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28 Cards in this Set

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Indications for wound dressing (WD)
to hide an injury
to protect a wound
to provide support immobilization, and compression
Ideal dressing accomplishes
high humidity b/t wound and dressing
thermal insulation for wound
removes exudate from wound
allows gas exchange
impermeable to bacteria
does not leave contaminants in wound
Contrindications
avoid comprimise of blood supply
Relative:
skin sensitivity to dressing
persistant povadone causes damage
decreased circulation in the affected area
avoid putting gauze directly on wound
Elderly - don't use adhesives
What to do if dressing adheres to wound
soak in normal saline for ten minutes
consider dressing materials designed not to stick
Why not to use adhesives on elderly
loss of collagen in dermis leads to skin which is easily torn
Wound types (WD)
closed
open
necrotic
infected
granulating
epithelializing
closed wound
no evidence that dressing decreases risk of infection
open wound
goal is to encourage clean granulation by creating moist environment without slough
Necrotic wounds
must be debrided surgically first
Tx if can't do surgery on necrotic wound
hydrocolloids or hydrogels
How do hydrocolloids work
contact with exudate causes particles to swell and form impermeable gel
rehydrating allows necrotic to separate and slough off
Infected wounds
tx with normal saline irrigation
Use Alignates for more extensive wounds
Alignates
moisture cause Ca in alignate to form a gel.

makes dressing removal easy and comfortable
granulating wounds
require a moist environment

Use Xeroform impregnated gauze or hydrocorroids
Epithelializing wounds
tx same as granulating
Three stages of wound healing
Inflammatory
Proliferative
Maturation
Inflammatory stage
0-6d
Five cardinal signs present
Homeostasis controls bleeding
PMNs control bacteria growth
4d - macrophages migrate and produce growth factors
Proliferative stage
4 - 24d
granulation tissue is generated
fibroblasts stim. production of collagen
margins contract
cells migrate to wound margins - sealing it
Can ONLY occur in presence of viable vasculature
Scar forms at end of this phase
Maturation stage
21d-24m
collagen reorganizes, remodels, and matures
only 80% tensile strength returns
Four steps to preventing infection
Adequate and timely resuscitation of the pt
Early wound care
Atbx
Tetanus immune prophylaxis
Pt prep WD
Inform pt
Explain, what, why, answer ???
Primary dressings
Alginates
Biosynthetic dressings
Collagens
Foams
Hydrocolloids
Hydrogels
Secondary dressings
Transparent films
Dressing Gauze
Flexible collodion
Dressing stabilizer
Dressing characteristics
soft
permeable
sterile
elastic
Things to read in this chapter
All about different types of dressing
Procedure for wound dressing
F/U for WD
Explain dressing changes (2-3d or if gets wet or dirty)
Clean wound 3x/d c H2O2
Shower should not spray directly on wound
No bath
what to expect with wound over time
Wash hands before and after tending wound
when to d/c dressing
RTC if (WD)
Signs of infection
Not able to perfrom dressing changes
Suppose reading this chapter did you no good because you never were actually taught about different dressings. Where do you go for info?
www.dressings.org
It tells you:
indications, contraindys, methods of use, frequency of change, warnings, sizes, etc