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Integument > Wound Dressings > Flashcards

Wound Dressings Flashcards

1
Q

How do dressings maintain homeostasis?

A
  • Degree of hydration (wound bed and person)
  • Sufficient blood perfusion
  • Availability of growth factors
  • Appropriate oxygen partial pressure
  • Acceptable levels of microflora (cells and growth in wound)
  • Maintain voltage gradients
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2
Q

Factors to consider with dressings

A
  • Moisture (Soak up or provide)
  • Gaseous exchange (O2)
  • Thermal insulation
  • Impermeability to micro-organisms
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3
Q

One degree increase in skin temperatue by one degree increases wound healing by ____%

A

33

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4
Q

What is strike through? Why is it bad?

A
  • Strike through is when drainage gets out of the dressing
  • Create a bacteria cross bridge (Change immediately!)
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5
Q

What is an occlusive dressing? What are the advantages to using one?

A
  • Means to occlude wound (block something off)

Advantage:
* Faster healing
* Autolytic debridement
* Decreased pain at wound site
* Control exudate drainage
* Cost effective (person that changes dressing)

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6
Q

Water Vapor Permiability - Occusive to Non-Occlusive

A
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7
Q

Can you cover an infected wound? What dressing should you use on it?

A
  • No, you cannot cover an infected wound
  • Must be semi-occlusive or non-occlusive
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8
Q

Gauze Dressing

A
  • Primary or Secondary
  • Open weave or Fine Mesh
    – Open weave will get stuck in granulation tissue (unless special dressings)
    – Fine mesh will not get grow into; can be used for tunnels
  • Plain, pre-moistened or impregnated
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9
Q

Primary vs Seconday Dressing

A

Primary: Next to the wound bed
Secondary: What goes over the top of it

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10
Q

Calcium Alginate/Hydrofiber Dressings - Advantages

A
  • Absorb up to 20X weight in exudate
  • Form a gel over wound
  • Supports enzymatic debridement
  • Fill in dead space
  • Easy to apply and remove

Primary Dressing

Must stay in wound bed or it will macerate the skin.

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11
Q

Calcium Alginate/Hydrofiber Dressings - Disadvantages

A
  • Not recommended for light exudate or dry eschar
  • Requires 2nd dressing as a cover dressing
  • Can dehydrate wound
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12
Q

Calcium Alginate needs to be changed every ____ hours

A

24-72 hours

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13
Q

Silver Impregnated Dressings

A

AQUACEL® Ag is the first antimicrobial dressing that:
* Provides immediate and sustained antimicrobial activity to kill many types of bacteria and fungi.
* Offers the unique gelling properties of Hydrofiber® technology enabling dressing to gel on contact with the wound fluid creating a large fluid-absorption capacity
* Locks bacteria within the gelled AQUACEL® Ag fibres7 away from the wound bed.
* AQUACEL® Ag is indicated for use on acute and chronic wounds including burns, surgical wounds, diabetic foot ulcers, pressure ulcers and leg ulcers.

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14
Q

What is Impregnated Gauze - MeSalt

A

NaCl solution in fine mesh gauze

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15
Q

Impregnated Gauze - MeSalt
Advantages

A
  • Permeable to oxygen
  • Can be used with infected wounds
  • Excellent absorption (30x weight)
  • Suppresses growth of E coli, staph, pseudomonas
  • Easy to apply and remove
  • Does not allow granulation to grow into dressing
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16
Q

Impregnated Gauze - MeSalt
Disadvantages

A
  • Must be pre-moistened with dry eschar or lightly exudating wounds
  • Requires a 2nd dressing as a cover dressing
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17
Q

Impregnated Gauze - MeSalt must be changed every ____ days

A

1-3

18
Q

Impregnated Gauze - Aquaphor
Advantages

Vaseline impregnated gauze

A
  • Permeable to oxygen
  • Can be used with infected wounds
  • Easy to apply and remove
  • Does not stick to wounds
  • Can be used for burns or graft sites
19
Q

Impregnated Gauze - Aquaphor
Disadvantages

A
  • Does NOT absorb drainage
  • Requires a secondary cover dressing
20
Q

Impregnated Gauze - Aquaphor needs to be changes every ____ days

A

2-3

21
Q

Semi-permeable Film (SPF)
Advantages

A
  • Impermeable to bacteria
  • Maintains moist environment
  • Promotes autolytic debridement
  • Allows visualization of wound
  • Less trauma with changes unless done too soon
  • No secondary dressing needed

