KEY Dressings & Decision Making in Wound Care PT 632

What is a primary dressing?

the dressing that comes in direct contact with the wound (if it has an adhesive it does NOT need a secondary dressing)

What is a secondary dressing?

is placed over the primary dressing and can provided additional protection, absorption, occlusion, or secure the primary dressing (can be called "wound cover")

What is a semipermeable film?

thin, typically transparent film that is adhesive

What are indications for the use of semipermeable film?

- superficial wounds

- minimal to no exudate

- can be used as secondary dressing

What are characteristics of semipermeable film?

- NOT absorptive

- moderately occlusive (protects from contaminants but allows some gas exchange)

What is hydrogel?

- can be gel or sheet and is not adhesive

- needs secondary dressing

- are available in anti-microbial version with silver added

What are indications for the use of hydrogel?

to hydrate dry wounds and other wounds with minimal damage

What are characteristics of hydrogel?

- minimally absorptive

- sheets can be mod/highly occlusive

- moisture adding

What are indications for the use of hydrocolloid?

- wounds with minimal drainage

- wounds that need autolytic debridement and protection

CANNOT use with an infected wounds

What is a hydrocolloid patch?

- durable, flexible typically brown

- stays on for 2-3 days

- does not need a secondary dressing

What are characteristics of hydrocolloid patches?

- somewhat absorptive

- highly occlusive

- IMPERMEABLE to water

What are gauze?

made from thread/yarn and are widely available in different shapes + sizes, they are non-adhesive and cheap

Explain the use of impregnated gauze.

can be impregnated with petroleum or antimicrobials and used for SIGNS/HIGH RISK OF INFECTION!

used as a "contact layer" b/c is contacts the wound bed and prevent damage of granulation tissue from other dressings

What are indications for the use of gauze?

can be used wet or dry OR wet-to-dry for non-selective mechanical debridement

What are characteristics of gauze?

- mod absorption

- not occlusive

- increased risk of infection compared to other dressings

- needs frequent changes

What are alginates/hydrofibers?

- cotton-like quality (alginates)

- felt-like quality (hydrofibers)

- both hold moisture well and can add saline before to add moisture to wound bed

- needs secondary dressing (non-adhesive)

- available in antimicrobial version w/ added silver

What are the indications for the use of aliginates/hydrofiber?

- mod/heavy exudate

- common for VIUs and PUs

- used with infected wounds with increased drainage

What are characteristics of alginates/hydorfibers?

- highly absorptive

- minimally occlusive

- does NOT adhere to wounds

- may need higher frequency of dressign changes

What is semipermeable foam?

- is available in sheets and pads in differing thickness

- can also have silicone adhesive border and do not need secondary dressing

What are indications for the use of semipermeable foam?

- wounds with variable drainage (most useful for mod/heavy)

- can provide protection, cushioning, and thermal insulation

- can be used to for protection of high risk or stage I PUs

- can be used as a dressing for stage III-IV pressure injury

What are characteristics of semipermeable foam?

- very highly absorptive

- moderately occlusive

- protective from contaminants BUT allows for gas exchange

When are antimicrobial dressings used?

for wounds with an active infection and typically use silver or iodine

it is available in many different forms like being imbedded in other dressings (combination dressings), powder, ointments

Where is a skin protectant or moisture barrier used?

usually around the periwound on intact skin in the form of a liquid that dries on the skin like an ointment or cream