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wound dressing for chronic wound
1. Dressings for Chronic wounds
Dr. Joel Arudchelvam
Consultant Vascular and Transplant Surgeon
2. Dressings for Chronic wounds
• Definition of chronic wound / dressing
• Types of dressings
• Summary of use of various dressings
• When to change
• What not to do
3. Chronic ( non healing ) ulcer /
wound
• Wounds / ulcers not showing signs of healing
after 6 weeks.
4. Wound dressings
• The material which is applied to the surface of
the wound to cover
•
– 1ry – dressing which touches the wound
– 2ry – dressing used to cover the primary dressing
5. Ideal wound dressing
Dressings are applied to wounds for
• To provide a protective cover
• To maintain moisture
• To absorb exudates
In addition an ideal dressing
• Does not induce pain or itching
• Easy to change
• Allows gaseous exchange
• Cheap
• Freely available
6. Types of Wound Dressings
• Gauze
• Tulle
• Hydrocolloid
• Hydrogel
• Alginate
• Foam
• Transparent film
• Etc.
15. Vacuum Assisted Closure VAC
• Mechanisms of action
– Macro strain
– Micro strain
• Macrostrain - visible contraction which
occurs when negative pressure is
applied.
– Draws wound edges together
– Provides direct and complete wound
bed contact
– Removes exudate
16. Vacuum Assisted Closure VAC
• Microstrain - micro deformation
at the cellular level
– Reduces edema
– Promotes granulation tissue
formation by facilitating cell
migration and proliferation
17. • Indications for use
– Large wounds
– Cavities
– Large amount of exudate
Vacuum Assisted Closure VAC
18. Summary
Wound with slough , dead tissue –
needs wound toilet.
Wound type Dressing
Dry Hydrocolloid, Hydrogel
Exudating wound Hydrocolloid, foam
Dead space / cavity Alginate, foam, VAC
Gauze, tulle and gel Most wounds
19. When to change dressings
• When there is an indication to change
– Soaking / smelling
– Need to inspect – pain , swelling , fever, ect.
• Discuss with doctor before changing
20. Avoid in chronic wounds
• Iodine (Betadine)
• Hydrogen peroxide
• Other toxic agents
21. Avoid
• Do not tie gauze bandage tightly around
limbs, digits – causes ischaemia
• Use – plaster , crepe instead