Download - Wound care for nurses
Wound dressings
• The material which is applied to the surface of the wound to cover it is called a dressing. – 1ry – dressing which touches the wound– 2ry – dressing used to cover the primary dressing
Ideal wound dressing Dressings are applied to wounds for the following reasons; • To provide a protective cover • To maintain moisture • To reduce pain • To absorb exudates
In addition an ideal dressing have the following features; • does not induce pain or itching • easy to change • Allows gaseous exchange • Cheap • Freely available
Types of Wound Dressings• Gauze dressings• Tulle • Hydrocolloid dressings• Hydrogel dressings• Alginate dressings• Foam dressings• Transparent film dressings• Etc.
Hydrocolloid Dressings
• Made up of pectin based material• Absorb exudate• Occlusive – should not be used on infected
wounds• Come in various shapes and sizes
Hydrogel Dressings
• Made up of primarily water in a polymer to maintain moist wound base
• used in dry wounds• Should not be used in exudating wounds
Alginate Dressings
• Made up of seaweed
• Absorb moderate amounts of drainage
• becomes a gel when it comes into contact with
wound fluid through Calcium/Sodium ion exchange
Foam Dressings
• Made up of polyurethane foam• Absorbs moderate to large amounts of fluid• Available in various sizes and shapes• Some types my macerate peri wound skin if it
allows drainage laterally
Silver Dressings
• Antimicrobial to reduce bio burden of wound through slow release of silver ion into the wound
• e.g. Acticoat, Biatin Ag, Atruman Ag
Vacuum assisted closure VAC• Macrostrain - visible stretch that occurs when negative pressure contracts
the foam.
– Draws wound edges together– Provides direct and complete wound bed contact– Evenly distributes negative pressure– Removes exudate and infectious materials
• Microstrain - micro deformation at the cellular level
– Reduces edema– Promotes granulation tissue formation by facilitating cell migration and
proliferation
Summary
Wound type Dressing
Dry Hydrocolloid, Hydrogel
Exudating wound Hydrocolloid, foam
Slough Hydrocolloid, hydrogels
Dead space / cavity Alginate, foam
When to change dressings
• When there is an indication to change– Soaking– Pain– Need to inspect
• Discuss with doctor before changing
Avoid
• Do not tie gauze bandage tightly around limbs, digits – causes ischaemia
• Use – plaster , crepe instead