound healing
Not good for slough wounds
Not good for dry wounds
What is the fluid-handling capacity of a foam dressing?
1:1 ration unless compressed
