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Flashcards in Wound management Deck (52)
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In wound healing, when does the inflammatory phase occur?

Days 0-5


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?

- Non-restrictive
- Non-adherent
- Sterile
- 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

- Adherent
- Non-adherent
- Absorbent
- Active
- Antimicrobial


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

- Melolin
- Primapore


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

Opsite Flexigrid


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


Explain the use and properties of foam dressings

- Absorb wound exudates while maintaining a moist environment suitable for granulation and epithelialisation to take place
- Outer layer of dressing prevents strike through
- Can absorb up to 10x their own weight
- Protective barrier over wound
- No debriding properties