Wound healing and its impact on dressings and postoperative care Flashcards Preview

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Flashcards in Wound healing and its impact on dressings and postoperative care Deck (61):
1

Acute wounds have been shown to heal 40% faster in a moist environment than when air exposed.

T

2

In moist wound healing of acute wounds, wound resurfacing occurs more rapidly because of a higher rate of mitosis.

F Because keratinocytes begin to migrate sooner.

3

Moist wound healing promotes a greater rate of vascularisation.

T

4

Dressings help establish a steep oxygen gradient, which stimulates capillary growth toward the more hypoxic centre.

T

5

The higher bacterial count in occlusive dressings predisposes to infection.

F
Occ dressings have higher bacteria count but lower rate of infection - 2.6% compared to non occlusive dressings - 7.1%

6

In contrast to acute wound fluid, chronic wound fluid is inhibitory to epithelialisation.

T

7

Chronic wounds have considerably lower protease activity than acute wounds.

F Higher.

8

Gauze, foams and alginates are types of absorptive dressings.

T

9

Hydrophilic types of non-adherent fabrics have greater occlusive capability, but hinder fluid drainage through them.

F
This is true for hydrophobic dressings, such as Telfa, Xeroform, Vasgauze, Jelonet, Bactigras (same as the others but impregnated with chlorhexidine)

10

Hydrophobic types of non-adherent dressings are less occlusive, but have the ability to readily facilitate the drainage of fluids and exudates into overlying dressings.

F
This is true for hydrophilic dressings eg. Mepitel, Adaptic, Xeroflo

11

Wide mesh gauze is usually not placed in direct contact with wounds because it adheres to the surface of the wound, resulting in pain on removal.

T Only exception is when mechanical debridement is desired
Gauze usually used over non-adherent, non-occlusive fabric dressings such as Xeroform

12

Foam dressings and alginates are both absorptive and occlusive/moisture-retentive dressings.

T

13

The moisture vapour transmission rate of wounded skin is 40 times higher than intact normal skin.

T

14

The primary advantage of foam dressings are that they can be used on wounds with unusual configurations and are highly absorptive.

T Eg. Allevyn, Mepilex
Should cover a 2cm margin around the wound edges
Too drying to use as primary dressing on dry wounds

15

Foam dressings are often used on dry wounds

F Because of their dehydrating capabilities they are not used on dry wounds

16

Film dressings do not contain acrylic adhesive.

F They are self adhesive.

17

Film dressings are permeable to oxygen, carbon dioxide and water, and impermeable to fluids and bacteria.

T Eg. Tegaderm
Generally used alone without a secondary dressing

18

The biggest disadvantage of film dressings is that they are non-absorptive, therefore fluid can collect under them.

T

19

Film dressings are recommended for patients with fragile skin, such as the elderly.

F

20

Film dressings should be used as the primary dressing of moderately to heavily exuding or infected wounds, sinus tracts, or cavities

F

21

Hydrocolloid dressings contain a hydrocolloid matrix consisting of materials such as gelatin, pectin, and carboxymethylcellulose.

T Eg. Duoderm, Comfeel.

22

Hydrocolloid dressings are permeable to water vapour, oxygen and carbon dioxide.

F Impermeable.

23

Hydrocolloids may initially cause the size of the wound to increase.

T Due to their debriding abilities. The skin around them may macerate
Can be reduced by applying zinc oxide to the wound margins

24

Hydrocolloids are associated with the formation of a yellow gel.

T
Gel has an unpleasant odour and can be confused with wound infection

25

Hydrocolloids are the dressing of choice for third degree burns and actively infected ulcers

F

26

Hydrogel dressings are available as gels, sheets or impregnated gauze.

T Eg. Solosite wound gel

27

Alginate dressings consist of the soft non-woven fibres of a cellulose-like polysaccharide derived from the calcium salt of seaweed.

T Eg. Algiste, Kaltostat.

28

Alginates should not be used for heavily exuding wounds.

F
Good for these but hydrofibre dressings better as more absorptive
Should not be used on dry or mildly exuding wounds

29

Alginates have haemostatic properties.

