Wound Care Part 4

Question 1

what is the primary purpose of a wound covering/dressing?

Answer 1

to maintain a moist environment and a homeostatic environment

Question 2

if the wound bed is too wet, what can occur?

Answer 2

maceration of the tissue

Question 3

when the tissue is too wet and becomes macerated, what has to be done?

Answer 3

it has to be dried out or debrided

Question 4

most dressings today are what kind of dressing?

Answer 4

semi-occlusive dressings

Question 5

what does it mean that a dressing is semi-occlusive?

Answer 5

air and gas can go from the inside of the wound to the outside, but nothing can come into the wound

Question 6

how can we make the right choice with our dressings?

Answer 6

match the dressing fxn to the wound need

Question 7

if a wound is dry, we should…

Answer 7

add moisture

Question 8

if a wound is wet, we should…

Answer 8

dry it out

Question 9

if a wound has black flat eschar, we should…

Answer 9

cross hatch and add autolytic debridement

Question 10

if a wound is black, dry, and shriveled up, we should…

Answer 10

apply betadine to keep it clean and dry to allow auto amputation

Question 11

if there are copious amounts of fluid in a wound, we should…

Answer 11

apply foam to absorb the fluid for a couple days

Question 12

t/f: wound needs change over time

Answer 12

true

Question 13

t/f: wound need vary by wound etiology

Answer 13

true

Question 14

what are the exudate absorptive dressings?

Answer 14

alginates

foams

specialty absorptives

Question 15

what are alginates?

Answer 15

absorptive derived from brown seaweed that interacts with wound fluid to create gel

Question 16

what should we warn the pt/fam/nursing about with alginates?

Answer 16

that they will turn brown but it is NOT infected

Question 17

what are foams?

Answer 17

an absorptive that is nonlinting, absorbant, and nonadherent used to drain minimal to heavy drainage

Question 18

what are specialty absorptives?

Answer 18

multi-layers with highly absorptive fibers, cellulose, cotton, rayon (same materials as a baby diaper)

Question 19

what dressing promotes autolytic debridement?

Answer 19

hydrocolloid patches (Duaderm)

Question 20

what are hydrocolloids?

Answer 20

occlusive, semi-occlusive dressing that is composed of gelatin, pectin, and carbamethylcellulose that helps manage wounds with necrosis and slough with light to moderate exudate

Question 21

how can we get better adherence of bandages?

Answer 21

hold your hand over it for about 30 sec to allow your body heat to increase its adherence

Question 22

what are antimicrobials?

Answer 22

topical wound care products derived from iodine, silver, and polyhexethylene biguanide

Question 23

what are the 2 main antimicorbials we use?

Answer 23

silver and providine iodine

Question 24

what is the preferred topical solution for dry gangrene?

Answer 24

providine iodine

Question 25

how do we apply providine iodine?

Answer 25

paint the entire wound area, allow it to dry by air, and cover it with a dry gauze as protection

Question 26

how do antimicrobials work?

Answer 26

the active ingredients are incorporated into a dressing to deliver an antimicrobial/antibacterial action to the wound

Question 27

what things are typically used for odor control in a wound?

Answer 27

charcoal or hydrophilic powders

Question 28

what is the only time we use hydrophilic powders for wound odor control?

Answer 28

when it is an open, infected wound

Question 29

t/f: open arterial wounds are covered based on their location and exudate

Answer 29

true

Question 30

what are the three actions we can use for moisture control?

Answer 30

absorb, maintain, or add moisture

Question 31

what are the 3 levels of occlusiveness?

Answer 31

occlusive, semi-occlusive, and non-occlusive

Question 32

what are the absorptives?

Answer 32

Alginates Collagen Composite Foams Hydrophilic powders Superabsorbants

Question 33

what are the products that maintain moisture?

Answer 33

Films Hydrocolloid (Duaderm) Hydrogel sheets Hydropolymers

Question 34

what are the products that add moisture to a wound?

Answer 34

amorphous gels (90% water in a gel)

Question 35

what are the occlusives?

Answer 35

Composite Films Foams Hydrocolloids Hydropolymers

Question 36

what is the semi-occlusive we use for wounds?

Answer 36

superabsorbents

Question 37

what are the non-occlusives?

Answer 37

Alginates Amorphous gels Collagen Contact layers Foams Hydrogels Hydrophilic powders

Question 38

if there is an infection present or a new wound, can we use an occlusive dressing?

Answer 38

NO!

Question 39

why can't we use an occlusive with an infection present?

Answer 39

bc it will create a breeding ground for bacterial growth

Question 40

t/f: pts with a bad immune system are at risk of infection with use of an occlusive dressing

Answer 40

true

Question 41

what is cellular tissue therapy?

Answer 41

live cell graft used for wounds that haven't responded to 30 days of standard care used to facilitate the pt's regenerative process for re-epithelialization and healing

Question 42

what are the 2 types of cellular tissue therapy?

Answer 42

bioengineered skin products human amniotic membrane allograft

Question 43

what are bioengineered skin products?

Answer 43

living cells, growth factors, other proteins, and a collagen matrix taken from fetal foreskin cells

Question 44

what are human amniotic membrane allografts?

Answer 44

decellularized, dehydrated graft with a preserved basement membrane and an intact ECM and structure

Question 45

although cellular tissue therapy can be extremely useful, it hasn't shown great workplace success, why is this?

Answer 45

bc the wound bed is not prepared properly to accept the graft

Question 46

what is the first thing we need to do to create an environment to healing?

Answer 46

cleanse the wound bed!!!