Wound care dressing basics - Revision history

Elcatracho: /* Overview */

2022-01-04T09:27:33Z

Overview

← Older revision		Revision as of 09:27, 4 January 2022
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	==Overview==		==Overview==
	Selecting appropriate dressings for wound care can improve lives and save limbs. The choice of appropriate dressings can significantly ~~effect~~ the rate of healing, the strength of the repaired skin, and the cosmetic appearance of the scar. In general, moisture content of the wound is paramount and dressings are selected that are best suited to maintain a balance: moist enough to promote healing while removing excess exudate <ref> Atiyeh BS, Ioannovich J, Al-Amm CA, El-Musa KA. Management of acute and chronic open wounds: the importance of moist environment in optimal wound healing. Curr Pharm Biotechnol 2002; 3:179. </ref> Occluded wounds heal 40% faster than open wounds. <ref> Svensjö T, Pomahac B, Yao F, et al. Accelerated healing of full-thickness skin wounds in a wet environment. Plast Reconstr Surg 2000; 106:602. </ref>		Selecting appropriate dressings for wound care can improve lives and save limbs. The choice of appropriate dressings can significantly affect the rate of healing, the strength of the repaired skin, and the cosmetic appearance of the scar. In general, moisture content of the wound is paramount and dressings are selected that are best suited to maintain a balance: moist enough to promote healing while removing excess exudate <ref> Atiyeh BS, Ioannovich J, Al-Amm CA, El-Musa KA. Management of acute and chronic open wounds: the importance of moist environment in optimal wound healing. Curr Pharm Biotechnol 2002; 3:179. </ref> Occluded wounds heal 40% faster than open wounds. <ref> Svensjö T, Pomahac B, Yao F, et al. Accelerated healing of full-thickness skin wounds in a wet environment. Plast Reconstr Surg 2000; 106:602. </ref>

	==General Considerations==		==General Considerations==

Neil.m.young: Text replacement - "* " to "*"

2016-10-27T17:42:32Z

Text replacement - "* " to "*"

← Older revision		Revision as of 17:42, 27 October 2016
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	==General Considerations==		==General Considerations==
	The ideal wound dressing <ref> Paddle-Ledinek JE, Nasa Z, Cleland HJ. Effect of different wound dressings on cell viability and proliferation. Plast Reconstr Surg 2006; 117:110S. </ref>:		The ideal wound dressing <ref> Paddle-Ledinek JE, Nasa Z, Cleland HJ. Effect of different wound dressings on cell viability and proliferation. Plast Reconstr Surg 2006; 117:110S. </ref>:
	* has the ability to keep the wound bed moist while absorbing excess fluids		*has the ability to keep the wound bed moist while absorbing excess fluids
	* protects the wound from further damage		*protects the wound from further damage
	* addresses bacterial bioburden		*addresses bacterial bioburden
	* does not injure viable surrounding peri-wound tissue		*does not injure viable surrounding peri-wound tissue
	* achieves hemostasis		*achieves hemostasis
	* debrides necrotic tissue		*debrides necrotic tissue
	* is appropriate for wound size, depth, and location		*is appropriate for wound size, depth, and location
	* inexpensive with a long shelf life		*inexpensive with a long shelf life
	* doesn't cause the patient pain during changes		*doesn't cause the patient pain during changes

	==Dressing Types==		==Dressing Types==
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	==Wound Packing==		==Wound Packing==
	Although wet-to-wet and wet-to-moist packing has been the standard of care for many years, research indicates that gauze dressings are labor intensive and therefore not optimal. Many superior options are now available. <ref> Ovington LG. Hanging wet-to-dry dressings out to dry. Home Healthc Nurse 2001; 19:477. </ref>		Although wet-to-wet and wet-to-moist packing has been the standard of care for many years, research indicates that gauze dressings are labor intensive and therefore not optimal. Many superior options are now available. <ref> Ovington LG. Hanging wet-to-dry dressings out to dry. Home Healthc Nurse 2001; 19:477. </ref>
	* Wet-to-Wet Dressings		*Wet-to-Wet Dressings
	Indication: To keep a clean wound clean and prevent the build-up of exudates.		Indication: To keep a clean wound clean and prevent the build-up of exudates.
	Technique: Moisten a piece of gauze with saline and just barely squeeze out the excess fluid so it isn't soaking wet. Unravel the gauze, place it onto the wound, and cover with a dry dressing over the top. The dressing should not be allowed to dry or stick to the wound. Change 2-3 times per day. Moisten with saline if it gets too dry.		Technique: Moisten a piece of gauze with saline and just barely squeeze out the excess fluid so it isn't soaking wet. Unravel the gauze, place it onto the wound, and cover with a dry dressing over the top. The dressing should not be allowed to dry or stick to the wound. Change 2-3 times per day. Moisten with saline if it gets too dry.

