advanced dressing

Powerpoint Templates

Advanced dressing

Thidanai Khameiad 5thyear medical student

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Powerpoint Templates

Wound dressing

Thorne C, Chung K, Gosain A, Gurtner G, Mehrara B, Rubin P, Spear S. Grabb and Smith’s plastic surgery. 7th edition. Philadelphia; 2014


Powerpoint Templates Page 4

Wound dressing Primary dressing is placed

directly on the wound and may provide absorption of fluids and prevent desiccation, infection, and adhesion of a secondary dressing.

Secondary dressing is one that is placed on the primary dressing for further protection, absorption, compression, and occlusion



ClassiicationWound care dressing divided into 7 class Film Composites Hydrogel Hydrocolloid

Alginates Foam Absorbtive dressing



Powerpoint Templates Page 6เก่งกาจ วนิัยโกศล. Advanced Wound Dressing. ภาควชิาศัลยศาสตร ์คณะแพทยศาสตร ์มหาวทิยาลัยขอนแก่น. Srinagarind Med J 2013; 28


Powerpoint Templates Page 7เก่งกาจ วนิัยโกศล. Advanced Wound Dressing. Srinagarind Med J 2013; 28



Dressing material: gauze Moderate

absorbtion Nonadhesive Light hydration Superficial wounds & light exuding wounds




Dressing material: Tulles

Low absorbtion Nonadhesive Shallow wounds & light exuding wounds



Dressing material: film

Nonabsorbing Fully adhesive Slow hydration Superficial wounds & light exuding wounds




Hydrogel sheets Low

absorption Nonadhesive or adhesive border Moderate hydration Superficial wounds & light exuding wounds, painful wounds




Amorphous hydrogel Low-moderate

absorption Nonadhesive Quick hydration Infected wound Superficial to deep wounds light to moderate exuding wounds




Hydrocolloids Low-moderate absorption Fully adhesive Moderate hydration Superficial wounds light to moderate exuding wounds Promote cell migration Wound debridement by autolytic




Foams High absorption Full to nonadhesive Not hydration Superficial to deep wounds Moderatly to heavily exuding wounds




Alginates High absorption Nonadhesive Not hydration Superficial or deep wounds Moderatly to heavily exuding wounds




Collagens Moderate to high absorption Nonadhesive Not hydration Superficial or deep wound light to moderatly exuding wounds




Silver-impregnated dressings

Colonization, infected wound Broad spectrum of bactericidal activity with low toxic to human Gauze, hydrocolloid, alginates, foams, creams and gels




Dermal collagen replacement Superficial and moderate-

depth partial thickness burns Increased speed of healing Decreased Pain Increase rate of epithelialization


Powerpoint Templates Page 19Nephew & Smith



Negative pressure wound therapy

Negosanti L, Pinto V, Sgarzani R. Clinical evidences personal experiences recent applications. World J Dermatol. 2012 October 2; 1(3): 13-23.




Kirby M. Negative pressure wound therapy. Br. J. Of Diabetes and Vascular Medicine. 2007;7(5):230-234.



Intermittent or continuous subatmospheric pressure to a wound at 50-175 mmHg Moist wound healing environment Removal of fluids and infectious materials Decreased bacterial colonization Enhanced formation of granulation tissue






Advantage DisadvantageReduction of edemaRapid cell divisionIncrease in local blood flowReduction in bacteria levels and Removal of harmful proteases

Time consumingExpensive

Labor intensiveNot always effective




Negative pressure wound therapyIndication Contraindication

Lymphatic leaks Venous stasis wounds Wounds with fistulae Sternal woundOrthopedics wounds Abdominal wounds Chronic open wounds (diabetic ulcers and stages 3 and 4 pressure ulcers) Acute and traumatic wounds

Necrotic tissue Malignant wound Ischemic wounds Active bleeding, exposed large vessel Infected wound



Powerpoint Templates Page 25Dini V, Miteva M, Romanelli P, Bertone M, Romanelli M. Evaluation of venous leg ulcers before and after negative pressure wound therapy. Wounds. 2011;23(9):257–266


Powerpoint Templates Page 26Tuncel U, Turan A, Bayraktar A, Aydin U, Erkorkmaz U.Clinical experience with the use of gauze-based negative pressure wound therapy. Wounds: 2012;24(8):227–233.



Chronic wounds Definition wounds that have failed to proceed through the orderly process that produces satisfactory anatomic and functional integrity.The majority of wounds that have not healed in 3 months are considered chronic.



Maintaining a moist wound environment eg.hydrocolloids. High absorption material Compression therapy


Venous stasis ulcers



Venous stasis ulcers

Compression dressing



Moist dressing


Arterial ulcers



Wound MaterialIntact skin Film, thin hydrocolloid,

offloading footwear

Minimal exudate Film, hydrocolloid, thin foam

Moderate exudate Hydrocolloid, foam, calcium alginate

Heavy exudate Foam, calcium alginate

Infection wound antimicrobial dressing

Arterial ulcers



Pressure ulcers



Pressure ulcersชนิดแผลกดทับ ลักษณะการทำาแผล ตัวอยา่งวสัดุ

Grade II ขึ้นไป ในแผลชื้นพอเหมาะรอบแผลแหง้ลอกออกง่าย

Occlusive dressingNon adhesive

แผลต้ืน, exudate น้อย ในแผลชื้นพอเหมาะรอบแผลแหง้ลอกออกง่าย

Film, hydrocolloid

exudate ปานกลาง-มาก วสัดท่ีุดดูซบั exudte ได้ดี Foam, alginate

แผลแหง้ ม ีeschar ต้องการความชื้นมากขึ้นเพ่ือใหเ้กิด autolytic

debridement

Hydrogel

แผลเป็นโพรงและหลมุลึก วสัดท่ีุเขา้ถึงก้นแผล Calcium alginate

แผลติดเชื้อ ยาฆา่เชื้อ Sustained silver releasing

Gauze impregnated with antimicrobial

agent พรพรหม เมอืงแมน, อภิรกัษ์ ชว่งสวุนิช, อภิชยั อังสพทัธ,์ จอมจกัร จนัทรสกลุ. Wound care 2014. พมิพค์รัง้ที่ 1. ชมรมแพทยอุ์บตัิเหตไุฟไหมน้้ำ้ารอ้นลวกแหง่ประเทศไทยรว่มกับชมรมสมานแผลแหง่ประเทศไทย. กรุงเทพมหานคร; 2014.



Diabetic woundsWound Material

Minimal exudate Hydrocolloid

Moderate exudate Hydrofiber

Heavy exudate Foam

Infection wound Gauze impregnated with antimicrobial agent

พรพรหม เมอืงแมน, อภิรกัษ์ ชว่งสวุนิช, อภิชยั อังสพทัธ,์ จอมจกัร จนัทรสกลุ. Wound care 2014. พมิพค์รัง้ที่ 1. ชมรมแพทยอุ์บตัิเหตไุฟไหมน้้ำ้ารอ้นลวกแหง่ประเทศไทยรว่มกับชมรมสมานแผลแหง่ประเทศไทย. กรุงเทพมหานคร; 2014.



Dermal living replacement

Dermagraft® is a sterile, cryopreserved, human fibroblast–derived dermal substitute generated by the culture of neonatal dermal fibroblasts onto a bioabsorbable polyglactin mesh scaffold.



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advanced dressing

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