Assignment

Submitted to:
Dr. Muhammad Ajmal Shah

Submitted by:
16934: Ayesha
16954: Hafiza Ishmal Faheem

Topic:
Introduction to surgical dressings.

Subject:
Pharmacognosy

Program:
Pharm-D

Department of Pharmacognosy.
Faculty of Pharmaceutical Sciences.
Government College University Faisalabad.

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Table of Contents
1 Introduction .......................................................................................................................................... 3
2 Purpose of surgical dressings ................................................................................................................ 3
3 History of surgical dressings ................................................................................................................. 3
4 Preparation of surgical dressings .......................................................................................................... 4
5 Ideal surgical dressings ......................................................................................................................... 4
5.1 Properties of ideal surgical dressings............................................................................................ 4
6 Commonly used surgical dressings ....................................................................................................... 4
7 Advantages of surgical dressings .......................................................................................................... 4
8 Types of surgical dressings .................................................................................................................... 4
8.1 Primary surgical dressing .............................................................................................................. 5
8.1.1 Plain gauze ............................................................................................................................ 5
8.1.2 Impregnated gauze ............................................................................................................... 5
8.1.3 Film dressing ......................................................................................................................... 5
8.2 Secondary surgical dressing .......................................................................................................... 5
8.2.1 Absorbents ............................................................................................................................ 5
8.2.2 Bandages ............................................................................................................................... 5
8.2.3 Adhesive tapes ...................................................................................................................... 6
8.3 Combined primary and secondary wound dressings .................................................................... 6
8.3.1 Hydrogels .............................................................................................................................. 6
8.3.2 Hydrocolloid dressings .......................................................................................................... 6
9 Classification of fibers of surgical dressings.......................................................................................... 6
10 Discussion on .................................................................................................................................... 7
...................................................................................................................................................................... 7

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 Surgical dressings
1 Introduction
“A dressing is a sterile pad or compress applied to a wound to promote healing and prevent further harm.”

Figure: Surgical dressings.

2 Purpose of surgical dressings

Why we use surgical dresssings??
1. To promote wound healing by primary intention.
2. To prevent infection.
3. To assess the healing process.
4. To protect the wound from mechanical trauma.
5. To absorb drainage.
6. To prevent contamination from bodily discharged.

3 History of surgical dressings

 Historically, a dressing was usually a piece of material, sometimes cloth, but the use of cobwebs,
dung, leaves and honey have also been described.
 Previously the accepted wisdom was that to prevent infection of a wound, the wound should be
kept as dry as possible.
 1860, English surgeon, joseph Lister, began treating his surgical gauze with carbolic acid, known
today as phenol, and subsequently dropped his surgical team’s mortality rate by 45%.
 1870, Robert Wood Johnson, co-founder of “Johnson & Johnson”, began producing gauze and
wound dressings treated with iodine.
 1960, George Winter published his controversial research on moist healing. He demonstrated that
wounds kept moist healed faster.
 1990, surgical dressings expanded into the well-recognized groups of products, such as vapor-
permeable adhesive films, hydrogels, hydrocolloids, alginates and synthetic foam dressings.

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4 Preparation of surgical dressings
What you will need? A clear available work space, such as a stainless steel trolly. A sterile dressing
procedure pack. Access to hand-washing sink. Non-sterile gloves to remove previous dressing.
Apron. Appropriate dressings. Appropriate solution for cleaning the wound, if needed.

5 Ideal surgical dressings

“Term applied to a wide range of materials used for dressing wounds and diseased tissues”.

5.1 Properties of ideal surgical dressings

1. Provide an environment for moist wound healing.
2. Promote homeostasis (i.e stops bleeding).
3. Protect the wound from further damage.
4. Promote healing.
5. Reduce heat loss.

6 Commonly used surgical dressings

 Tulles
 Hydrogels
 Porcine skin
 Gauzes
 Tissue adhesives
 Polymeric films
 Hydrocolloids

7 Advantages of surgical dressings

o Moist environment for desiccated wounds. The dressing provides moist environment for
autolysis, cell migration, granulation and re-epithelialization.
o Microbial protection can be increased by incorporation of antimicrobial drugs in dressing.
o Provide support to the wound or injured tissues.
o Reduction of pain, odor and increase patient comfort.
o Reduce overall costs associated with wound treatment.