	* Wet-to-Moist Dressings		*Wet-to-Moist Dressings
	Indication: To clean a dirty or infected wound.		Indication: To clean a dirty or infected wound.
	Technique: Moisten a piece of gauze with saline and squeeze out the excess fluid so it is damp, not dripping wet. Unravel the gauze, place it onto the wound, and cover with a dry dressing over the top. The dressing is allowed to dry out and when it is removed it pulls off the debris. Ideally, change 3-4 times per day. Change more often on a wound that is in need of more debridement, less often on a cleaner wound. Switch to the wet-to-wet dressing when the wound is clean.		Technique: Moisten a piece of gauze with saline and squeeze out the excess fluid so it is damp, not dripping wet. Unravel the gauze, place it onto the wound, and cover with a dry dressing over the top. The dressing is allowed to dry out and when it is removed it pulls off the debris. Ideally, change 3-4 times per day. Change more often on a wound that is in need of more debridement, less often on a cleaner wound. Switch to the wet-to-wet dressing when the wound is clean.

Ghendel: /* Dressing Types */

2016-09-01T04:42:00Z

Dressing Types

← Older revision		Revision as of 04:42, 1 September 2016
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	\| Silver-Imgregnated \|\| Antimicrobial action \|\| Use with critically colonized wounds \|\| Can discolor skin, some people are sensitive to it		\| Silver-Imgregnated \|\| Antimicrobial action \|\| Use with critically colonized wounds \|\| Can discolor skin, some people are sensitive to it
	\|-		\|-
	\| Silicone \|\| Low adherence, protects neighboring viable skin, conforms to wound \|\| ~~use~~ a contact layer \|\| Dries out easily		\| Silicone \|\| Low adherence, protects neighboring viable skin, conforms to wound \|\| Use as a contact layer \|\| Dries out easily
	\|-		\|-
	\| Collagen Matrix \|\| Biologic dressing, accelerates rate of complete wound healing \|\| Non-healing Stage 3 and 4 pressure ulcers, when traditional dressings have failed \|\| Expensive		\| Collagen Matrix \|\| Biologic dressing, accelerates rate of complete wound healing \|\| Non-healing Stage 3 and 4 pressure ulcers, when traditional dressings have failed \|\| Expensive

Ghendel: /* Overview */

2016-09-01T04:40:33Z

Overview

← Older revision		Revision as of 04:40, 1 September 2016
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	==Overview==		==Overview==
	Selecting appropriate dressings for wound care can improve lives and save limbs. The choice of appropriate dressings can significantly effect the rate of healing, the strength of the repaired skin, and the cosmetic appearance of the scar. In general, moisture content of the wound is paramount and dressings are selected that are best suited to maintain a balance: moist enough to promote healing while removing excess exudate <ref> Atiyeh BS, Ioannovich J, Al-Amm CA, El-Musa KA. Management of acute and chronic open wounds: the importance of moist environment in optimal wound healing. Curr Pharm Biotechnol 2002; 3:179. </ref> Occluded wounds heal 40% faster than open wounds <ref> Svensjö T, Pomahac B, Yao F, et al. Accelerated healing of full-thickness skin wounds in a wet environment. Plast Reconstr Surg 2000; 106:602. </ref>		Selecting appropriate dressings for wound care can improve lives and save limbs. The choice of appropriate dressings can significantly effect the rate of healing, the strength of the repaired skin, and the cosmetic appearance of the scar. In general, moisture content of the wound is paramount and dressings are selected that are best suited to maintain a balance: moist enough to promote healing while removing excess exudate <ref> Atiyeh BS, Ioannovich J, Al-Amm CA, El-Musa KA. Management of acute and chronic open wounds: the importance of moist environment in optimal wound healing. Curr Pharm Biotechnol 2002; 3:179. </ref> Occluded wounds heal 40% faster than open wounds. <ref> Svensjö T, Pomahac B, Yao F, et al. Accelerated healing of full-thickness skin wounds in a wet environment. Plast Reconstr Surg 2000; 106:602. </ref>

