World Council of Enterstomal Therapist

Nursing ( WCET )
Roland Joseph Toledo., RM., RN., ETN
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 GAUZE
KASA / GAUZE
• Secondary dressing
 Absorban
 mechanical
debridement
 TRANSPARANT FILM DRESSING
• Waterproof and gas permeable
Supports autolysis debridement
Reduces pain Non absorbent
Example: Tegaderm, transparent
fixomull, opsite with padding (island
dressing) absorbent
 HYDROGEL
• Modified CMC polymer
with the main mixture of water (number
vary on each product
Create a moist atmosphere (reidration)
Very instrumental for burns
degree 1 or 2 with cold effects
Shape: tube, spray, impregmented
Examples: intrasite gel, curafil, cutimed gel
aloe vera etc.
APPLYING
 HYDROCOLOID
• Sodium
carboxylmethilcellulosa (NaCMC) and
gelatin
 waterproof,adhesive,Occlusive
 powder,paste,seal
Contoh : comfeel , ultec pro,
duoderm
APPLYING
 CALSIUM ALGINATE
Polysaccharide fiber: seaweed
Hemostatic agents: calcium binder
ion pd coagulation
Absorbs moderate to large
exudate
Give it with exudate to begel
Sheet form, rope
Examples: Curasob, seasorb, calcostat,
calci care, cutimed alginate, sorbsan,
etc.
Application
 POLYUTHERANE FOAM
•Semipermeable, waterproof,
some are adhesive
- Form: sheets and roop to fill the
- cavity leave no residue
- Absorbent with more moderate-
- moderate exudative abilities - --
- very much (stage III / IV)
- Safe to use on wound infections-
Hypergranulation control
-Example: allyvin, suprasorb P, B-
itain comfell tielle / lite / plus, -
flexipore, spyrosorb, cuttinova
 APPLYING

FOAM ADHESIVE FOAM NON ADHESIVE

 SILVER
•Silver containing in combination with
silver metal ions.
When placed on the silver wound is
activated and becomes antimicrobial. It
can act in one of two ways over a period
of time: it gives ionic silver to the wound,
kills bacteria
absorbing this infected material can be
placed directly to the wound base. The
frequency of wound changes varies
between products.
Example: Aquacel Ag, Urgotul, cargitrol
askina, acticot
APPLYING
 COLLAGEN
•Not recommended for necrotic wounds.
Collagen Dressing sheets, pads, particles
and gel derived from type I bovine. This
dressing encourages the newly formed
collagen fibers and the granulation tissue
in the wound.
dressing collagen sheets Only used on
cuts of degree 1 and 2
The olagen dressing of the fish shapes is
used on any degree of wound.
 MAGGOT THERAPY
- sterile larvae for wound management
comes from greenbottle Lucilla
sericata.
- When initially applied to larval
wounds only 2-3mm long. On removal
of necrotic wounds their size can be
increased to 8-10mm in length.
- used on a variety of necrotic wounds
that require debridment. Infected,
foul-smelling wounds are also
indicated by the larvae of swallowing
and killing the bacteria that are in the
wound
MAGGOT
 NPWT
Vacuum is, the use of drainage is assisted to
absorb blood or serous fluid from the fluid
in the wound.Foam with open-cell structure
that temaptakan into the wound. The entire
area is then covered with a transparent
adhesive membrane, .When the drain tube
is connected to the vacuum source, the
liquid is drawn from the wound through the
foam into the reservoir for subsequent
disposal.preventing perforation of
obstruction in the canal by contact with the
base or wound edges, and removing local
infection with high pressure.
 DACC (Dialcylcarbamoxyl chloride)
•When microorganisms come into close
contact with DACC, they become irreversibly
bonded and help reduce microorganisms
helping to reduce the burden of bacteria at
the wound base using moist wound
environments and can reduce the burden of
microbes in
DACC-coated showed binding action of
common wound pathogens, including
Staphylococcus aureus, Pseudomonas
aeruginosa and Candida albicans and was
found to be most effective in moderate to
high-grade lesions
Ex, Cutimed
APPLYING
 PHMB
(polyhexamethylene biguanide )
Used in critical colonization injuries or
wounds showing signs of low, medium and
large number of infections.
An antimicrobial liquid
Necrosis:
Cell death is caused by a decrease in the
enzymatic process of the body
Devridement / debdidemang:
Remove necrosis tissue from the wound
surface
APPLYING
APPLYING
APPLYING
Honey is naturally antimicrobial and a preferred treatment application
because it does not possess the same toxicity as ionic silver. Additionally,
MEDIHONEY® has been used successfully along with other advanced wound care
modalities, including being used before, during, and after negative pressure
applications, as well as being used as cover dressings for skin grafts and skin
substitutes.

HONEY
MEDIHONEY® dressings, a unique line of dressings by Derma Sciences containing active Manuka
(Leptospermum scoparium) Honey from New Zealand, possess unique qualities that make them ideal
for the management of chronic and acute wounds and burns. A strong and growing evidence base –
including several large scale randomized controlled studies – have shown that MEDIHONEY® dressings
are effective on hard-to-heal wounds and burns, in addition to helping to debride wounds and keeping
wound beds clean of necrotic tissue.
Gauze has been used as a wound dressing for centuries, and continues to be the most readily
available wound dressing in use today. A wide variety of gauze dressings are available, with
choices to be made between sterile and non-sterile types, gauzes with and without an adhesive
border, and woven and non-woven gauze dressings. Woven gauzes are manufactured from
cotton yam or threads and woven like fabric. Non-woven gauzes are usually manufactured from
synthetic fibers, which are pressed together to give the appearance of a woven fabric. Gauze may
be used as a primary or secondary wound dressing.

GAUZE
Impregnated-gauze dressings may be used as a contact layer on granulating wounds. Despite the ongoing popularity
of gauzes, these dressings have a number of significant drawbacks. Woven gauze may traumatize the wound bed on
removal, or leave residue in the wound bed that may result in inflammatory response, or the formation of a
granuloma. Finally, as gauze is highly permeable and relatively non-occlusive, gauze dressings may promote
desiccation in wounds with minimal exudate unless used in combination with another dressing or topical agent.
ISLAND DRESSING

Gauze dressings continue to be the most readily available wound dressings in use today. Gauze is highly permeable
and relatively non-occlusive. Therefore, gauze dressings may promote desiccation in wounds with minimal exudate
unless used in combination with another dressing or topical agent. Gauze may be used as a primary or secondary
wound dressing. Gauze dressings are inexpensive for one-time or short-term use. Gauze dressings come in many
forms: squares, sheets, rolls, and packing strips.
TAPE - FIKSASI
 REFRENCY
1. Hampton BG, Bryant RA. Ostomies & Continent Diversions :
Nursing Management. 1st Ed. United State of America (St.
Louis). Mosby Year Book Inc. 1992. p 42-64.
2. WCET Journal
3. Primary intention international – Australian
4. Australia-Canada-Malaysia-Singapore-Indonesian journal of
Wound management
5. Ostomy/Wound Management Journal of extended patient
care management
6. WOCN,WUWHS,AWM Journal
7. Journal of stomal therapy Australian (JSTN)