8 Types of surgical dressings

Functionally, the dressing can be divided into:

i. Primary surgical dressing

ii. Secondary surgical dressing
iii. Combined primary and secondary surgical dressing

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8.1 Primary surgical dressing
A primary dressing directly contacts the wound and may provide absorptive capacity. Prevent desiccation
(wound dryness), infection and adhesion of secondary dressing to the wound. e.g gauze, lint, plaster.

These include:

 Plain gauze
 Impregnated gauze
 Film dressing

8.1.1 Plain gauze

The plain gauze has been used as primary dressing to reduce the infected wounds. It sticks to all but
clean and incised wounds. Thus removal may be painful, often counterproductive and causing removal of
granulation tissue and new epithelium. e.g TRU-ABSORB™ (Gauze spomges)

8.1.2 Impregnated gauze

Impregnation of gauze reduces its adherence to wounds. For this purpose, cotton, rayon or cellulose
acetate gauze has been impregnated with a variety of substances such as paraffin and Vaseline. e.g
Cuticell®

8.1.3 Film dressing

They may be transparent. These are applied to exuding wounds where they permit enough evaporation
and promote moist wound healing and prevent maceration. e.g Tagaderm™

8.2 Secondary surgical dressing

The secondary dressing are intended to be placed over a primary dressing, providing further protection,
absorptive capacity and compression or occlusion. e.g gauze, lint, adhesive bandage. These include:

 Absorbents
 Bandages
 Adhesive tapes

8.2.1 Absorbents
Cotton is the basic surgical absorbent and may be absorbent or non-absorbent cotton. e.g Cutimed®
Hydrocontrol.

I. Absorbent cotton
II. Non-absorbent bleached cotton
III. Non-absorbent unbleached cotton

8.2.2 Bandages
The bandages hold dressings in place by providing pressure or support. They may be elastic, inelastic or
become rigid after shaping for immobilization. e.g BAND-AID® (Saniplasts). It may be:

I. Gauze roller bandage

II. Muslin bandage roll
III. Elastic bandage

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 8.2.3 Adhesive tapes
The surgical adhesive tapes have adhesive material on some appropriate backing materials. Adhesive
tapes are offered in many different forms, varying both in the type of backing and in formulation of
adhesive mass to fulfill individual requirements. e.g Micro-pore™ (Hypoallergenic surgical tape).
The tapes are divided into two broad categories:

I. Acrylate adhesives
II. Rubber based adhesives

8.3 Combined primary and secondary wound dressings

These are called composite dressings and have primary and secondary components that prevent adherence
to the wound with some degree of absorbency. e.g gauze, lint, adhesive tapes, bandages. These include:

 Hydrogels
 Hydrocolloid dressings

8.3.1 Hydrogels
The hydrogels are complex lattices in which the dispersion medium is trapped rather like water in a
molecular sponge. The hydrogel is typically a cross linked polymer. Hydrogels are useful in burn
treatment. e.g LUOFUCON®

8.3.2 Hydrocolloid dressings

The hydrocolloid dressing combine the benefits of occlusion and absorbency. Hydrocolloids are
dispersion of particles around which water molecules and solvated ions form a shell like structure. The
hydrocolloid mass of dressing consist of gum-like materials. e.g DynaDerm™

9 Classification of fibers of surgical dressings

The classification of fibers of surgical dressing are as follows:

Silk, Wool.
Animal
Natural
Vegetable Cotton, Jute, Flax, Hemp.

Classification of fibers
of surgical dressings

Viscose, Nylon, Alginate film, Terylene, Orlon.

Synthetic

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10 Discussion on
Cotton, rayon, nylon, catgut, cellulose and wool.

Cotton
Also called raw cotton, tasteless,
odorless and white in color.
C
Made from inorganic substances
like coal, water and air.
Non-adhesive fabric
Rayon used by surgeons to cover
skin graft donor-site
wounds
Natural absorbable suture is
obtained by longitudinally
slitting the intestinal sub-
mucosa of sheep and goat.

Pain levels
were
significantly Consist of hairs from the fleece
reduced in of sheep, creamy white in color,
the cellulose smooth, elastic and slightly
based fiber curly.
dressing.r
dressing

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