wound products.ppt ppt
TRANSCRIPT
Dr. Clare Fenwick, 2010
Dr. Clare Fenwick, 2010
Aim of wound dressings Heal, prevent infection and manage exudate Protect wound and surrounding tissue Reduce pain and minimise client distress Maintain wound temperature Manage potential or actual haemorrhage Manage wound odour Immobilise an injury
Dr. Clare Fenwick, 2010
Product selection
Wound aetiology Wound location Wound exudate Product life span Cost factors Availability
Dr. Clare Fenwick, 2010
Wound Bed Preparation
Cleansing techniques Debridement
Sharp Surgical Mechanical Enzymatic Autolytic Biodebridement (maggots)
Clare Fenwick Griffith University Gold Coast 2010
Sharp Debridement
Clare Fenwick Griffith University Gold Coast 2010
Sharp Debridement
Clare Fenwick Griffith University Gold Coast 2010
Surgical debridement using waterjet hydrosurgery
Pre-operative
Intra-operative
Clare Fenwick Griffith University Gold Coast 2010
Mechanical debridement
Clare Fenwick Griffith University Gold Coast 2010
Enzymatic Debridement
Clare Fenwick Griffith University Gold Coast 2010
Autolytic Debridement
Clare Fenwick Griffith University Gold Coast 2010
Biodebridement
Dr. Clare Fenwick, 2010
Cleansing techniques
Clean versus sterile technique Normal saline and tap water are OK Hand washing is essential to reduce infection Dirty hand & clean hand Wound field concept
Dr. Clare Fenwick, 2010
Clean and dirty hand
Dressing Equipment
clean dirty
Dr. Clare Fenwick, 2010
Wound Field concept
Dressing Equipment
Dr. Clare Fenwick, 2010
Dressing & Exudate
None – Low Films Hydrogels
Low – Mod Hydrocolloid
Mod – Heavy Alginates Hydrofibre Foams
Dr. Clare Fenwick, 2010
Wound products Inert non stick dressings Film dressings Foam dressings Hydrogel dressings Hydrocolloid dressings Alginate dressings Hydrofibre dressings Zinc dressings Nanocrystalline Silver dressings Cadexomer Iodine Vacum assisted closure Manuka Honey
Clare Fenwick Griffith University Gold Coast 2010
Inert non stick dressings
Gauze Paraffin tulle dressings (Jelonet®,
Bactigras®) Non-paraffin, non-tulle, woven products,
(eg Adaptic®, Inadine®) Non stick dressings (eg Melolin®,
Cutilin®) Combine
Primary dressing Protective low absorption dressing
Application:Clean wound basePlace shiny side of dressing to wound. May require soaking if exudate strikethrough has occurred.
Contraindications/Possible Side effects: Harsh debridement of the wound bed if exudate driesLimited use as a primary dressingDries out the wound bed
Clare Fenwick Griffith University Gold Coast 2010
Film dressings
Product names include Opsite Flexigrid® Opsite Post-Op® Tegaderm® Polyskin®
Primary and secondary dressingLow exudating wounds, protective dressing.
Application:Clean wound base Prepare periwound area with a protective barrier wipe. Apply adhesive side to wound and remove outer layer. Adhesive strongest in first 24 hours, can remain for 7 days. Observe for maceration, remove if this occurs.
Contraindications/ Possible Side effects: Do not apply to infected wounds or if allergic to tapesIf not removed correctly can be traumatic to the wound bed . NB Green sided Opsite is for wounds, orange sided Opsite is for vascular access devices
Clare Fenwick Griffith University Gold Coast 2010
Film dressings
Product names include Opsite Flexigrid® Opsite Post-Op® Tegaderm® Polyskin®
Primary and secondary dressingLow exudating wounds, protective dressing.
Application:Clean wound base Prepare periwound area with a protective barrier wipe. Apply adhesive side to wound and remove outer layer. Adhesive strongest in first 24 hours, can remain for 7 days. Observe for maceration, remove if this occurs.
Contraindications/ Possible Side effects: Do not apply to infected wounds or if allergic to tapesIf not removed correctly can be traumatic to the wound bed . NB Green sided Opsite is for wounds, orange sided Opsite is for vascular access devices
Film Dressing
Clare Fenwick Griffith University Gold Coast 2010
Foam dressings
Product names available Allevyn® Allevyn Adhesive® Allevyn Cavity® Cavi-Care®
Primary and secondary dressingLight/mod/highly exudating wounds, protective dressing, cavity wounds
Application:Clean wound baseRead packaged for insertion side (patterned or shiny side up) Sheet foam left insitu up to 7 days (24 hours if infected)Cavity foams left insitu up to 14 days (daily washing of foam if infected)
Contraindications/ Possible Side effects: Avoid covering with occlusive dressings. Avoid wounds dressed with antibacterial solutions.
