Professional Documents
Culture Documents
Wound Care
Wound Care
Tissue Management
Debridement
Mechanical Sharp Autolytic Enzymatic
Infection Control
Infection Control
Infection Control
Topical Antibiotics used for a limited time period when clinical infection is present
Muprirocin (Bactroban): MRSA, gram + Polymyxin: gram -; pseudomonas Bacitracin: wide spectrum gram + and
If epibole present, no healing will take place Silver nitrate Promotes healing from the bottom up Fill depth of wound with packing material Do not pack tightly Ex: wound fillers; gauze; alginates To determine what you use: do you want to absorb exudate or hydrate the wound bed this determines dressing choice
Dressings
Primary
The therapeutic or protective covering applied directly to the wound base
Secondary
Materials that serve as therapeutic or protective function and are used to secure the primary dressing i.e. keeps the dressing in place
Product Categories
Product Categories
Product Categories
Product Categories
Thin, non-adherent sheets placed in wound bed to protect against contact from other agents Provides protection Porous to allow fluid exchange Often used with fillers or topical medications Always used when bone or tendon is exposed Can leave in wound bed up to 7 days Ex: Tegapore, Dermanet, Mepitel, Telpha Clear, Curity Nonadherent, Vaseline Impregnated Gauze
Product Categories
Product Categories
Product Categories
Product Categories
Product Categories
Product Categories
Tapes
Gauze Dressings
Commonly known as 4x4s, 2x2s, packing strip, kerlix, conform, kling. Made of woven and non-woven fibers of cotton, rayon, polyester, or combination Moderately absorptive
Gauze Dressings
Skin Sealants
Liquid skin protectors that provide a plastic type film over skin Protects from moisture and tape damage Ex: Skin prep, NO-STING skin prep, Cavilon Barrier Film, Hollister Skin gel, Sure prep, Benzoin spray or sticks
Prescription Products
Collagenase Santyl
Provides enzymatic debridement Does not harm viable tissue Digests collagen necrosis
Prescription Products
Panafil Ointment
Provides enzymatic debridement Does not harm viable tissue Digests nonviable protein necrosis Use when there is <25% necrotic tissue present
Prescription Products
Wound Types
Pressure, Venous, Arterial, Diabetic, Acute, Unusual
Pressure Ulcers
Rounded Crater like Regular edges Take on shape that caused the pressure The deeper the less likely they bleed Often peri-wound is non-blanchable erythema
Arterial Ulcers
Location
Between toes or tips of toes Over phalangeal heads Around lateral malleolus Areas subjected to trauma/rubbing footwear
Characteristics Even wound margins Punched out appearance Pale, deep, wound bed Blanched peri-wound tissue Extreme pain Cellulitis
Unstable gangrene
Amputation required
black non-viable tissue Exclusive to the extremities Tx: paint with betadine or alcohol and dress with dry gauze
Diabetic Ulcers
Characteristics
Painless Even wound margins Rounded/oblong shape over bony prominence Deep Surrounding callous Cellulitis/underlying osteomyelitis
Venous Ulcers
Characteristics
Irregular wound margins Superficial Lumpy granulation tissue Generally painless Exudate is moderate to heavy initially Surrounding skin can be weepy Dermatitis vs. cellulitis
Treatment:
Cleanse and choose dressings for wound Compress Optimize contributing factors Elevate Establish a maintenance plan
Compression pumps
Treatment Considerations
Other considerations
Dry stable eschar: leave intact Unstable necrotic tissue: aggressive debridement Granulating wound bed: appropriate moist wound healing Infected wound: silver products; cadexomer iodine; use precaution with occlusive dressings Adjunctive therapies: Regranex (spendy); anodyne
Questions?
Thank you!