Wound care for nurses

May 15, 2016Download as PPTX, PDF22 likes21,637 views

An ideal wound dressing provides protection, maintains moisture, reduces pain, and absorbs exudate. It should not induce pain or itching, be easy to change, allow gaseous exchange, and be inexpensive and readily available. Common types include gauze, tulle, hydrocolloid, hydrogel, alginate, and foam dressings. Vacuum assisted closure (VAC) uses negative pressure to contract the wound and remove exudate, promoting healing through micro and macrostrain. The appropriate dressing depends on the wound characteristics, with dry wounds suited to hydrocolloid or hydrogel and exudating wounds to hydrocolloid or foam.

Wound Dressings
Dr. Joel Arudchelvam
Consultant Vascular and Transplant Surgeon

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.

Gauze
• Cheap
• Freely available
• Dry
• Painful on removing
• Damages epithelium

Tulle
• Cheap
• Freely available
• Easy removal
– E.g : Vaseline

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

Vacuum assisted closure VAC
• Indications for use
– Large wounds
– Cavities
– Large amount of exudate

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 in chronic wounds
• Iodine (Betadine)
• Hydrogen peroxide
• Other toxic agents

Avoid
• Do not tie gauze bandage
tightly around limbs, digits
– causes ischaemia
• Use – plaster , crepe
instead

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Wound care for nurses

1. Wound Dressings Dr. Joel Arudchelvam Consultant Vascular and Transplant Surgeon

2. 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

3. 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

4. Types of Wound Dressings • Gauze dressings • Tulle • Hydrocolloid dressings • Hydrogel dressings • Alginate dressings • Foam dressings • Transparent film dressings • Etc.

5. Gauze • Cheap • Freely available • Dry • Painful on removing • Damages epithelium

6. Tulle • Cheap • Freely available • Easy removal – E.g : Vaseline

7. Hydrocolloid Dressings

8. Hydrocolloid Dressings • Made up of pectin based material • Absorb exudate • Occlusive – should not be used on infected wounds • Come in various shapes and sizes

9. Hydrogel Dressings

10. 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

11. Alginate Dressings

12. 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

13. Foam Dressings

14. 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

15. 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

16. Vacuum assisted closure VAC

17. Vacuum assisted closure VAC

18. 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

19. Vacuum assisted closure VAC • Indications for use – Large wounds – Cavities – Large amount of exudate

20. Summary Wound type Dressing Dry Hydrocolloid, Hydrogel Exudating wound Hydrocolloid, foam Slough Hydrocolloid, hydrogels Dead space / cavity Alginate, foam

21. When to change dressings • When there is an indication to change – Soaking – Pain – Need to inspect • Discuss with doctor before changing

22. Avoid in chronic wounds • Iodine (Betadine) • Hydrogen peroxide • Other toxic agents

23. Avoid • Do not tie gauze bandage tightly around limbs, digits – causes ischaemia • Use – plaster , crepe instead

24. Thank You

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