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28 Cards in this Set
- Front
- Back
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Indications for wound dressing (WD)
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to hide an injury
to protect a wound to provide support immobilization, and compression |
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Ideal dressing accomplishes
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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 |
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Contrindications
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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 |
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What to do if dressing adheres to wound
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soak in normal saline for ten minutes
consider dressing materials designed not to stick |
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Why not to use adhesives on elderly
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loss of collagen in dermis leads to skin which is easily torn
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Wound types (WD)
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closed
open necrotic infected granulating epithelializing |
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closed wound
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no evidence that dressing decreases risk of infection
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open wound
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goal is to encourage clean granulation by creating moist environment without slough
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Necrotic wounds
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must be debrided surgically first
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Tx if can't do surgery on necrotic wound
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hydrocolloids or hydrogels
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How do hydrocolloids work
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contact with exudate causes particles to swell and form impermeable gel
rehydrating allows necrotic to separate and slough off |
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Infected wounds
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tx with normal saline irrigation
Use Alignates for more extensive wounds |
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Alignates
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moisture cause Ca in alignate to form a gel.
makes dressing removal easy and comfortable |
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granulating wounds
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require a moist environment
Use Xeroform impregnated gauze or hydrocorroids |
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Epithelializing wounds
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tx same as granulating
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Three stages of wound healing
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Inflammatory
Proliferative Maturation |
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Inflammatory stage
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0-6d
Five cardinal signs present Homeostasis controls bleeding PMNs control bacteria growth 4d - macrophages migrate and produce growth factors |
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Proliferative stage
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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 |
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Maturation stage
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21d-24m
collagen reorganizes, remodels, and matures only 80% tensile strength returns |
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Four steps to preventing infection
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Adequate and timely resuscitation of the pt
Early wound care Atbx Tetanus immune prophylaxis |
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Pt prep WD
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Inform pt
Explain, what, why, answer ??? |
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Primary dressings
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Alginates
Biosynthetic dressings Collagens Foams Hydrocolloids Hydrogels |
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Secondary dressings
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Transparent films
Dressing Gauze Flexible collodion Dressing stabilizer |
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Dressing characteristics
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soft
permeable sterile elastic |
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Things to read in this chapter
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All about different types of dressing
Procedure for wound dressing |
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F/U for WD
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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 |
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RTC if (WD)
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Signs of infection
Not able to perfrom dressing changes |
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Suppose reading this chapter did you no good because you never were actually taught about different dressings. Where do you go for info?
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www.dressings.org
It tells you: indications, contraindys, methods of use, frequency of change, warnings, sizes, etc |