Clare Fenwick Griffith University Gold Coast 2010
Foam dressings
Product names available Allevyn® Allevyn Adhesive® Allevyn Cavity® Cavi-Care®
Primary and secondary dressingLight/mod/highly exudating wounds, protective dressing, cavity wounds
Application:Clean wound baseRead packaged for insertion side (patterned or shiny side up) Sheet foam left insitu up to 7 days (24 hours if infected)Cavity foams left insitu up to 14 days (daily washing of foam if infected)
Contraindications/ Possible Side effects: Avoid covering with occlusive dressings. Avoid wounds dressed with antibacterial solutions.
Foam Dressing
Clare Fenwick Griffith University Gold Coast 2010
Hydrogel dressings
Product names available Solugel® Intra site® Gel Solosite® Gel Clear-Site® Duoderm® Gel Aquaflo®
Primary dressingSloughy or necrotic wounds requiring chemical debridement. Lightly exudating wounds, hydrate dry wounds. .
Application:Clean wound base Coat wound base with at least 5 mm gel. Apply sheet directly to wound base. Can remain insitu up to 3 days Requires a secondary dressing
Contraindications/ Possible Side effects: Remove if patient complains of burning or discomfort. Can cause maceration if too much is applied. Don’t use on highly exudating wounds or blind sinuses
Clare Fenwick Griffith University Gold Coast 2010
Hydrogel dressings
Product names available Solugel® Intra site® Gel Solosite® Gel Clear-Site® Duoderm® Gel Aquaflo®
Primary dressingSloughy or necrotic wounds requiring chemical debridement. Lightly exudating wounds, hydrate dry wounds. .
Application:Clean wound base Coat wound base with at least 5 mm gel. Apply sheet directly to wound base. Can remain insitu up to 3 days Requires a secondary dressing
Contraindications/ Possible Side effects: Remove if patient complains of burning or discomfort. Can cause maceration if too much is applied. Don’t use on highly exudating wounds or blind sinuses
Hydrogel Dressing
Clare Fenwick Griffith University Gold Coast 2010
Hydrocolloid dressings
Product names available Duoderm Extra Thin® Duoderm CGF® Duoderm® Paste Comfeel Plus Transparent® Comfeel Plus® Contour Dressing Comfeel Plus® Pressure Relieving Dressing Comfeel® Paste Comfeel® Powder
Primary and secondary dressingSloughy wounds requiring autolytic debridement, low/moderateexudating wounds.
Application:Clean wound base, wipe periwound with barrier wipeWarm product in hands to activate adhesive Place adhesive side to wound. Leave at least 2 cm border around wound. Can be left insitu up to 7 days, dependant on exudate level. Dressing becomes opaque when due for change
Contraindications/ Possible Side effects: Do not apply to infected wounds or if client is allergic. Remove if patient complains of discomfort.
Clare Fenwick Griffith University Gold Coast 2010
Hydrocolloid dressings
Product names available Duoderm Extra Thin® Duoderm CGF® Duoderm® Paste Comfeel Plus Transparent® Comfeel Plus® Contour Dressing Comfeel Plus® Pressure Relieving Dressing Comfeel® Paste Comfeel® Powder
Primary and secondary dressingSloughy wounds requiring autolytic debridement, low/moderateexudating wounds.
Application:Clean wound base, wipe periwound with barrier wipeWarm product in hands to activate adhesive Place adhesive side to wound. Leave at least 2 cm border around wound. Can be left insitu up to 7 days, dependant on exudate level. Dressing becomes opaque when due for change
Contraindications/ Possible Side effects: Do not apply to infected wounds or if client is allergic. Remove if patient complains of discomfort.
Hydrocolloid Dressing
Clare Fenwick Griffith University Gold Coast 2010
Alginate dressings
Product names available Kaltostat® Algoderm® Sorbsan® Curasorb® Kaltocarb®
Primary dressingMedium to heavy exudating, bleeding, sloughy or infected wounds.