	==General Considerations==		==General Considerations==

Ghendel: /* Wound Packing */

2016-09-01T04:11:09Z

Wound Packing

← Older revision		Revision as of 04:11, 1 September 2016
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	==Wound Packing==		==Wound Packing==
	Although wet-to-wet and wet-to-~~dry dressings have~~ been the standard of care for many years, research indicates that gauze dressings are labor intensive and therefore not optimal. Many superior options are now available. <ref> Ovington LG. Hanging wet-to-dry dressings out to dry. Home Healthc Nurse 2001; 19:477. </ref>		Although wet-to-wet and wet-to-moist packing has been the standard of care for many years, research indicates that gauze dressings are labor intensive and therefore not optimal. Many superior options are now available. <ref> Ovington LG. Hanging wet-to-dry dressings out to dry. Home Healthc Nurse 2001; 19:477. </ref>
	* Wet-to-Wet Dressings		* Wet-to-Wet Dressings
	Indication: To keep a clean wound clean and prevent the build-up of exudates.		Indication: To keep a clean wound clean and prevent the build-up of exudates.
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	Indication: To clean a dirty or infected wound.		Indication: To clean a dirty or infected wound.
	Technique: Moisten a piece of gauze with saline and squeeze out the excess fluid so it is damp, not dripping wet. Unravel the gauze, place it onto the wound, and cover with a dry dressing over the top. The dressing is allowed to dry out and when it is removed it pulls off the debris. Ideally, change 3-4 times per day. Change more often on a wound that is in need of more debridement, less often on a cleaner wound. Switch to the wet-to-wet dressing when the wound is clean.		Technique: Moisten a piece of gauze with saline and squeeze out the excess fluid so it is damp, not dripping wet. Unravel the gauze, place it onto the wound, and cover with a dry dressing over the top. The dressing is allowed to dry out and when it is removed it pulls off the debris. Ideally, change 3-4 times per day. Change more often on a wound that is in need of more debridement, less often on a cleaner wound. Switch to the wet-to-wet dressing when the wound is clean.
	Note: The wet-to-~~dry~~ dressing is not a substitute for mechanical/sharp debridement.		Note: The wet-to-moist dressing is not a substitute for mechanical/sharp debridement.

	==See Also==		==See Also==

Ghendel: /* Dressing Types */

2016-09-01T04:10:15Z

Dressing Types

← Older revision		Revision as of 04:10, 1 September 2016
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	\| Hydrocolloid \|\| Traps exudate and moisture, washes away during dressing changes and produces a painless mechanical debridement \|\| Epithelialization stage, clean, low exudative wound \|\| Do not use on necrotic wounds, highly exudative, may macerate viable skin.		\| Hydrocolloid \|\| Traps exudate and moisture, washes away during dressing changes and produces a painless mechanical debridement \|\| Epithelialization stage, clean, low exudative wound \|\| Do not use on necrotic wounds, highly exudative, may macerate viable skin.
	\|-		\|-
	\| Hydrogel \|\| ~~rehydrates~~ wounds, feels cooling \|\| Debridement stage, dry wounds, wounds with low exudate. \|\| Do not use on necrotic wounds, highly exudative, may macerate viable skin.		\| Hydrogel \|\| Rehydrates wounds, feels cooling to the patient \|\| Debridement stage, dry wounds, wounds with low exudate. \|\| Do not use on necrotic wounds, highly exudative, may macerate viable skin.
	\|-		\|-
	\| Alginate \|\| Absorbs fluids, conforms to wound bed, comes in a rope or ribbon for packing \|\| Highly exudative wounds and cavities \|\| Caution with friable tissue		\| Alginate \|\| Absorbs fluids, conforms to wound bed, comes in a rope or ribbon for packing \|\| Highly exudative wounds and cavities \|\| Caution with friable tissue

