Open Wound Management (OWM)

Flashcards covering key vocabulary related to Open Wound Management, including debridement types, bandage anatomy, dressing characteristics, moist wound healing, and alternative strategies like Manuka honey, sugar, LLLT, cold plasma, and negative pressure wound therapy.

Open Wound Management (OWM)

Treatment for highly contaminated wounds that cannot be primarily closed, involving covering the wound with an appropriate dressing and bandage to support the body’s natural healing process.

Second Intention Healing

When a wound heals by natural processes, avoiding reconstructive surgery, often managed to completion via open methods.

Debridement

The first step of OWM, involving the removal of contaminants (foreign material, bacteria) and damaged tissue from a wound.

Selective Debridement

Removal of only unhealthy tissue from a wound.

Nonselective Debridement

Removal of both healthy and unhealthy tissue from a wound.

Surgical Debridement

Tissue removal by a surgeon based on characteristics like color, texture, vascular supply, and temperature; selective on a macroscopic level.

Autolytic Debridement

Performed by WBC's during the first 3 to 5 days after wound occurrence, removing damaged cells and matrix with microscopic precision; considered most selective.

Mechanical Debridement

Physical removal of tissue adhered to a dried-on dressing, which is nonselective and considered the least desirable form of debridement.

Bandage Therapy Advantages

Maintains clean environment, prevents self-mutilation, reduces edema/hemorrhage/dead space, promotes acid environment, increases oxygen availability, immobilizes injured tissue, has an analgesic effect, promotes healing, minimizes scar tissue, and protects aesthetics.

Bandage Therapy Disadvantages

Can cause pressure sores, increases cost of care, complicates logistics, requires frequent changes, requires expertise, and poor application can have devastating consequences.

Primary (contact) Layer of a Bandage

The sterile layer that directly touches the wound surface, designed to protect, debride, absorb exudate, deliver topical medications, and promote healing.

Intermediate (secondary) Layer of a Bandage

A non-sterile layer typically made of loose-weave, absorbent materials, providing thickness based on exudate, occlusivity of the primary layer, and needed protection/support.

Outer (tertiary) Layer of a Bandage

A non-sterile layer that contacts the secondary layer, made of porous materials like surgical adhesive tape, elastic wrap, or stockinette, to provide support and protection without limiting absorption.

Adherent (wet-to-dry) Dressing

Used for mechanical debridement of necrotic tissue and debris and for absorption of wound exudates, typically short-term due to its nonselective nature and pain on removal.

Non-adherent Dressing

Traditionally used once granulation tissue forms, but current standards recommend hydrophilic nonadherent contact layers for all wounds to absorb exudate, create a moist environment, and reduce bandage changes.

Semi-occlusive Dressing

Allows air to penetrate and exudate to escape from the wound surface; most commonly used in veterinary medicine, less likely to macerate adjacent normal tissue.

Occlusive Dressing

Impermeable to air and fluid, used on less exudative wounds to keep tissue moist.

Wet-to-Dry Bandage Therapy

Commonly used early in wound management for protection, coverage, initial moist environment, mechanical debridement, and exudate absorption, but not indicated once granulation tissue develops due to nonselective debridement.

Tie-Over Bandage

A technique used to bandage anatomic sites that cannot accept a conventional bandage, such as proximal extremities, trunk, perineum, head, or dorsosacral region, using suture loops to secure the dressing.

Moist Wound Healing (MWH)

The process of creating an optimal wound environment using specialized primary layers called moisture retentive dressings (MRD) to enhance the body's inherent wound-healing abilities.

Moisture Retentive Dressings (MRD)

Usually non-adherent and occlusive dressings that protect and retain wound fluid, currently considered the standard of care for wound management.

Moisture Vapor Transmission Rate (MVTR)

A measure of how much water vapor can pass through a material, used to measure the occlusiveness of bandage material; low MVTR correlates with positive wound healing.

Transepidermal Water Loss (TEWL)

A measure of water movement through intact skin, which significantly increases in partial and full-thickness wounds.

Calcium Alginate

A type of Moisture Retentive Dressing (MRD) used in wound management, typically for highly exudative wounds.

Polyurethane Foam

A type of Moisture Retentive Dressing (MRD) used in wound management, known for its absorptive properties.

Hydrogel

A type of Moisture Retentive Dressing (MRD) that provides moisture to a dry wound and can aid in autolytic debridement.

Hydrocolloid

A type of Moisture Retentive Dressing (MRD) that forms a gel upon contact with wound exudate, creating a moist healing environment.

Manuka Honey

An alternative wound management strategy possessing antimicrobial/anti-fungal properties, high osmolarity, acid-promoting effects, and ability to accelerate sloughing of necrotic tissue and improve epithelialization.

Unique Manuka Factor (UMF)

A rating system that assesses the non-peroxide antimicrobial activity of Manuka honey, with ratings preferably >10+ for clinical use.

Sugar (Wound Management)

An inexpensive alternative wound management strategy with antimicrobial and osmolality effects that draw lymph, promote healing, interfere with bacterial signaling, and enhance superficial debridement.

Low-level Laser Therapy (LLLT)

An alternative wound management strategy that has been found to significantly decrease the time of wound healing.

Cold Plasma (Wound Management)

An alternative wound management strategy that is very effective at killing all organisms, useful for resistant infections and chronic wounds, with painless application.

Negative Pressure Wound Therapy (NPWT)

Also known as VAC (vacuum-assisted closure), involves applying a vacuum evenly across a wound surface, typically through a foam dressing, to remove exudate, decrease edema, promote blood supply, and stimulate cells for healing.

NPWT Goals

Remove wound exudate, decrease interstitial edema, draw wound edges together, promote blood supply, and stimulate cells involved with inflammatory and proliferative responses to injury.

NPWT Indications

Ideal for large open and effusive wounds devoid of granulation tissue, chronic non-healing wounds, extremity wounds, post-op management of flaps/grafts, and open abdominal management.

NPWT Contraindications

Poor peri-wound skin, necrotic/devitalized tissue, coagulopathy, exposed major blood vessels, open joint, neoplastic malignancy, unexplored draining tract, untreated osteomyelitis, small wounds, and lack of overnight care.