Application:Clean wound base Lightly pack or line the wound, product swells with exudate. Avoid pre-moistening the product. Discontinue use if the dressing remains dry. Can be left insitu up to 4 days, dependant on exudate level.Requires a secondary dressing, do not use an occlusive dressing
Contraindications/ Possible Side effects: Do not use on dry wounds as it dehydrates the wound bed
Clare Fenwick Griffith University Gold Coast 2010
Alginate dressings
Product names available Kaltostat® Algoderm® Sorbsan® Curasorb® Kaltocarb®
Primary dressingMedium to heavy exudating, bleeding, sloughy or infected wounds.
Application:Clean wound base Lightly pack or line the wound, product swells with exudate. Avoid pre-moistening the product. Discontinue use if the dressing remains dry. Can be left insitu up to 4 days, dependant on exudate level.Requires a secondary dressing, do not use an occlusive dressing
Contraindications/ Possible Side effects: Do not use on dry wounds as it dehydrates the wound bed
Calcium Alginate Dressing
Clare Fenwick Griffith University Gold Coast 2010
Hydrofibre dressings
Product names available Aquacel
Primary dressing:Medium to heavy exudating or infected wounds
Application:Clean wound base Line the wound base with product Cover with a secondary dressing. Can be left insitu up to 7 days, dependant on exudate level.
Contraindications/ Possible Side effects: Heavily infected wounds require Hydrofibre impregnated with Silver. Do not use in people allergic to hydrocolloids
Clare Fenwick Griffith University Gold Coast 2010
Hydrofibre dressings
Product names available Aquacel
Primary dressing:Medium to heavy exudating or infected wounds
Application:Clean wound base Line the wound base with product Cover with a secondary dressing. Can be left insitu up to 7 days, dependant on exudate level.
Contraindications/ Possible Side effects: Heavily infected wounds require Hydrofibre impregnated with Silver. Do not use in people allergic to hydrocolloids
Hydrofibre Dressing
Clare Fenwick Griffith University Gold Coast 2010
Nanocrystalline Silver dressings
Product names available Acticoat® Aquacel Ag® Actisorb plus® (charcoal)
Primary dressing:Infected wounds (150 pathogens including MRSA and VRE), burns, donor and recipient sites.
Application:Clean wound baseMoisten product with sterile water, daily if not enough exudateCut to wound size and shape, apply blue side downCover with a secondary dressing. Can be left insitu up to 7 days, dependant on exudate level.
Contraindications/ Possible Side effects: Do not use on people going for a Magnetic Resonance ImagingDo not use in people allergic to silver
Clare Fenwick Griffith University Gold Coast 2010
Nanocrystalline Silver dressings
Product names available Acticoat® Aquacel Ag® Actisorb plus® (charcoal)
Primary dressing:Infected wounds (150 pathogens including MRSA and VRE), burns, donor and recipient sites.
Application:Clean wound baseMoisten product with sterile water, daily if not enough exudateCut to wound size and shape, apply blue side downCover with a secondary dressing. Can be left insitu up to 7 days, dependant on exudate level.
Contraindications/ Possible Side effects: Do not use on people going for a Magnetic Resonance ImagingDo not use in people allergic to silver
Nanocrystalline Silver Dressings
Clare Fenwick Griffith University Gold Coast 2010
Zinc dressings
Product names available Steripaste® Viscopaste® Flexidress® Gelocast®
Primary dressingSloughy wounds, epithelialising wounds and to protect limbs at risk of skin tears or degloving.
Application:Cut length as required, usually 3-4 times the size of the wound Fold to make a patch and place over wound. Requires a secondary dressing.Can be left insitu up to 7 days.
Contraindications/Possible Side effects: Allergy to zinc
Clare Fenwick Griffith University Gold Coast 2010
Zinc dressings
Product names available Steripaste® Viscopaste® Flexidress® Gelocast®
Primary dressingSloughy wounds, epithelialising wounds and to protect limbs at risk of skin tears or degloving.
Application:Cut length as required, usually 3-4 times the size of the wound Fold to make a patch and place over wound. Requires a secondary dressing.Can be left insitu up to 7 days.
Contraindications/Possible Side effects: Allergy to zinc
Zinc Paste Dressings
Dr. Clare Fenwick, 2010
Other Dressings
Wound Honey Cadexomer Iodine Vacum assisted closure (VAC) (see
lecture)
Dr. Clare Fenwick, 2010
References
Carville, K. (2005). Wound Care Manual. Western Australia: Silver Chain Foundation.
Ellis, T. (2002). Wound bed preparation- a wound management imperative. Woundcare Network(10), 1-4.
Myers, B. A. (2008). Wound Management Principles and Practice (2nd ed). New Jersey: Prentice Hall.