T
They form a gel after absorbing blood which can be foul smelling and mimic wound infection

30

Hydrofibre dressings are composed of soft, absorbent carboxymethyl cellulose fibres that interact with wound exudates to form a soft gel.

T Eg. Aquacel.

31

Alginates are three times more absorbent than hydrofibre dressings.

F Other way around
Hydrofibre best choice for heavily exuding wounds
Hydrofibre ribbons used to pack wound cavities

32

Alginated dressings are hydrophobic

F Hydrophilic

33

Silver-impregnated dressings are bactericidal without antibiotics and maintain a moist environment to facilitate wound healing.

T Eg. Aquacel Ag, Acticoat

34

Maggot therapy is most efficacious in wounds infected with Gram-negative bacteria.

F Gram-positive eg. MRSA

35

The closed technique of wound dressing after laser surgery is associated with more rapid re-epithelialisation and less pain than the open technique.

T

36

After laser resurfacing there is pain, burning and stinging for the first few days, and during the first 1-2 days there is oozing of thermally denatured collagen

T

37

Bleeding frequently occurs after laser resurfacing

F Rare due to hemostatic action of the laser

38

The recommended ankle pressure in patients with venous ulcers of the leg is 50-60mmHg.

F 30-40mmHg.

39

Occlusive dressings maintain a basic pH which inhibits bacterial growth

False
Mildly acidic pH which inhibits growth of some bacteria eg staph and pseudomonas

40

Acute wound fluid stimulates DNA synthesis in cultured skin cells

True
Chronic wound fluid does not

41

Moisture retentive occlusive wounds offer advantages for chronic wounds such as venous ulcers

True
Offer;
Pain relief
Painless wound debridement
Containment of wound exudates
Reduced complications
Improved QoL

42

Absorptive dressings include;
Gauze
Foams
Alginates

True
All are non-adherent fabrics

43

Skin grafts and skin substitutes can be considered biologic dressings

True

44

Occlusive non-biological dressings include traditional types and new types

True
New types are
Hydrofibre dressings
Hyaluronic acid dressings
Collagen dressings

45

Hydrocolloids are new type non-biological occlusive dressings

False
Traditional type

46

Foams and films are traditional type non-biological occlusive dressings

True
These include;
Foams
Films
Hydrocolloids
Hydrogels
Alginates

47

Dressings with a moisture vapour transmission rate of

False
MVTR

48

Wounded skin has a moisture vapour transmission rate of 200g/m2

False
This is for intact normal skin
Wounded skin MVTR is 40x higher than this

49

Foams and gauze are both Absorptive and occlusive dressing types

False
Foams and aliginates are both types
Gauze is absorptive only

50

Foam dressings may be self adhesive or non-adhesive types

True
Can be used as primary dressing or secondary dressing to provide additional absorption or protective cushioning

51

Film dressings may be left in place for several days until a pocket of fluid accumulates under the dressing

True
They can reduce pain from the wound while in situ

52

When applying a hydrocolloid dressing the warmth of the hand can be used to help seal the dressing

True

53

Hydrogels consist of up to 80% water

True
Hydrophilic polymer + water
Polymer is usually starch type such as polyethylene oxide

54

Hydrogels are good for heavily exudative wounds

False
Good for superficial wounds with mild exudate such as post dermabrasion or peel or for dry or necrotic wounds

55

Hydrogels should be changed daily

False
Change every 3 days for necrotic wounds and every 7 days for granulating wounds

56

Collagen dressings are derived from cow hide

T
Consist of type 1 bovine collagen
Provide a collagen matrix for cellular migration

57

Hyaluronic acid dressings are biodegradable absorbent polymers that form a hydrophilic gel with the wound exudate

T
Accelerate the formation of granulation tissue and re-ethelialization

58

Honey increases healing in venous ulcers when used with compression

F

59

Honey may be better than conventional dressings in partial thickness burns

T
But delays healing when compared with early excision and grafting of partial and full thickness burns

60

Aloe Vera delays wound healing by secondary intention

True
No evidence for use of aloe Vera on skin wounds

61

Cultured epidermal allografts mainly come from cadaver skin

False
From neonatal foreskins