Flashcards in Wound management Deck (52)
In wound healing, when does the inflammatory phase occur?
Outline the inflammatory phase of wound healing
- Initiates inflammation of tissue
- Haemorrhage followed by haemostasis
- Produces heat, redness, swelling, pain
- Localised vasodilation, oedema and serous-type ooze
When does the debridement phase of wound healing occur?
From day 0
Outline the debridement phase of wound healing
- Migration of leukocytes
- Phagocytosis removing and destroying bacteria
- Cellular debris removed
When does the proliferative phase of wound healing occur?
Day 3 up to 4 weeks
Outline the proliferative phase of wound healing
- Repair of damaged tissues
- formation of a repair framework and granulation tissue
- Wound contraction and epithelialisation
When does the remodelling phase occur in wound healing?
Day 20 to years
Outline the remodelling phase of wound healing
- Repaired tissue is replaced by collagen
- Wound continues to contract
- Tissue regains some elasticity and protective barrier function
Discuss the rate of epithelialisation of a superficial wound in relation to the presence of a scab
Much slower to epithelialise when covered normally by a dry scab is present
What are the ideal properties of a dressing to promote granulation tissue formation?
- Provides moist environment
Outline the desirable properties of a dressing in the case of chronic granulation tissue
Something that actively debrides the tissue and helps re-stimulate growth of healthy granulation tissue
List the broad types of wound dressing
What is the primary function of adherent/debridement wound dressings?
Control wound infection and debride infected/neccrotic wounds
Give examples of adherent/debridement dressings
- Wet-to-dry, dry-to-dry
- Saline soaked or dry sterile gauze applied directly on wound's surface
Outline the management of adherent/debridement dressings
- Change at least every 24hours
- Should peel away necrotic tissue/debris
- Fresh granulation tissue handled carefully to avoid compromising the progression of the wound
- May need analgesia/sedation as removal can be painful
Give examples of non-adherent wound dressings
- Perforated polyurethane membranes
- Paraffin gauzes
- Vapour permeable films
Give examples of perforated polyurethane membrane dressings
What are the indications for use of a perforated polyurethane membrane dressing?
Post operative wound where the incision site and sutures require protection throughout the immediate post-op period
Explain the contraindications for use of a perforated polyurethane membrane dressing
Should not be used in granulating wounds as they lack the ability to provide the ideal healing environment for the granulation process, may disrupt healing on removal
What are paraffin gauze dressings?
Dressings comprising a thin, cotton netting impregnated with soft paraffin
Briefly describe the use of paraffin gauze dressings
- Applied as primary layer over open wound
- Should have secondary layer over gauze to act as absorbent layer and draw exudate away from wound
Explain the function of paraffin gauze dressings
Prevent dressing stickig to the wound and to support healing under moist and aseptic conditions
What wounds is the use of paraffin gauze dressings most suited to?
Skin wounds, burns, skin graft sites, traumatic injuries where skin loss is evident
Give example of vapour permeable film dressings
What is the main function of vapour permeable film dressings?
Promote moist wound healing and provide protective barrier, allows for vapour exchange at wound surface while maintaining moist environment
Briefly describe the use of a vapour permeable film dressing
The thin membrane of the dressing should be stretched over the wound, with the edges sticking to the skin surface (can be tricky to apply)
What wounds are vapour permeable films suited to?
Small or shallow wounds producing little exudate only, as this becomes trapped underneath the dressing
What is the primary function of absorbent dressings?
Provide absorbent layer for wounds producing high volumes of exudate, such as large, extensive wounds undergoing the granulation process
Give examples of absorbent dressings
- Foams e.g. Allevyn, Tielle
- Super-absorbent dressings e.g. Eclypse