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Wound Care Protocol
Presented by:
Dr. M. Paul
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Primary Care Provider – Wound Care Protocol
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Principles of wound bed
preparation
• Debridement
• Moisture balance
• Bacterial balance
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5 Tips for the Clinician• Assess patient and patient’s wound with each dressing change.
• Keep dressing as thin as possible in the plantar surface.
• If packing, wick it. Remember, “Fluff. Don’t stuff”.
• Temperature of affected limb is important. It may indicate infection, inflammation and/or
decreased vascular supply.
• Listen to the patient and/or his circle of care.
Adapted by Sibbald, Goodman, Woo et al. Special Considerations in Wound Bed Prep. 2011: An Update Advances in Skin & Wound Care Sept. 2011.
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Clinical Pathways
• Diabetic foot ulcer
• Surgical wounds
• Pressure ulcers
• Venous stasis ulcers
• Chronic maintenance wounds
• Infected surgical wounds
• Pilondial sinus / incision and drainage
• Trauma wound
• Atypical wounds
• Burns
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Superficial granulating wound
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Products
Minimum exudate Moderate to severe exudate
hydrogels
hydrocolloids
Hydrofibers
Calcium
alginates
foams
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Cavity wound
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Products
Minimum exudate Moderate to Severe
exudate
PHMB
Hydrofiber, calcium alginate
and foam
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Burns
• Nanocrystalline silver
• Hydrofiber with silver
• Flamazine
• Polysporin to face
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Chronic wounds
Inadine and
Iodosorb
Silver productsPHMB
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Infected wounds
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HOST
BACTERIA
STAGES OF INFECTION
Contaminated
Host in control
Colonized
Established bacterial
population, host control
bacterial balance
Critically Colonized
Established bacterial
population, wound not
progressing, bacterial
imbalance, no signs of infection
Infected
Bacteria in control
TREAT
WITH:
Topical
Antimicrobials
Systemic
Antibiotics
Adapted by P. Coutts from D. Keast and P. Bowler
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Products
• Antimicrobial dressings
– Silver
– Iodine
– PHMB
• Acetic acid
Hydrofera blue
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Intertrigo
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Venous stasis ulcers
Compression bandages
Dressings:
• calcium alginate with AG
• hydrofiber with silver
• PHMB
• Iodine dressing
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Necrotic wounds
• Autolytic debridement
• Autolytic debridement contraindicated
in ischemic wounds
• Inadine or Iodosorb
• Betadine solution painted on
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Use of NPWT and
Disposable Negative Pressure
VAC
PICO
QUANTUM
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Medical Professionals:
The first people you see after saying:
“Hold my beer and watch this”.