Ghendel: /* References */

2016-09-01T04:09:35Z

References

← Older revision		Revision as of 04:09, 1 September 2016
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	==References==		==References==
	<references/>		<references/>
	~~# Svensjö T, Pomahac B, Yao F, et al. Accelerated healing of full-thickness skin wounds in a wet environment. Plast Reconstr Surg 2000; 106:602.~~
	~~# Paddle-Ledinek JE, Nasa Z, Cleland HJ. Effect of different wound dressings on cell viability and proliferation. Plast Reconstr Surg 2006; 117:110S.~~
	~~# Ovington LG. Hanging wet-to-dry dressings out to dry. Home Healthc Nurse 2001; 19:477.~~
	~~# Atiyeh BS, Ioannovich J, Al-Amm CA, El-Musa KA. Management of acute and chronic open wounds: the importance of moist environment in optimal wound healing. Curr Pharm Biotechnol 2002; 3:179.~~

	[[Category:Procedures]]		[[Category:Procedures]]

Ghendel: /* Overview */

2016-09-01T04:09:11Z

Overview

← Older revision		Revision as of 04:09, 1 September 2016
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	==Overview==		==Overview==
	Selecting appropriate dressings for wound care can improve lives and save limbs. The choice of appropriate dressings can significantly effect the rate of healing, the strength of the repaired skin, and the cosmetic appearance of the scar. In general, moisture content of the wound is paramount and dressings are selected that are best suited to maintain a balance: moist enough to promote healing while removing excess exudate. Occluded wounds heal 40% faster than open wounds <ref> Svensjö T, Pomahac B, Yao F, et al. Accelerated healing of full-thickness skin wounds in a wet environment. Plast Reconstr Surg 2000; 106:602. </ref>		Selecting appropriate dressings for wound care can improve lives and save limbs. The choice of appropriate dressings can significantly effect the rate of healing, the strength of the repaired skin, and the cosmetic appearance of the scar. In general, moisture content of the wound is paramount and dressings are selected that are best suited to maintain a balance: moist enough to promote healing while removing excess exudate <ref> Atiyeh BS, Ioannovich J, Al-Amm CA, El-Musa KA. Management of acute and chronic open wounds: the importance of moist environment in optimal wound healing. Curr Pharm Biotechnol 2002; 3:179. </ref> Occluded wounds heal 40% faster than open wounds <ref> Svensjö T, Pomahac B, Yao F, et al. Accelerated healing of full-thickness skin wounds in a wet environment. Plast Reconstr Surg 2000; 106:602. </ref>

	==General Considerations==		==General Considerations==

Ghendel: /* General Considerations */

2016-09-01T04:08:01Z

General Considerations

← Older revision		Revision as of 04:08, 1 September 2016
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	==General Considerations==		==General Considerations==
	The ideal wound dressing:		The ideal wound dressing <ref> Paddle-Ledinek JE, Nasa Z, Cleland HJ. Effect of different wound dressings on cell viability and proliferation. Plast Reconstr Surg 2006; 117:110S. </ref>:
	* has the ability to keep the wound bed moist while absorbing excess fluids		* has the ability to keep the wound bed moist while absorbing excess fluids
	* protects the wound from further damage		* protects the wound from further damage

Ghendel: /* Wound Packing */

2016-09-01T04:06:55Z

Wound Packing

← Older revision		Revision as of 04:06, 1 September 2016
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	==Wound Packing==		==Wound Packing==
	Although wet-to-wet and wet-to-dry dressings have been the standard of care for many years, research indicates that gauze dressings are labor intensive and therefore not optimal. Many superior options are now available.		Although wet-to-wet and wet-to-dry dressings have been the standard of care for many years, research indicates that gauze dressings are labor intensive and therefore not optimal. Many superior options are now available. <ref> Ovington LG. Hanging wet-to-dry dressings out to dry. Home Healthc Nurse 2001; 19:477. </ref>
	* Wet-to-Wet Dressings		* Wet-to-Wet Dressings
	Indication: To keep a clean wound clean and prevent the build-up of exudates.		Indication: To keep a clean wound clean and prevent the build-up of exudates.