Tegaderm

22
Q

Semi-permeable Film (SPF)
Disadvantage

A
  • Do not use for large exudates
  • Requires intact dry borders for adhesives
  • Difficult to handle
  • May not stay in place in high friction areas
23
Q

Semi-permeable Film (SPF) needs to be changes every ____ hours

A

24-72

24
Q

Semi-permeable Foam
Advantages

A
  • Faster healing
  • Moist wound environment
  • Good exudate absorption
  • Fair moisture vapor transmission
  • Fair oxygen permeability
  • Maintains body temperature in wound
25
Q

Semi-permeable Foam
Disadvantages

A
  • Non-adhesive
  • Clinician must supply tape or covering
  • Easily displaced by mechanical forces
  • More expensive than SPFs, but still cost effective vs. gauze
26
Q

How often does Semi-permeable Foam need to be changed?

A

1-3 days

27
Q

Hydrocolloid Thin
Advantages

Semipermeable

A
  • Impermeable to bacteria
  • Maintains moisture
  • Autolytic debridement
  • Self-adhesive, molds well
  • Provides limited to moderate absorption
  • May be left in place for long time
  • Minimal trauma when removed
  • Waterproof
  • Lowest oxygen gradient that may promote granulation tissue
28
Q

Hydrocolloid Thin
Disadvantages

Semipermeable

A
  • Do not use if heavy exudate or eschar
  • Not transparent
29
Q

Hydrocolloid Thins need to be changed every ____ days

A

3-7 days

30
Q

Hydrogels (HDG)
Advantages

A
  • Soothing, reduce pain
  • Rehydrate wound bed
  • Autolysis
  • Minimal/moderate absorption
  • Easily removed (without borders)
  • Leaves no residue in the wound bed
  • Transparent
31
Q

Hydrogels (HDG)
Disadvantage

A
  • Cannot be used in infected wounds
  • Do not use if heavy exudate
  • May required secondary dressing (non-boarded)
  • Some may dry out
32
Q

Hydrogels need to be changes every ____ hours

A

8 to 72

33
Q

What dressings can be used with an infected wound

A

Gaze to Hydrocolloid Thin

34
Q

Hydrocolloid Thick (HDCi)
Advantages

Impermeable

A
  • Impermeable to bacteria
  • Maintains moisture
  • Autolytic debridement
  • Self-adhesive, molds well
  • Provides moderate absorption
  • May be left in place for long time
  • Minimal trauma when removed
  • Waterproof
35
Q

Hydrocolloid Thick (HDCi)
Disadvantages

A
  • May not be used on infected wounds
  • May not be used on arterial insufficient wounds (ABI <.8)
  • Not transparent
  • May tear fragile surrounding skin when removed
  • Leaves adhesive residue on surrounding skin
36
Q

Hydrocolloid Thick (HDCi) needs to be changed every ____ days

A

3-7

37
Q

Growth Factor Stimulation

A

Regranex Gel
* Recombinant human platelet-derived growth factor (rh-PDGF)
* Actively stimulates angiogenesis and granulation tissue formation

38
Q

Types of Grafts:
Autograpft
Allograft
Homograft
Heterograft

A
  • Autograpft: tissue from same patient
  • Allograft: tissue from another person
  • Homograft: tissue from same species
  • Heterograft: tissue from different species; SIS is good forepithelialization for diabetic and AI patients.
39
Q

The “VAC”

A
  • Vacuum Assisted Closure
  • Continuous assisted drainage from wound bed prevents maceration
  • Physically assists neovascularization and wound contraction through positive pressure
  • Can prepare wound bed for skin grafts
40
Q

VAC precautions

A
  • Active bleeding (anticoagulation)
  • Difficult hemostasis in the wound bed
  • Patients on anticoagulants
41
Q

VAC Contrindications

A
  • Large amounts of necrotic tissue in the wound bed
  • Cancer in the wound margins
  • Untreated osteomyelitis
  • Fistulas to organs or body cavities
42
Q

Collagenase and ____ can never be used together

A

Silver Dressings

Integument (7 decks)

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